Health Affairs

Health Affairs, 25, no. 4 (2006): 1086-1094 doi: 10.1377/hlthaff.25.4.1086 © 2006 by Project HOPE	New Online   Getting Health Reform Done   After the State of the Union   Incremental Reform   E-Health in Developing World   Most-Read Articles in 2009

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Do Mandates Requiring Insurers To Pay For Emergency Care Influence The Use Of The Emergency Department?

Renee Y. Hsia, Jia Chan and Laurence C. Baker

Many states have "prudent layperson" mandates that require health plans to reimburse hospitals for emergency department (ED) care delivered to patients who believe that they have symptoms warranting emergency treatment. Increased, and possibly unnecessary, ED use has often been attributed to these policies. We use data from thirty-five states to study relationships between passage of prudent layperson policies in the late 1990s and ED use among the privately insured. None of the analyses show evidence that the mandates are associated with increased use. We conclude that prudent layperson mandates are not associated with increases in ED visits among privately insured patients.

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