EMTALA Creator Leaves Congress

US Rep. Fortney “Pete” Stark (D. Calif) will be absent when Congress reconvenes in the new Session for the first time since his landmark EMTALA law was passed in 1986. Stark was defeated in a Democract party primary for his California district.

For most of his career in Congress, Stark was a major player in the finance committee responsible for Medicare and helped personally craft important policy legislation such as EMTALA, Stark I, and Stark II laws.

In 1986, Stark was chair of the committee overseeing Medicare, and with the assistance of Ralph Nader’s Public Citizen group and the National Organization of Women was responsible for passage of the EMTALA law.

Original drafts of the legislation received little attention as a Democrat majority in Congress crafted a massive “Consolidated Omnibus Budget Reconciliation Act (COBRA)” to put a veto-proof bill on President Reagan’s desk. Chief on the minds of legislators was a massive reworking of the Medicare payment system into the Medicare Prospective Payment system. Also occupying much of the attention of law makers was a new “Insurance Portability” law that would become known as COBRA insurance.

Very few gave any attention to the proposed EMTALA law except the American College of Emergency Physicians. ACEP successfully scored a victory by removing jail terms for physicians that were found to have violated the law. The proposed law, however, died in committee without ever coming before the full Congress.

So, if the EMTALA law died in committee, how is it that the law now exists? The answer to that is Pete Stark.

As the clock wound down in the Conference Committee that was working to resolve differences before the last minute deadline — much like current “fiscal cliff” brinksmanship — Stark successfully inserted EMTALA into the COBRA law by arguing that it was “budget neutral”, a term now translated as “unfunded mandate.”

Pete Stark was on the “most hated” political list for most physician’s groups as one of the most powerful opponents of medical group agendas. He humbly declared on more than one occasion “Medicare is what I say it is.”

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