By law, the ER would have to do an initial workup and stabilize her even if she owes them money. They can send it to collections or whatever like any other medical debt but they'd still be required to treat her if she showed up again claiming to be sick. The worst the hospital could really do is refuse to let her see non-ER doctors until her account's paid off.I wonder why someone like her did not buy health insurance during the enrollment period. She spent multiple times at the emergency room lately, and while there is a deductible of a few thousand dollars, this is pale in comparison with the cost of the visits. It has been suggested that she skips on paying the bills, but can you do this forever?
For a bit of a history lesson, part of the logic behind the Romneycare/Obamacare individual mandate was that uninsured people were using the ER in place of a primary care physician because they couldn't be turned away (regular doctors can require proof of insurance or even payment up front) and then skipping out on the bill (which would be recouped by raising prices on everyone else). Unfortunately the results over the past ~10 years have found that ER admissions have either slightly gone up or held steady despite the mandate.