Bill Would Bar Hospitals From Turning Away Poor

A hospital “anti-dumping” provision just approved by Congress would forbid hospitals to turn away emergency room patients or “dump” them on other institutions for fear that they cannot pay.

The provision is part of a little-noticed section of the reconciliation bill approved March 20 and awaiting President Reagan’s signature. The overall bill was designed to cut the federal deficit by $18 billion over the next three years.

The same bill would require private employers with 20 or more workers to continue health insurance coverage for 18 months for employees who are laid off, and for three years for families of workers who die. The worker or the surviving family would have to pay the premiums, but could do so at the low-cost group rate.

Women in Labor

The anti-dumping provision seeks to address a problem that has received increasing attention in recent years: hospitals’ turning away women in labor and other patients needing immediate attention because they do not have a health insurance card or the cash to pay.

Last June, when Sen. Edward M. Kennedy (D-Mass.) and Rep. Pete Stark (D-Oakland) introduced the anti-dumping and insurance continuation provisions, Kennedy said that because many people do not have health insurance: “All across our country, emergency patients are being killed or crippled because they cannot find a hospital that will take them in. . . . When one of our citizens arrives at a hospital emergency room with a potentially life-threatening illness or injury, he deserves a checkup and treatment, not a credit check and a trip down the road.”

The anti-dumping provision would prohibit a hospital’s emergency room from turning away a patient without first stabilizing his condition and making sure another institution is willing to receive him.

Failure to follow the new rules could result in civil penalties of up to $25,000 per occurrence against a hospital or the doctor involved, the hospital’s exclusion from participation in the Medicare program and lawsuits for damages suffered by the patient or by the hospital on whom the patient was “dumped.”

Patients of All Ages

The requirements apply to all patients of all ages, not just Medicare patients or those being funded by government programs, and to virtually all hospitals with emergency rooms.

Although a good deal of health legislation in recent years has been tailored to reduce federal costs and in some cases to shrink medical services, the measure passed last week includes half a dozen provisions running counter to this trend.

Taken together, the provisions could improve health protection for millions. Since costs would be paid mainly by hospitals and by laid-off workers or workers’ survivors, the costs to the government are small.