WASHINGTON, DC—The American College of Emergency Physicians (ACEP) issued a statement in response to the possible stripping away of mandatory insurance coverage of emergency medical care in the House of Representatives’ bill, the American Health Care Act (AHCA), to replace the Affordable Care Act. ACEP’s president, Dr. Rebecca Parker, stated:
“ACEP cannot support any legislation that does not include emergency medical care as a covered benefit in health insurance. The Affordable Care Act included emergency services as an essential health benefit and any replacement legislation must do the same. Americans overwhelmingly (95 percent) say health insurance companies should cover emergency medical care and emergency physicians agree with them. Patients can’t choose where and when they will need emergency care and they shouldn’t be punished financially for having emergencies.
“As the House considers changes to the AHCA, they must not erode the protection that patients currently have to access emergency medical care. If the House does choose that course of action, ACEP would have to oppose the bill, and we would work very hard to ensure those protections are reinstated by the Senate.
“Historically, insurance companies have always chosen to deny coverage when given the option. That’s why federal legislation must ensure that patients having emergencies can go to the emergency department knowing their insurer will cover the bill. When asked if someone visited the emergency department because they believed they were having a heart attack, but were later diagnosed with a panic attack, more than 8 in 10 (83 percent) Americans said that patient’s health insurance should cover that emergency visit.
“The principle of covering medical care based on symptoms that most people would consider potentially life-threatening, rather than the final diagnosis, is called the “prudent layperson" standard. This was codified into federal law, including in the Affordable Care Act, following years of denials of coverage for emergency care by health insurance companies. It must also be included in any replacement legislation, such as the American Health Care Act.
“Emergency medicine is essential to America, providing lifesaving and critical care to millions of patients each year.”