While the Affordable Care Act should drastically reduce the number of uninsured Americans, people without access to proper medical care is still a real problem. Even with insurance, high co-pays drive gravely ill people away from getting help. Although it’s posted in every ER, many people don’t know that everyone in America has the right to emergency healthcare.
Congress passed The Emergency Medical Treatment and Active Labor Act (EMTALA) in 1986, which requires hospitals to care for anyone in need of emergency treatment. It doesn’t matter if the patient isn’t a citizen, they’re uninsured, or can’t pay.
Patients must be stabilized or transferred to a hospital better suited to treat their condition before the hospital can discharge them. Many patients are afraid this means that this hospital can keep them longer than they feel necessary, but that is not the case. EMTALA allows for patients to discharge themselves under most circumstances, under informed consent.
Another myth about EMTALA is that it means the emergency room can’t turn you away. The only time a hospital can refuse a patient medical care is if they come with a non-emergency. Most hospitals will provide treatment for medical problems that don’t appear to be an emergency, either because of liability in the case of the illness being more severe than it appears, or because they realize that the emergency room is the only viable choice for uninsured and poor patients.
While EMTALA requires hospitals to provide care even with outstanding medical bills, these bills still need to be paid or they may go to collections. Many patients qualify for financial assistance, but the process can be frustrating and lengthy.
If the financial guarantor is worried about the cost of medical bills, there are a variety of sites that perform free online triage. While these sites are simply for educational purposes and cannot be used as a substitute for actual physician care, they can help patients recognize when home care is a more suitable treatment than going to the ER or when retail clinics and online consultations would suffice.
Some conditions that patients may not realize qualify as an emergency are opioid withdrawal and many fevers, specifically if there is a possible abscess and high white count. Labor, as one might guess from the name of the act, is also always considered an emergency, no matter the circumstances.
In order to determine the severity of a patient’s symptoms, hospitals have several requirements under EMTALA. Anyone who requests emergency care (or the representative of the patient), must be allowed a screening examination to determine whether or not an emergency exists. This is commonly referred to as triage, and is often conducted by a nurse. The hospital may not pursue payment until it is clear that doing so will not interfere with patient care.
As stated before, a hospital cannot discharge a patient and must give them adequate treatment until they are stabilized and can manage self-care. Inpatient care must be equal for all patients, regardless of legal status or ability to pay. The only reason a hospital can release a patient before stabilization is if they do not have the ability to properly treat the condition. In this case, the patient must be provided with an “appropriate” transfer to a facility than can care for them. Hospitals that provide the specialty care cannot turn down the transfer.
The most important thing that Americans need to take from EMTALA is that no matter what, they have the right to emergency medical care. The emergency room is not a substitute for proper care under a general physician, but it’s always there.