The Public Policy Institute of California conducted the study. Associate researcher Shannon McConville says she was surprised by how often Medi-Cal patients went to the ER. 

“They have the highest usage rate of any insurance group and they had higher avoidable visits, particularly among children.” 

In fact, McConville says Medi-Cal patients were more likely to go to the emergency room than people without insurance.

Dr. Kelly Nations is Sacramento’s Sutter Medical Center emergency department medical director. He says these low-income patients go to the ER as a last resort. 
 
“They frequently tell us that they’ve made an effort. That, ‘I don’t want to be here. I’ve tried to go to my primary doctor, I can’t get an appointment until two weeks from now and I’m just having too much trouble to wait that long.’” 

Nations says more and more primary care doctors will not accept Medi-Cal patients because of low reimbursement rates. This year lawmakers cut doctors’ payment rates by 10 percent. 

The study found Medi-Cal patients made up about a quarter of emergency room visits in 2005. That’s almost 10 percent more than the uninsured. ER’s in Los Angeles and the Central Valley had the most crowded conditions according to the report. The PPIC study concludes having more late-night urgent care centers and doctors available during the weekend could help take the stress of emergency rooms