Addressing Boarding and Crowding in the Emergency Department
HB2936, the “Addressing Boarding and Crowding in the Emergency Department Act of 2025” or “ABC-ED Act of 2025,” would expand the uses of certain public health data modernization grants so states or regions can build real-time or near-real-time systems to track hospital bed capacity. The bill specifically targets how bed availability affects emergency department boarding, emergency wait times, and the time EMS personnel spend waiting to transfer patients, and it would also require a public-facing dashboard of the tracked information, subject to privacy laws.
The bill also directs the Centers for Medicare and Medicaid Innovation to include pilot models focused on improving emergency care for older adults and for individuals experiencing an acute psychiatric crisis. Those models could support staffing and training changes, emergency department infrastructure changes, geriatric-focused protocols, coordination with post-acute care facilities, dedicated psychiatric emergency units, and faster transfers or placement into appropriate facilities. In addition, the bill requires the Comptroller General to study best practices for hospital-capacity tracking systems and report to Congress within one year on their design and effects.
The bill would amend the Public Health Service Act to authorize grant and cooperative agreement funding for expanded public health data systems focused on hospital capacity, and it would amend the Social Security Act to require CMS innovation pilots addressing emergency care for older adults and psychiatric crisis patients. It would also create a GAO study and reporting requirement on hospital-capacity tracking systems, potentially influencing how states, hospitals, EMS agencies, and public health departments collect, integrate, and publish capacity data, especially for emergency departments, ICUs, psychiatric services, and skilled nursing facilities.
Based on the bill text and the absence of recorded committee debate or votes in the provided materials, the bill appears to have a generally pragmatic, bipartisan public-health orientation. Its sponsors frame it as a response to emergency department boarding and crowding, with an emphasis on data modernization, care coordination, and operational improvements rather than broader regulatory change. The inclusion of both hospital capacity tracking and targeted CMS pilots suggests a constructive approach aimed at improving patient flow and emergency care outcomes.
The main areas that could generate debate are the scope and cost of building real-time, interoperable capacity-tracking systems, the burden on hospitals and public health agencies to maintain accurate data, and privacy concerns around public-facing dashboards even with redactions. There may also be differing views on federal involvement in hospital operations and whether CMS pilot models should prioritize older adults, psychiatric crisis care, or both. Stakeholders likely to have the most interest include hospitals, emergency physicians, EMS providers, state health departments, geriatric care advocates, behavioral health providers, and privacy advocates.