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Despite nearly 114 million emergency department (ED) visits each year--an increase of more than 26% from a decade ago--hundreds of EDs closed during the past 10 years. The result: an even greater strain on those EDs that remain open. To shed light on this problem, the American College of Emergency Physicians (ACEP) rallied 4,000 emergency physicians and nurses at the U.S. Capitol on September 27 to urge Congress to preserve access to emergency care for all Americans. According to ACEP, hundreds of EDs have closed, causing Americans to lose access to care due to ED crowding, ambulance diversion, an increased on-call staffing burden, high professional liability insurance, and rising numbers of uninsured and underinsured patients (see the July PCR for additional information).