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Publication Information

14 Journal of Law and Policy 695 (2006)


Part I of this article briefly discusses the Emergency Medical Treatment and Active Labor Act's salient provisions. Part II examines the history of emergency care and changes in healthcare organization and finance affecting the provision of charity care-topics which are significant in unraveling the alleged effects EMTALA has had on the healthcare system. Part III examines policy issues raised by EMTALA within our present system of health insurance and healthcare organization and finance.

This article reaches two conclusions. First, EMTALA, while a poor and archaic fit with our present system of healthcare delivery and finance, in fact has helped to preserve our largely private, voluntary system of healthcare. Second, EMTALA is not likely a major culprit in the financial woes of private hospitals and in ED overcrowding and closures. Rather, greater pressures on the healthcare system, pressures that EMTALA itself was meant in part to address, are to blame. To solve these problems, U.S. policy regarding the nature and provision of healthcare itself must be reformed. While there are a number of minor measures concerning issues of finance and capacity that could be implemented to improve access to emergency care without requiring significant changes, a real solution may require greater public financing and control of health insurance, and the creation of incentives to expand emergency capacity in at least some settings.