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Laws no guarantee of access to health care

By Maryalene LaPonsie on August 27th, 2012

While consumers may be under the impression federal laws are ensuring their access to health care, recent reports indicate otherwise.

A study published in the August 2012 issue of the journal Health Affairs finds some hospitals are refusing emergency care to those without health insurance coverage despite a federal law to the contrary. In addition, news reports have shed light on a potential problem with the Patient Protection and Affordable Care Act's provision that allows dependents to remain on parent health insurance plans through age 26.

'Patient dumping' still a problem

In 1986, the Emergency Medical Treatment and Labor Act was established to ban the practice of "patient dumping" in which hospitals would turn away patients who did not have medical insurance. However, the Health Affairs study finds patient dumping still exists.

Researchers from the George Washington University School of Public Health and Health Services looked at five case studies from Denver Health, a safety-net hospital in the Colorado capital.

Those case studies demonstrated instances in which uninsured patients facing health emergencies were declined treatment by other providers before arriving at Denver Health.

"We don't know the full extent of EMTALA (Emergency Medical Treatment and Labor Act) violations because they aren't properly reported and tracked, but we do know that there are serious problems with how the law has been implemented," Sara Rosenbaum, one of study authors, said in comments published on the Health Affairs blog.

Dependents might not get maternity coverage

Meanwhile, Kaiser Health News is reporting dependents who remain on their parents' medical insurance as young adults may find themselves without maternity coverage.

The Patient Protection and Affordable Care Act allows children up to age 26 to remain on their parents' health insurance plans. However, that doesn't mean they get all the same coverage as their parents.

While the Pregnancy Discrimination Act of 1978 requires group health insurance plans with at least 15 members to provide maternity coverage, some dependents are learning the law doesn't extend that same protection to them.

Dan Priga of the human resources consulting firm Mercer told Kaiser Health News he estimates 70 percent of employers who pay for employee health claims directly do not cover maternity coverage for dependents.

Although the lack of maternity coverage for dependents has reportedly caught some families off-guard, the problem is expected to partially correct itself in 2014. At that time, maternity coverage must be provided to all covered individuals with health insurance plans in the individual and small-group markets. However, large groups will still be able to exclude dependents if they wish.

Maryalene LaPonsie
Maryalene LaPonsie has been writing professionally for more than a decade on topics including education, insurance and personal finance. She holds a Bachelor's Degree in Political Science from Western Michigan University.

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