The proposed ER Utilization Program is disrespectful to emergency physicians who stabilize and treat all manner of urgent and life-threatening conditions, as required by EMTALA law, as well as to patients who are expected to manage their own care with insufficient outpatient support and self-diagnose emergent vs nonemergent conditions. The "preventable" diagnoses list include codes for severe asthma with exacerbation and diabetic ketoacidosis, which are not only frequently seen and treated in the ED, but often admitted. If these patients do not get emergency care, they would likely die. Other codes on the list include Bell's Palsy, which a prudent layperson would likely assume to be a stroke, and thus warrant emergency evaluation. Another is right lower quadrant abdominal pain, which would raise concern for appendicitis in both laypeople and physicians, until proven otherwise by a full ED evaluation. Other codes include poisoning in pregnancy, projectile vomiting, and various abscesses - where should patients go to have these problems attended to, if not the ED? How are any of these visits preventable? Hospitals and physician groups who primarily serve Medicaid populations will be significantly affected by reduced rates, which would have a huge negative impact on their ability to serve their patients, further widening the equity gap in medical care. Don't cut reimbursement for the providers who care for the least well-off in society.