Monday, August 17, 2009

Healthcare and undocumented immigrants: What about EMTALA?

Photo used under Creative Commons from brykmantra.

As we have stated before, undocumented immigrants are not eligible for federal welfare benefits like Medicaid. Ah ha! Some may say, what about EMTALA? EMTALA is the Emergency Medical Treatment and Active Labor Act of 1986. According to the United States Department of Health and Human Services:

In 1986, Congress enacted [and President Ronald Reagan signed] the Emergency Medical Treatment & Labor Act (EMTALA) to ensure public access to emergency services regardless of ability to pay. Section 1867 of the Social Security Act imposes specific obligations on Medicare-participating hospitals that offer emergency services to provide a medical screening examination (MSE) when a request is made for examination or treatment for an emergency medical condition (EMC), including active labor, regardless of an individual's ability to pay. Hospitals are then required to provide stabilizing treatment for patients with EMCs. If a hospital is unable to stabilize a patient within its capability, or if the patient requests, an appropriate transfer should be implemented.

EMTALA also does not allow a hospital to refuse otherwise eligible emergency treatment because of someone's citizenship or immigration status. EMTALA was passed without funding, however, and states complained that it was an "unfunded govermental mandate." As a result, Congress passed the Medicare Modernization Act of 2003 (MMA). The MMA does provide $250 million dollars per year to reimburse hospitals for their unrecoverable costs for emergency care to undocumented immigrants under EMTALA.

It is important to remember that EMTALA was designed to prevent "patient dumping" from private hospitals to public ones. It was not designed as immigration legislation. It was a public policy decision that Congress and President Reagan made. They did not want any patients- U.S. citizens or otherwise-to be refused emergency medical care because of an inability to pay. EMTALA does not provide health insurance for illegal immigrants. EMTALA was enacted to keep patients from dying because of they had no insurance or money to pay for treatment.

So if both Joe Illegal and Joe Citizen are in a car wreck and need emergency care, the hospital is not going to let them die in the waiting room while they verify their immigration status and credit rating. It is correct to say that there are costs associated with EMTALA but according to the Kaiser Family Foundation, all immigrants, including the undocumented, were less likely to visit the emergency room of a hospital than their citizen counterparts.

So once again, please remember that illegal immigrants are not eligible for federal welfare benefits. All people in the United States, regardless of immigration status, are covered under EMTALA.


  1. Thank you for saying this so clearly. The news, even MSNBC, have not explained that, by law, hospitals have been providing medical care for illegal aliens since 1986. And that this comes out of the Ronald Reagan Administration and Congress with EMTALA. This has nothing to do with current healthcare reform.
    Are the Republicans willing to say they want people to die in the street?
    The fact that Ronald Reagan didn't want that to happen could soften some hearts and change some minds. That is an important message.

  2. health care, access to a doctor for a medicine all have that right, is a human right given by law, we should not get to peel for a drug to a person they too have their rights

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