The Emergency Medical Treatment and Active Labor Act was passed in 1986 under COBRA. All hospitals in the U.S., except for Shriners' Hospital for crippled Children and military hospitals, are subject to the rules of the EMTALA because they accept federal funds, along with Medicaid and Medicare.
There are two main purposes of the Emergency Medical Treatment and Active Labor Act. First, to make sure no one is refused emergency medical treatment and second, to prevent hospitals from sending patients to another hospital because the patient does not have insurance or only has Medicaid or Medicare. Hospitals are required to make sure the patient is stabilized before inquiring about their ability to pay. Once the patient is stabilized the hospital has no other obligations to treat the patient further and can then release the patient or send them to another hospital.
Emergency medical services are guaranteed by the Emergency Medical Treatment and Active Active Labor Act to provide emergency care by hospitals not only if the patient does not have the ability to pay but emergency services must also be given regardless of citizenship or legal status. This guarantee under the EMTALA is controversial in the U.S. since many citizens do not want to provide any type of free healthcare for illegal immigrants.