When he was running for office two years ago, Sen. Ted Cruz of Texas insisted that rather than expanding Medicaid, Texas should just let the uninsured get all their health care from emergency rooms. The argument that emergency rooms are an acceptable backup for the uninsured has also been used by Mitt Romney, Heritage Foundation president Jim DeMint and many other prominent Republicans.

But now, some members of the GOP are trying to keep the uninsured from using emergency rooms at all. Georgia Gov. Nathan Deal is pushing Congress to allow hospitals to turn people away from emergency rooms, and Georgia congressman and US Senate candidate Paul Broun – who previously cited ERs to claim that “everyone has access” to health care – has introduced a bill that would allow ERs to treat only patients who they determine have an “emergency medical condition.”

Now, the Madison Project, a Tea Party group that has earned the high-profile backing of Sen. Cruz in its effort to defeat three sitting GOP senators in primaries this year, is also advocating for allowing emergency rooms to turn away anybody not deemed to need immediate emergency care.

In a blog post on the group’s website yesterday, Madison Project policy director Daniel Horowitz writes of taking his son to the emergency room only to encounter a waiting room “full of illegals” (although he doesn’t specify how he knew the citizenship status of his fellow patients), including “adults who, let’s just say, did not look like they were about to keel over.”

My wife and I were entreated to the chaos of emergency room care last night after our two-year-old son slipped while climbing onto a high kitchen counter and banged his head on the floor. He had a massive lump on his forehead and we were concerned about internal bleeding. When we drove to the closest hospital, the waiting room was full of illegals. Most of them were adults who, let’s just say, did not look like they were about to keel over. Opting not to wait all night simply for a decision whether to put our son through a CT scan, we drove for a half hour in the rain to a hospital that was less likely to be full of those who use ERs for regular care. Thank God our son recovered and there was no internal bleeding, but in a different situation that extra time could have been critical. Also, if you ever wonder why you get hosed with outrageous bills simply for stepping foot in a hospital, look no farther than the “undocumented” costs of illegal aliens.

The solution for this, Horowitz concludes, is to allow hospitals “to turn away people from ERs if they do not have an immediate need for emergency care” thereby “solv[ing] the problem of illegal immigrants using ERs for primary care.”

The problems with illegal immigrants and emergency hospital care also provide us with an opportunity to examine true free market healthcare reform. Any GOP healthcare proposal must be predicated not on “replacing” Obamacare, but on fixing even some of the anti-market federal policies that existed before passage of the monstrosity. One of those policies is the mandate on hospitals to treat everyone who comes to an ER – including illegal immigrants – irrespective of whether they are suffering from a real emergency. In 1986, Congress passed The Emergency Medical Treatment and Active Labor Act (EMTALA) as part of the Consolidated Omnibus Budget Recon­ciliation Act (COBRA), which was ostensibly the first act in universal healthcare mandates. If we ever plan to curb skyrocketing hospital costs and improve access to emergency care, we must address this massive unfunded federal mandate of EMTALA. Among the provisions of Rep. Paul Broun’s Patient Option Act, which is one of the best healthcare reform proposals, are some good reforms of emergency and indigent care. Under Broun’s proposal, hospitals would be allowed to turn away people from ERs if they do not have an immediate need for emergency care. This would solve the problem of illegal immigrants using ERs for primary care.

Could it be that Tea Party leaders like Sen. Cruz never actually thought that emergency rooms were suitable alternatives for the uninsured and were instead just looking for any excuse not to expand insurance coverage?