As Congress debates health care reform, there are provisions in the Affordable Care Act that are essential to millions of emergency patients and must be protected.
More than nine in 10 registered voters in a recent poll said that health insurance companies should include coverage for emergency medical care. When asked if someone visited an emergency department because they believed they were having a heart attack, but were later diagnosed with a panic attack, more than eight in 10 (83 percent) said health insurance plans should cover the 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 the Affordable Care Act, following years of denials of coverage for emergency care by health insurance companies.
Patients can’t choose where and when they will need emergency care and shouldn’t be punished for having emergencies. They should not be the ones who have to decide at home if they are having an emergency and worry if their visit will be covered.
We urge all of our patients to investigate what their health insurance policy covers and make sure policymakers and insurance companies provide fair and reasonable coverage for emergency care.
Christopher Sampson is a Columbia-area emergency medicine physician.