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Many hospital emergency rooms across the nation are reporting an increase in patients. It wasn’t supposed to be that way under Obamacare.

Health care reform was supposed to reduce unnecessary and costly ER visits. But right away there were dire predictions of the opposite. An Oregon study, done after that state began expanding its Medicaid program in 2008, predicted an increase in ER visits of up to 40 percent.

A just-released nationwide survey of about 1,800 emergency room doctors found that almost half reported increases in ER patients since the first of the year. Nine percent reported the volume of emergency patients increased “greatly” while 37 percent said visits increased “slightly.” The same survey reported that 31 percent of ER doctors found an increase in Medicaid emergency room patients.

The poll was done by the American College of Emergency Physicians (ACEP). Their top spokesman is Dr. Stephen Anderson, who works at MultiCare Auburn. He said Washington has done much better than most states in managing ER traffic. And it started well before implementation of the Affordable Care Act, with an initiative of best practices.

“And with that, we actually, in the year before the institution (of the Affordable Care Act), dropped our usage about 10 percent by putting in some programs that did not block access to care, but coordinated the care of the highest need patients,” said Anderson.

Since Obamacare began, ER visits in Washington are higher by about three people across the state.

“Which is much lower than the rest of the nation but it’s still an increase and if I left you with any sentence, I’d leave you with a quote that ‘access to insurance does not equal access to care,'” Anderson said.

Here’s why: Washington enrolled about 400,000 new Medicaid clients through the state’s new health care exchange. Anderson explains that patients getting health care for the first time often can’t or don’t get a primary care doctor right away.

“And so now, if you can’t get primary care, you go back to the doc that you always had before and that’s why people go to the emergency department,” he said.

Anderson said that’s why patient education is part of Washington campaign to control ER visits, called “E.R. is for Emergencies.” He was speaking from Washington, D.C. where he addressed a gathering of the leaders of the ACEP “on exactly what we did to coordinate care and be ready for this,” said Anderson. “We are clearly the model for America right now.”

But he said controlling unnecessary ER visits can’t happen until the medical community solves one key problem.

“There are not enough primary care physicians anywhere in the country to handle the increase we’re seeing (in emergency room visits) with the Affordable Care Act,” said Anderson.