Addressing Boarding and Crowding in the Emergency Department
- Bill Number
- H.R. 2936
- Origin Chamber
- House
- Congress
- 119th Congress, Session 1
- Policy Area
- Health
- Status
- Introduced
- Latest Action
- 2025-04-17: Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
- Last Updated
- 2026-06-24T08:09:48Z
AI-Generated Summary
Purpose of the Legislation
The Addressing Boarding and Crowding in the Emergency Department Act of 2025 (ABC-ED Act of 2025) aims to improve emergency department (ED) efficiency and patient care by enhancing public health data systems to track hospital capacity and by testing innovative models for better emergency care, particularly for older adults and individuals in psychiatric crises. It addresses issues like ED overcrowding, long wait times, and delays in patient transfers.
Key Provisions
- Expansion of Public Health Data Grants (Section 2): Amends the Public Health Service Act to allow grants or cooperative agreements for developing state- or region-wide, real-time (or near real-time) systems that track hospital bed capacity and its impact on ED boarding rates (when patients wait in hallways due to lack of beds), treatment wait times, and delays for emergency medical services (EMS) personnel to hand off patients. These systems must include public-facing dashboards with privacy-protected data.
- Center for Medicare and Medicaid Innovation (CMMI) Pilot Programs (Section 3): Amends the Social Security Act to require CMMI (a part of the Centers for Medicare & Medicaid Services that tests new payment and care delivery models) to include two specific pilot models:
- One focused on improving ED care for older adults through better staffing, facility changes, geriatric-specific policies, and improved coordination with post-acute care facilities (e.g., nursing homes or assisted living).
- Another for individuals in acute psychiatric crises, including dedicated ED units and faster transfers to appropriate facilities.
- Government Accountability Office (GAO) Study (Section 4): Directs the GAO (an independent agency that audits federal programs) to conduct a study on best practices for hospital capacity tracking systems. The study must cover system features (e.g., integration with electronic medical records, coverage of EDs, intensive care units, and psychiatric services) and evaluate impacts on ED boarding, wait times, and EMS delays. A report must be submitted to Congress within one year of enactment.
Significant Changes to Existing Law
- Public Health Service Act (Section 2823): Adds a new grant category (subparagraph C) to existing data modernization grants, explicitly allowing funds for hospital bed tracking and related ED metrics, which were not previously specified. This builds on prior provisions for surveillance and data infrastructure without altering core eligibility or funding amounts.
- Social Security Act (Section 1115A): Mandates the inclusion of the two new ED-focused pilot models in CMMI's required testing portfolio, expanding the list of mandatory models (now up to clause xxix). This shifts CMMI from optional to required development of these innovations, potentially influencing future Medicare and Medicaid payment reforms.
- New Study Requirement: Introduces a one-time GAO study not previously mandated, providing an evidence base for future policy adjustments without creating ongoing programs.
Potential Impacts
- Government Agencies: The Department of Health and Human Services (HHS) and state public health entities will gain flexibility in using grants for capacity tracking, potentially improving resource allocation during surges (e.g., pandemics). CMS must prioritize and fund the new pilots, which could increase administrative workload but lead to cost-saving care models. The GAO study may inform broader federal healthcare data standards.
- Citizens: Patients, especially older adults and those with psychiatric needs, could benefit from reduced ED wait times, better coordinated care, and fewer boarding incidents, leading to safer and faster treatment. EMS workers may spend less time waiting to transfer patients, improving response times for emergencies.
- International Relations: No direct impacts, as the bill focuses on domestic U.S. healthcare systems.
Main Stakeholders Affected
- Healthcare Providers: Hospitals, ED staff, and post-acute facilities (e.g., skilled nursing homes) will need to adopt tracking systems and participate in pilots, potentially gaining tools for better operations but facing initial setup costs.
- Public Health and Emergency Services: State and local health departments, plus EMS personnel, benefit from improved data for planning and reduced delays.
- Vulnerable Populations: Older adults (via geriatric-focused care) and individuals experiencing psychiatric crises, who may receive more specialized ED services and smoother transitions to ongoing care.
- Payers and Beneficiaries: Medicare and Medicaid enrollees, as pilots could lead to widespread adoption of efficient models, affecting reimbursement and access for millions.
Notable Legal, Constitutional, or Political Implications
- Legal: The amendments integrate seamlessly with existing federal health laws (e.g., privacy protections under HIPAA are explicitly required for dashboards), avoiding conflicts. Grants and pilots maintain voluntary participation for states and providers, reducing enforcement challenges.
- Constitutional: No apparent issues, as the bill operates within Congress's authority over interstate commerce and spending for public health, without infringing on state rights or individual liberties.
- Political: Introduced bipartisanship (Republican and Democratic sponsors) suggests broad appeal for addressing ED overcrowding, a non-partisan issue. It could influence future healthcare funding debates by emphasizing data-driven improvements, potentially setting precedents for mandatory innovation testing in CMMI.
This summary was generated by AI and may contain inaccuracies. Refer to the official source document for the authoritative text.
Sponsor
Cosponsors (29)
Rep. Dingell, Debbie [D-MI-6], Rep. Torres, Ritchie [D-NY-15], Rep. Amodei, Mark E. [R-NV-2], Rep. Ross, Deborah K. [D-NC-2], Rep. Tlaib, Rashida [D-MI-12], Rep. McBride, Sarah [D-DE-At Large], Rep. Crow, Jason [D-CO-6], Rep. Matsui, Doris O. [D-CA-7], Rep. Auchincloss, Jake [D-MA-4], Rep. Carter, Earl L. "Buddy" [R-GA-1], Rep. Davis, Donald G. [D-NC-1], Rep. Vindman, Eugene Simon [D-VA-7], Rep. Obernolte, Jay [R-CA-23], Rep. Neguse, Joe [D-CO-2], Rep. Soto, Darren [D-FL-9], Del. Norton, Eleanor Holmes [D-DC-At Large], Rep. Green, Al [D-TX-9], Rep. Pingree, Chellie [D-ME-1], Rep. Magaziner, Seth [D-RI-2], Rep. Wilson, Joe [R-SC-2], Rep. Thompson, Glenn [R-PA-15], Rep. Keating, William R. [D-MA-9], Rep. Barragán, Nanette Diaz [D-CA-44], Rep. Rutherford, John H. [R-FL-5], Rep. Underwood, Lauren [D-IL-14], Rep. Stevens, Haley M. [D-MI-11], Rep. Miller-Meeks, Mariannette [R-IA-1], Rep. Castor, Kathy [D-FL-14], Rep. Bacon, Don [R-NE-2]
Recent Actions
- 2025-04-17: Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
- 2025-04-17: Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
- 2025-04-17: Introduced in House
- 2025-04-17: Introduced in House
Bill Versions
- Addressing Boarding and Crowding in the Emergency Department — issued 2025-04-17 — PDF (6 pages)