by Cristin Severance and Kelsey Mittauer | CBS11
DALLAS (CBS11) – A U.S. Representative is weighing in on the idea of charging a co-pay to Medicaid patients who go to North Texas hospital emergency rooms for non-emergency reasons.
Rep. Michael Burgess is also a doctor. The Republican Congressman says part of the issue can be traced back to the implementation of Obamacare. “When the Affordable Care Act passed, there was concern that it would drive overutilization of emergency rooms… and it turns out that was the case.”
Last week’s Consumer Justice investigation found millions of taxpayer dollars being spent to treat acne, constipation, bunions and other health issues deemed “non-emergency” in nature by the Texas Health and Human Services Commission.
“Talk to any emergency room doctor and they will tell you a better part of their day is spent tending to things that could be very easily taken care of at a doctor’s office or an urgent care center where the overhead is much, much lower,” said Rep. Burgess.
Right now Medicaid patients are treated for free at hospital emergency rooms. Experts say that means there is no incentive for them to avoid the ER, but a co-pay could make them think twice.
The State of Texas could submit a waiver to the federal government to charge some Medicaid patients a co-pay for emergency room treatment in the event their medical situation is deemed non-emergency. “The dollar amount is fairly small, I think it’s $8 by statute,” said Burgess. “But there are populations that cannot be charged a co-pay. Pregnant women, for example, children, for example.”
Submitting a waiver would not require legislative action, but State Sen. Kelly Hancock says he’s interested in studying the issue before the next session. Hancock says he’s putting together a “working group” to look into the effects any type of co-pay would have on Medicaid patients.
Rep. Burgess says it’s especially important right now to not misuse the emergency room, with so many ERs overwhelmed with flu cases. Still, critics say the emergency room may be the only choice for some, since fewer doctors are accepting Medicaid patients.
Even so, Rep. Burgess says everyone should have a primary care doctor. “It’s continuity of care — someone who’s going to pay attention as to whether or not you’ve had your flu shot for example, or whether or not you’ve had screening tests that you should have at various points of your life.”