The inventory of Creative Commons images in a search for “Heritage Foundation” is rather small, so this is a picture of a jaguar named Khan from the Wildlife Heritage Foundation. How do you not include a picture of a Jaguar named Khan?

The Heritage Foundation, the conservative think tank that has been on the front lines of recent opposition to the Affordable Care Act (a/k/a “Obamacare”). It has not always been so opposed to aspects of the law like the individual insurance mandate, as it rather strongly supported such an idea way back in 1989. As it turns out, its support for various parts of the ACA was in evidence much more recently.

The “universal health care” that many Republicans have recently touted is formally known as the Emergency Medical Treatment and Active Labor Act (EMTALA) of 1986. In short, EMTALA states that hospitals accepting payment from federal programs, including Medicare and Medicaid, cannot deny treatment to a person due to inability to pay or insufficient insurance coverage, if that person is experiencing an acute medical emergency. The government does not directly cover the costs of care required by EMTALA, meaning that the costs either get unloaded as tax write-offs for bad debt, or they are covered by higher hospital costs charged to other patients and private insurers. EMTALA had the best of intentions, but it has had the effect of shifting the costs onto other private actors, not the public. Although the Tea Party has tried, no one has ever seriously argued in recent years that people should not have access to acute care because of a lack of ability to pay. It’s a fundamental human decency thing, at least in my opinion.

The Heritage Foundation generally agreed with these sentiments, i.e. that EMTALA had good intentions but caused many problems, as recently as 2007, and their analysis and recommendations included features now found in the Affordable Care—sorry, Obamacare that they so vehemently oppose all of a sudden. Back in July 2007, John S. O’Shea, M.D., a Health Policy Fellow at The Heritage Foundation’s Center for Health Policy Studies, wrote the following:

The Emergency Medical Treatment and Active Labor Act (EMTALA) is another example of federal legislation that hurts the very people that it was meant to protect: low-income patients in need of emergency medical services. Enacted in 1986, the law is a con­gressional response to well-publicized cases in which patients were refused immediate medical treatment based on their inability to pay. Continue reading →