This provision was drafted and enacted by the House of Representatives of the 99th Congress as part of H.R. 3128, the Consolidated Omnibus Budget Reconciliation Act of 1985.
This policy affects all patients, or potential patients, in the United States and further affects all hospitals and care providers. It ensures that all patients suffering from emergency medical condition(s) are provided the appropriate medical care regardless of their initial ability to pay. Furthermore, it requires that hospitals, their emergency departments, and their staff must treat and stabilize these patients prior to transferring to another facility.
This policy was, in part, designed to prevent "patient dumping" whereby hospitals would refuse to treat certain patients due to inability to pay for treatment and either refuse admittance or transfer them to other hospitals. Furthermore, it specifically addresses female patients in active labor, requiring that hospitals ensure that these patients are also treated and stabilized in the emergency department or receiving facility.
This policy ensures that EMTs and Paramedics who transport patients to hospitals are not refused admittance or directed to other facilities due to their patients' inability to pay or other factors. While emergency departments still may declare a divert status, whereby incoming EMS units are advised that the ER is either full or unable to accept patients due to other factors, this act, and other relevant state statutes, require that hospitals still accept, treat, and stabilize any patients that are brought to their facilities.
The Emergency Medical Treatment & Labor Act (EMTALA) goal is to guarantee everyone access to emergency care at hospitals (Medicare, Health & Human Services, or CMS participating ones) regardless of ability for the patient to pay for the services or not. This was aimed to open up equal access to critical treatment regardless of class, social standing, or wealth.
The Emergency Medical Treatment & Labor Act was drafted by congress in 1985 as part of the Consolidated Omnibus Budget Reconciliation Act (COBRA) of 1985 which is a larger healthcare and social security law. The law passed in 1986.
This policy applies to all persons residing (regardless of legal status) in the U.S. and any of its territories as well as the District of Columbia who require medical screening examinations as outlined in the act or treatment for an emergency medical condition.
While most hospitals would provide stabilizing, lifesaving treatment to those that needed it, there were some that did not. This act really helps the good hospitals (the majority of them) that were already doing what this policy made law, but there were enough instances and examples of hospitals that were not, so the legislature acted. It is also important to note that this act was part of a larger bill (COBRA) that dealt with national healthcare and social security policy.
It matters to public health greatly because without it, hospitals could refuse to provide critical treatment until they were satisfied that the patient could pay, which can result in death from delay or refusal of care.
Those that cannot pay for healthcare services (or are suspected to not be able to) are the most vulnerable population as they can literally die because of their social standing getting in the way of care and treatment.