Claim:
Former U.S. President Ronald Reagan signed the Emergency Medical Treatment and Active Labor Act, which required emergency rooms to provide emergency health care to anyone, regardless of immigration status, in 1986.
Rating:
Context
Under the law Reagan signed, ERs that take Medicare payments — which is most of them — must provide emergency care to anyone, regardless of ability to pay or immigration status. Some social media posts claimed the act guaranteed “health services to all undocumented immigrants,” but the act required only that hospitals provide everyone with emergency health care, not other forms of health services.
Following the U.S. government shutdown in October 2025 and prominent Republicans’ subsequent false claims that Democrats shut down the government over health care for “illegal aliens,” a rumor spread online that former President Ronald Reagan, a Republican, signed legislation guaranteeing emergency medical care to all patients regardless of immigration status.
The claim spread on platforms including Facebook, TikTok and Bluesky. Many posts claimed the law Reagan allegedly signed was called the Emergency Medical Treatment and Active Labor Act of 1986.
Reagan did sign the Emergency Medical Treatment and Active Labor Act in 1986. The act required “participating hospitals” that offer emergency services to provide that kind of care for anyone, regardless of patients’ ability to pay or their immigration status. The legislation defined participating hospitals as those that accept payments from Medicare, the federal health insurance program for people over 65 or with certain disabilities.
Given that nearly all hospitals in the United States accept Medicare — and thus must provide emergency care to immigrants who are in the country illegally — we have rated this claim true.
Some posts claimed the act “guaranteed health services to undocumented immigrants” without specifying what kind of services. These posts were misleading because the act required hospitals to provide only emergency care — not all forms of health care — to immigrants in the country illegally.
It is also worth noting that some of the images circulating with this claim showed Reagan signing the Immigration Reform and Control Act of 1986, not the health care act. (The immigration reform act legalized most people who arrived illegally before 1982 and prohibited employers from knowingly hiring immigrants without authorization to be in the country.)
Emergency Medical Treatment and Active Labor Act
Reagan signed the Emergency Medical Treatment and Active Labor Act, or EMTALA, as part of the Consolidated Omnibus Budget Reconciliation Act of 1985 (introduced in 1985 but signed into law in 1986).
For the section on emergency care in the budget act, see Section 9121, “RESPONSIBILITIES OF MEDICARE HOSPITALS IN EMERGENCY CASES,” on Page 83 of a PDF of the act’s text that appears on Congress’ website. Per the bill’s history on the website, the president in office at the time signed the law on April 7, 1986. Reagan served as 40th president of the United States from 1981 to 1989.
The EMTALA was codified in U.S. Code 1395dd (archived), per the bill text. Here’s what the code said as of this writing (emphasis ours):
(a) Medical screening requirement
In the case of a hospital that has a hospital emergency department, if any individual (whether or not eligible for benefits under this subchapter) comes to the emergency department and a request is made on the individual’s behalf for examination or treatment for a medical condition, the hospital must provide for an appropriate medical screening examination within the capability of the hospital’s emergency department, including ancillary services routinely available to the emergency department, to determine whether or not an emergency medical condition (within the meaning of subsection (e)(1) of this section) exists.
(b) Necessary stabilizing treatment for emergency medical conditions and labor
(1) In general
If any individual (whether or not eligible for benefits under this subchapter) comes to a hospital and the hospital determines that the individual has an emergency medical condition, the hospital must provide either-
(A) within the staff and facilities available at the hospital, for such further medical examination and such treatment as may be required to stabilize the medical condition, or
(B) for transfer of the individual to another medical facility in accordance with subsection (c) of this section.
In other words, participating hospitals with emergency departments must provide medical screenings to anyone who requests an exam or treatment, and if the hospital determines that person needs emergency care, the hospital must either treat the patient or transfer them to another medical facility.
According to the Congressional Research Service, the act passed “amid reports of hospital emergency rooms refusing to treat poor or uninsured patients.” Lawmakers wanted to end the practice of “patient dumping,” in which hospitals transferred uninsured patients from private to public hospitals “without consideration of their medical condition or stability” solely for financial reasons, according to a 2001 article on the act by researcher and emergency medicine physician Joseph Zibulewsky.
“Although only 4 pages in length and barely noticed at the time, EMTALA has created a storm of controversy over the ensuing 15 years, and it is now considered one of the most comprehensive laws guaranteeing nondiscriminatory access to emergency medical care and thus to the health care system,” Zibulewsky wrote.
As such, it was unclear whether Reagan or the lawmakers who backed EMTALA considered the act’s broader impacts. However, as the law clearly states that hospitals who accept Medicare payments must treat any individual for emergency medical conditions, it is accurate to say Reagan signed the legislation giving undocumented immigrants the right to emergency health care in the United States.
For further reading, Snopes previously debunked the Republicans’ claim that Democrats forced a government shutdown over free health care for people without legal immigration status, including a talking point related to the law on emergency care.
