Bill Overview
Title: Emergency Care Improvement Act
Description: This bill permanently allows for coverage under Medicare and Medicaid of services that are provided by freestanding emergency centers. The bill takes effect January 1, 2023, or the first day after the end of the COVID-19 public health emergency, whichever is first.
Sponsors: Rep. Arrington, Jodey C. [R-TX-19]
Target Audience
Population: People globally who rely on emergency care services
Estimated Size: 136000000
- Freestanding emergency centers provide emergency services to individuals who might not have immediate access to hospital emergency rooms.
- Medicare primarily covers individuals who are 65 and older as well as certain younger individuals with disabilities, making this population particularly relevant.
- Medicaid provides health coverage to low-income individuals, including families and children, pregnant women, low-income seniors, and people with disabilities.
- There are approximately 72 million Medicaid enrollees and 64 million Medicare enrollees in the U.S.
- The legislation may also impact people in countries that use similar models or look to U.S. policy as a potential model for their healthcare systems.
Reasoning
- Given the policy targets Medicare and Medicaid beneficiaries, the simulated interviews should focus on individuals most likely to use these services, such as older adults, disabled individuals, low-income families, and rural populations.
- The policy budget suggests a substantial investment, indicating a moderate level of change expected in accessibility and service availability.
- While the policy is aimed at broadening emergency care access, its actual impact on individual wellbeing will vary based on current access levels and individual health needs.
Simulated Interviews
retired (rural Alabama)
Age: 68 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 10.0 years
Commonness: 12/20
Statement of Opinion:
- I rely on Medicare for my healthcare needs, and having more emergency centers covered is a relief.
- In emergency situations, the distance to the nearest hospital is always a concern.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 7 | 6 |
| Year 5 | 7 | 6 |
| Year 10 | 7 | 5 |
| Year 20 | 6 | 5 |
IT professional (urban California)
Age: 35 | Gender: male
Wellbeing Before Policy: 8
Duration of Impact: 0.0 years
Commonness: 15/20
Statement of Opinion:
- I don't think the policy will impact me directly.
- I have comprehensive health insurance coverage through my job.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 8 |
| Year 2 | 8 | 8 |
| Year 3 | 8 | 8 |
| Year 5 | 8 | 8 |
| Year 10 | 8 | 8 |
| Year 20 | 8 | 8 |
school teacher (suburban Texas)
Age: 45 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 20.0 years
Commonness: 10/20
Statement of Opinion:
- Access to emergency healthcare that's covered is a major concern for my family.
- This policy could make emergency situations less stressful financially.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 5 |
| Year 2 | 7 | 5 |
| Year 3 | 8 | 5 |
| Year 5 | 8 | 4 |
| Year 10 | 9 | 4 |
| Year 20 | 9 | 4 |
construction worker (urban New York)
Age: 54 | Gender: male
Wellbeing Before Policy: 4
Duration of Impact: 15.0 years
Commonness: 8/20
Statement of Opinion:
- The fact that more emergency care locations are now covered gives me peace of mind.
- I hope it means shorter wait times and better service too.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 4 |
| Year 2 | 6 | 4 |
| Year 3 | 7 | 4 |
| Year 5 | 7 | 4 |
| Year 10 | 7 | 3 |
| Year 20 | 7 | 3 |
retired farmer (rural Montana)
Age: 62 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 10.0 years
Commonness: 6/20
Statement of Opinion:
- I think this is a great initiative, given how isolated our community can feel.
- In emergencies, having closer options means everything.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 6 | 5 |
| Year 5 | 6 | 5 |
| Year 10 | 6 | 5 |
| Year 20 | 6 | 5 |
retired engineer (suburban Florida)
Age: 72 | Gender: male
Wellbeing Before Policy: 7
Duration of Impact: 5.0 years
Commonness: 10/20
Statement of Opinion:
- Any expansion in coverage is good, but I'm not sure how much it will impact me personally.
- I usually plan for healthcare wherever I travel.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 7 | 7 |
| Year 3 | 7 | 7 |
| Year 5 | 7 | 7 |
| Year 10 | 7 | 6 |
| Year 20 | 7 | 6 |
part-time student (urban Massachusetts)
Age: 29 | Gender: other
Wellbeing Before Policy: 4
Duration of Impact: 15.0 years
Commonness: 7/20
Statement of Opinion:
- I focus all my resources on my child's healthcare, and this policy might just help a little.
- It would be nice to know that emergency visits are covered wherever we have to go.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 4 |
| Year 2 | 7 | 4 |
| Year 3 | 8 | 3 |
| Year 5 | 8 | 3 |
| Year 10 | 8 | 3 |
| Year 20 | 8 | 3 |
retired librarian (urban Illinois)
Age: 78 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 10.0 years
Commonness: 11/20
Statement of Opinion:
- It's comforting to know I have more options if something happens.
- I hope this means extended benefits last beyond emergencies.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 7 | 5 |
| Year 10 | 7 | 5 |
| Year 20 | 6 | 5 |
unemployed (rural New Mexico)
Age: 38 | Gender: male
Wellbeing Before Policy: 3
Duration of Impact: 20.0 years
Commonness: 9/20
Statement of Opinion:
- This change could be a lifeline. I've been hearing about issues with emergency bills.
- It can't come fast enough, honestly.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 3 |
| Year 2 | 6 | 3 |
| Year 3 | 6 | 3 |
| Year 5 | 7 | 2 |
| Year 10 | 8 | 2 |
| Year 20 | 8 | 2 |
small business owner (urban Washington)
Age: 50 | Gender: female
Wellbeing Before Policy: 8
Duration of Impact: 0.0 years
Commonness: 12/20
Statement of Opinion:
- I don't anticipate changes for my healthcare, but I'm glad others might benefit.
- Most concerns I hear are from friends who don't have good insurance.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 8 |
| Year 2 | 8 | 8 |
| Year 3 | 8 | 8 |
| Year 5 | 8 | 8 |
| Year 10 | 8 | 8 |
| Year 20 | 8 | 8 |
Cost Estimates
Year 1: $4500000000 (Low: $3800000000, High: $5200000000)
Year 2: $4700000000 (Low: $4000000000, High: $5400000000)
Year 3: $4900000000 (Low: $4200000000, High: $5600000000)
Year 5: $5300000000 (Low: $4600000000, High: $6000000000)
Year 10: $5800000000 (Low: $5100000000, High: $6700000000)
Year 100: $9000000000 (Low: $7800000000, High: $10400000000)
Key Considerations
- Potential increase in Medicare and Medicaid fraud or abuse due to lack of regulatory oversight compared to hospitals.
- State-level regulations and variations in freestanding emergency centers' accreditation and operation.
- Potential for increased insurance premiums as a consequence of higher overall costs.
- The elasticity in patient choice when seeking care at different types of emergency facilities.