Ensuring access to quality emergency medical care is paramount, regardless of location or demographics. However, recent discussions in Congress have shed light on the hurdles rural communities face in accessing such care. One significant barrier highlighted is the limited availability of freestanding emergency departments (FSEDs) in rural areas, largely due to their ineligibility for Medicare reimbursement. 

FSEDs offer a solution to bring emergency care closer to communities, yet their reliance on private insurance or out-of-pocket payments inhibits their expansion into underserved regions. Moreover, the challenging implementation of the No Surprises Act exacerbates reimbursement issues, leaving emergency care providers unfairly compensated. In the words of an emergency care provider, "we don't know if you can pay or not. We don't know if you have insurance or not. We may not even be able to talk to you. But we do the same thing to stabilize your anatomy and physiology." This ethos underscores the fundamental principle of emergency care – it should be accessible to all. 

On a brighter note, the rural emergency hospital (REH) designation, introduced in 2020, has shown promise, particularly in Texas, where 19 hospitals have transitioned, preserving essential services in rural areas. However, the closure of 36 rural hospitals since 2020 underscores the urgency of addressing financial challenges and workforce shortages. 

Everyone deserves to be confident that quality emergency care is within reach, regardless of their zip code or circumstances.