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Invited Commentary
April 1, 2019

EMTALA—A Noble Policy That Needs Improvement

Author Affiliations
  • 1NYC Health and Hospitals, New York, New York
JAMA Intern Med. 2019;179(5):693-694. doi:10.1001/jamainternmed.2019.0026

The US Congress enacted the Emergency Medical Treatment and Active Labor Act (EMTALA) in 1986, which requires all US hospitals that accept Medicare to provide emergency department (ED) care to all patients regardless of their ability to pay.1 It is nobly intended and has ensured emergency care at for-profit, nonprofit, and public hospitals. The EMTALA requires that if a hospital has the capability, it must stabilize the patient prior to transfer to another facility, unless the patient requests an immediate transfer.2 There is no doubt that EMTALA has led to substantial improvement in disparities in access to emergency care. However, the flaws that have appeared over the past 3 decades highlight the need for additional improvements to ensure the goal of access to health care for all.

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