Among changes that reform experts have said could make the greatest difference are:

• Improving price transparency,
• Lowering out-of-pocket maximums,
• Expanding primary care access for Medicaid patients,
• Reducing prior authorization burdens,
• Establishing dedicated funding tied to uncompensated EMTALA care and emergency preparedness.

Potter said emergency physicians are uniquely positioned to push for those changes.

“Physicians are influential,” Potter said. “They should use that influence to advocate for change, both for themselves and their patients.”

A System Patients Can Afford to Use

Cost sharing was designed to reduce unnecessary utilization. But the evidence and the experience of frontline physicians tell a more troubling story. Patients are not only avoiding unnecessary care. They are avoiding necessary care, then arriving sicker, later, and with fewer options.

The patient who delays treatment because the deductible reset. The patient who declines admission over observation costs. The patient who waits until symptoms become unbearable because the fear of the bill outweighs the fear of the illness itself. These are not cases at the margin. They are the daily reality of emergency medicine in 2026.

Emergency physicians cannot fix this alone. They did not design the deductibles, negotiate the contracts, or write the policies that put patients in these positions. But they are the ones in the room at the end of the delay, managing the heart attack that started as chest pain the patient ignored for three days, the sepsis that began as a simple infection the patient couldn’t afford to treat.

That is an unsustainable position for physicians and a dangerous one for patients.

Right now, for too many patients, the most dangerous moments in their quest for emergency care are the ones that occur before they decide to come to the emergency department.

Ms. Scott is a freelance writer based in Dallas.

References

1. ACEP Leadership & Advocacy Conference. Protecting and Preserving Medicare’s Promise. https://www.acep.org/siteassets/sites/lac/media/issues/protecting-and-preserving-medicare.pdf