Insurers Challenge State Laws Limiting Surprise Ambulance Bills

In recent years, efforts to protect consumers from unexpected healthcare costs have faced resistance from insurance companies, especially concerning surprise ambulance bills. Families like Nicole Silva's, whose daughter was involved in a severe car accident, often find themselves unexpectedly burdened with hefty ambulance charges. Silva's daughter, who was transported via ground ambulance, then air ambulance, and later another ground ambulance, faced a bill of over $3,000, despite being covered by Medicaid. Such bills are frequently sent to debt collectors, and the financial strain can be overwhelming, pushing families into debt or wage garnishment.

Recognizing this issue, some states have enacted laws to curb surprise ambulance billing. These regulations aim to set limits on what insurers are required to pay for emergency transportation services, particularly ground ambulance rides, which are not covered under federal protections like the No Surprises Act. While 19 states, including Utah and North Dakota, have passed protections, legislations in places like Colorado and Montana have faced hurdles. Colorado’s initial effort to extend protections to public ambulance services was vetoed by Governor Jared Polis, mainly due to concerns about increasing premium costs.

The challenge stems from the complexity of ambulance service operations, which include private firms, volunteer fire departments, and public entities, making regulation and rate-setting complicated. Insurance trade groups like AHIP argue that establishing minimum reimbursement rates could inflate healthcare costs and premiums. Conversely, consumer advocates emphasize that surprise bills disproportionately affect vulnerable populations and can discourage individuals from seeking emergency care.

Federal lawmakers have struggled to address ground ambulance billing comprehensively. Although the No Surprises Act offers protections for air ambulances and in some hospital settings, it does not cover ground services due to data gaps and varied business models. An advisory committee recommended solutions that prioritize patient protection, but legislative action remains limited.

The debate continues as states grapple with balancing cost control and fair compensation for ambulance providers. Experts highlight the necessity for a nationwide solution to prevent financially devastating bills and ensure equitable emergency healthcare access for all Americans.