American College of Emergency Physicians
Emergency physicians across the nation are visiting Capitol Hill on April 29 during ACEP's 2025 Leadership and Advocacy Conference to speak with their legislators about addressing the boarding crisis, protecting emergency physician mental health, and preserving access to lifesaving emergency care by stabilizing Medicare and Medicaid physician payments.
- Addressing the Emergency Department Boarding Crisis
- Protecting Emergency Physician Mental Health
- Stabilizing the Safety Net: Ensure the Promise of Medicare and Medicaid
Solving the Emergency Department Boarding Crisis
Emergency physicians do all they can to treat anyone, anytime. But dangerous health system bottlenecks, known as boarding, occur when patients are held in the ED after being admitted to the hospital due to a lack of available inpatient beds or transfer options. This gridlock delays care, worsens outcomes, and overwhelms emergency systems. These delays put patient lives at risk.
Boarding is a public health emergency. ACEP collected more than 140 personal stories from emergency physicians across the country and is leading a multi-year, comprehensive advocacy campaign to tackle the boarding crisis that includes policy and regulatory changes, stakeholder summits, and a full slate of state and federal advocacy initiatives.
Patients who board more than four hours face elevated health and safety risks, according to The Joint Commission. However, polling of emergency physicians revealed that (97%) cited boarding times of more than 24 hours, with one-third stating they had patients stay more than one week, and 28% citing they had patients boarding more than two weeks.
How Can Congress Help?
Emergency physicians are encouraging support for The Addressing Boarding and Crowding in the Emergency Department (ABC-ED) Act (H.R. 2936), a bipartisan bill introduced by Reps. John Joyce, MD (R-PA) and Debbie Dingell (D-MI).
The ABC-ED Act will help ensure more efficient use of health care resources, relieve pressures on strained emergency departments, and improve patient outcomes by modernizing infrastructure, spurring innovative care models, and improving accountability by directing the GAO to study best practices in hospital capacity tracking and the impact on boarding and emergency delays.
Resources:
- Support the ABC-ED Act
- ACEP resources and advocacy on boarding
- Emergency Physicians Welcome Additional Hospital Reporting Measures on Boarding
- AHRQ Highlights Emergency Physician Leadership on Boarding Solutions
Protecting Emergency Physicians' Mental Health
Emergency medicine (EM) is a fast, intense and demanding profession. The boarding crisis, worsening financial concerns, deteriorating physician autonomy, rising violence against emergency physicians, and other challenges are driving record levels of burnout. According to the 2024 Medscape Report, 63% of emergency physicians reported burnout or depression – more than any other specialty. More must be done to support the mental health and well-being of our nation’s emergency physicians and health care workforce.
How Can Congress Help?
ACEP urges legislators to cosponsor and swiftly pass the Dr. Lorna Breen Health Care Provider Protection Reauthorization Act (H.R 929 / S. 266).
The Dr. Lorna Breen Health Care Provider Protection Act implemented long-overdue changes in licensing and credentialing processes that have unintentionally contributed to stigma associated with health care workers seeking mental health care and supporting over 250,000 health workers through 45 initiatives. Named in honor of Dr. Lorna Breen, our emergency physician colleague who died by suicide on April 26, 2020, the law has saved lives and protected careers. The law must be reauthorized so that we can keep up the momentum on this critical work.
Resources:
Cosponsor The Dr. Lorna Breen Health Care Provider Protection Reauthorization Act
Stabilizing the Safety Net: Ensure the Promise of Medicare and Medicaid
Emergency physicians serve on the frontline of the health care system. By oath and under the Emergency Medical Treatment and Labor Act (EMTALA), they provide lifesaving emergency care to every patient regardless of insurance status or ability to pay. But growing financial and operational pressures on emergency physicians are straining the health care safety net and threatening access to emergency care.
How Can Congress Help?
Congress can provide stability and certainty to ensure that Medicare can fulfill its promise to the millions of American seniors that depend upon and have earned these benefits, by working with ACEP to:
- Establish a permanent inflationary update to Medicare physician payments
- Enact long-term reforms to bring predictability and sustainability to Medicare payments
- Reverse the 2.83% Medicare cut that took effect on Jan 1, 2025.
Repeated annual cuts harm the viability of the health care safety net and strain our ability to effectively partner with Congress to address critical challenges facing the physician community and our patients.
Similarly, changes and reforms to the Medicaid program that are under consideration could result in tens of millions of individuals losing Medicaid eligibility and would add a surge of millions of uninsured individuals, especially if savings are not reinvested in improving access to care. This will force even more patients to seek care in our already overburdened EDs as other physicians across our communities begin to close practices or stop accepting Medicaid--all while further driving up the annual losses emergency departments face from uncompensated care and risking increased burnout of the emergency physician workforce.
Congress has an important chance to protect access to high quality emergency care by stabilizing Medicaid and Medicare physician payments and maintaining the long-term viability of emergency medicine.
Resources:
Protect Access to Lifesaving Emergency Care
New RAND Report: Strategies for Sustaining Emergency Care
