Who pays when someone without health insurance goes to the ER?

Posted

I read an interesting article from a recent USA Today piece discussing this subject matter. Did you know that a 1985 federal law requires that an ER must treat anyone entering its doors, regardless of the patient’s ability to pay? Yep, that is correct. The Emergency Medical Treatment and Active Labor Act (EMTALA) states that patients will be taken care no matter their financial circumstances. You will never, ever be turned away because of that. Consequently, the year the Affordable Care Act passed, hospitals provided about $40 billion in uncompensated care, according to the USA Today article. In other words, they provided care without being paid.

On the surface, one might think that this is a sweet deal for the uninsured, but not so fast eager beaver! If someone does not have insurance to cover the cost of an ER visit, I learned that the joke really is on him or her. Said differently, he/she is responsible for the bill. Period. Over and Out! Regardless if one has insurance or not, the hospital is more than likely to bill the uninsured for services rendered. Sure, the hospital might not collect, but they will nonetheless, let the patient know there is no free lunch. As a result, the article states that according to a 2016 study by the National Bureau of Economic Research, someone who goes into the ER without insurance doubles his or her chances of filing for bankruptcy over the next four years. As you might expect, these “poor” folks will have collection agencies hounding them for money that they may not have. Therefore, bankruptcy may be their only viable alternative.

I learned after reading another article on ShareCare.com, that regardless of one’s ability to pay, patients visiting an emergency room are examined to make sure they do not have a serious condition. If the ER physician identifies an emergency condition, the patient will be given the necessary treatment. However, what happens if the Doc identifies the uninsured condition as a “non-emergency?” Now what? According to Dr. Mark E. Caputo, a spokesperson from Holy Cross Hospital who is quoted in the article, that patient would be referred to a physician or community resource that may be able to assist him/her further.  

Yes indeed, the notion that there is no free lunch still exists in my world!

 

Harry Pappas Jr. CFP®

Managing Director-Investments

Master of Science Degree Personal Financial Planning
Certified Estate & Trust Specialist ™

Certified Divorce Financial Analyst™
Pappas Wealth Management Group of Wells Fargo Advisors

818 North Highway A1A, Ste 200

Ponte Vedra, Florida 32082

904-273-7955

harry.pappas@wellsfargoadvisors.com 

The use of the CDFA™ designation does not permit Wells Fargo Advisors or its Financial Advisors to provide legal advice, nor is it meant to imply that the firm or its associates are acting as experts in this field.

 

Wells Fargo Advisors is a trade name used by Wells Fargo Clearing Services, LLC, Member SIPC, a Registered Broker-Dealer and a non-bank affiliate of Wells Fargo & Company.

The opinions expressed here reflect the judgment of the author as of the date of the report and are subject to change without notice. Statistical information has been obtained from sources believed to be reliable, but its accuracy and completeness are not guaranteed. The material has been prepared or is distributed solely for information purposes and is not a solicitation or an offer to buy any security or instrument or to participate in any trading strategy. 

Comments

No comments on this story | Please log in to comment by clicking here
Please log in or register to add your comment