ACA Improves EMTALA Health Care Access Mandate Somewhat
ACA addresses hidden costs, but does not go far enough in designing integrated system of care
THURSDAY, Feb. 21 (HealthDay News) -- Although the 2010 Patient Protection and Affordable Care Act (ACA) goes some way to ensuring wider health care access, the system is still incomplete, according to a viewpoint published in the Feb. 20 issue of the Journal of the American Medical Association.
Katherine Diaz Vickery, M.D., from the University of Michigan in Ann Arbor, and colleagues discuss the shortfalls of the Emergency Medical Treatment and Active Labor Act (EMTALA), signed into law by President Ronald Reagan in 1986 and allowing every individual to receive initial evaluation and basic lifesaving treatment in an emergency room, and its relevance to the ACA.
According to the authors, with the focus on stabilization of emergency condition, EMTALA was an incomplete remedy for the problem of health care access. The ACA continues the mandate, extending access to care in preventive, primary, and secondary health care settings, with changes to address hidden costs. However, the ACA goes only some way to providing an integrated system. The ACA limits provision of health insurance to legal immigrants and U.S. citizens, leaving a large proportion of the population without insurance who will likely seek uncompensated health care. In addition, for those who qualify for insurance, the ACA does not clarify how to provide incentives to seek appropriate care. There is no specified plan to integrate primary care and emergency department safety-net systems.
"Ultimately, the ability of the U.S. health care system to satisfy the ethical obligation to ensure access to care -- first codified in EMTALA -- will be a core measuring stick for the success of the ACA and for any future reforms," the authors write.