The combined payments of Medicare and Medicaid, $602 billion in 2004,[3] or roughly 44% of all medical expenditures in the United States, make not participating in EMTALA impractical for nearly all hospitals.
[4][5] The cost of emergency care required by EMTALA is not covered directly by the federal government, so it has been characterized as an unfunded mandate.
[7] The Hill-Burton Act of 1946, which provided federal assistance for the construction of community hospitals, established nondiscrimination requirements for institutions that received such federal assistance—including the requirement that a "reasonable volume" of free emergency care be provided for community members who could not pay—for a period for 20 years after the hospital's construction.
Amendments to the act in 1975 removed the 20-year expiration date and instead required hospitals receiving Hill-Burton funding to provide free care in perpetuity.
[9] An emergency medical condition (EMC) is defined as "a condition manifesting itself by acute symptoms of sufficient severity (including severe pain) such that the absence of immediate medical attention could reasonably be expected to result in placing the individual's health [or the health of an unborn child] in serious jeopardy, serious impairment to bodily functions, or serious dysfunction of bodily organs."
Not all medical conditions qualify for uncompensated mandated services imposed by EMTALA, which is contrary to the misperception that many individuals assume: that if they are ill, they will be treated regardless of their ability to pay.
Because the MSE is a mandated EMTALA service, health insurers are required to cover benefits for their subscribers.
EMTALA intentionally omitted requirements that hospitals provide uncompensated stabilizing treatment for individuals with medical conditions determined not to be EMCs.
Admitted patients who experience a medical emergency while at a hospital are normally not covered by EMTALA but are instead protected by varying state laws and quality assurance under the deemed status of the facility.
The amendments include the following: The most significant effect is that regardless of insurance status, participating hospitals are prohibited from denying an MSE of individuals seeking treatment for medical conditions.
[15] The Biden administration filed a motion in federal court to block Idaho's enforcement of that state's abortion ban in cases in which EMTALA applied.
[22][23] However, the issue remains unresolved, with the ruling only seen as delaying the Idaho state law banning emergency abortions rather than striking it down altogether.