Martha, you are correct, there are long delays in emergency rooms and the causes are many: closing of emergency rooms, lack of access to certain specialists for emergency services who don't want the life-style disruption and the mal-practice risk, and lack of access to other providers after hours. This last factor results in a very expensive and inefficient use of time and resources. Also, emergency rooms get backed up with patients waiting to be admitted. The hosital may have beds, but not enough nurses to provide care, so the patient waits for a bed. The nursing shortage is especially aggravated by a lack of teachers to train nurses. Because the problem stems from many sources, there is no easy fix.
As to the Medicaid system being free -- Medicaid is only available to the very poor, and only for certain categories of very poor individuals. Even as a LBYMer type, I don't want to try to live on the incomes that these families do. Medicaid eligiblilty for a family in Florida is 24% of the federal poverty level. That's an annual income of $4,120 for a family of three. Kids can get coverage at higher incomes, but not parents. And if you are just poor and don't have kids - not covered.
OTOH, Medicaid is a very rich benefit package compared to what the rest of us get, but then Medicaid recipients tend to be sicker than the general population, and they can't afford any out of pocket expenses for uncovered services. Because they are sicker, they are expensive to serve. One way states control this cost is by limiting provider reimbursements, resulting in reduced access and delays in care. Nevertheless, the program is expensive to states and the federal goverment, so it is not "free." We all pay.
I have no fixes, but tackling the Medicaid population is part of the uninsured problem, since Medicaid beneficiaries go on and off regularly, and as a result have intermittent time with no coverage and no access, which makes their conditions worse and more costly.
Thanks for listening. Having one of those days in the health care policy world.