Why I Voted for the Ambulance Reimbursement

It is simply unfair to ask our taxpayers to pay for ambulances while we give insurance companies a free ride.


On May 15, I voted along with five of my colleagues (a 6-3 vote) in favor of , services which are now supported by Montgomery County taxpayers.

Ambulance service is commonly covered by insurers. Medicare and Medicaid cover it. So do major private insurers including the BlueCross BlueShield Service Benefit PlanCareFirstKaiser PermanenteUnited HealthcareGovernment Employees Health Association, the Maryland Health Insurance Plan and many more.

If you have any of these plans, you are paying for ambulance coverage now, in your premium. But the county isn’t billing the insurers for it. The insurers are just keeping the money that they collect by charging you for the coverage.

Most surrounding jurisdictions bill insurers, including Prince George’s County (which collects $11.5 million a year), Fairfax County ($15.5 million) and the District of Columbia ($20 million). Most Maryland jurisdictions also bill insurers.

Our county government estimates that we are leaving more than $17 million on the table by not charging a reimbursement. It is simply unfair to ask our taxpayers to pay for ambulances while we give insurance companies a free ride.

Opponents of the reimbursement argue that residents will be so frightened by the prospect of paying for service that they will not call for help in an emergency. The fire chief for Prince William County (VA), which charges a reimbursement, rebutted this allegation in testimony to our County Council. He said: “This is simply unfounded and I can tell you that Prince William County has not experienced any decline in EMS incidents. In fact, we’re having an increase in EMS call volume consistent with our population.”

The fire chief for Anne Arundel County, which also collects a reimbursement, testified, that “There has been no reduction in call volume consistent with the introduction of the Fee for Service program. In fact, our call volume continues to increase at the steady rate of approximately 5 percent per year. In the three years since the program started, no county resident has paid any money out of pocket for an ambulance transport when transported by a county ambulance.”

Nevertheless, many Montgomery County voters believed residents would be directly billed for ambulance service when they rejected a reimbursement law in 2010, when I was first elected to the council. That is why I added the following language to the new law:

Section 21-23A(f)(1) and (2)

County residents must not be required to pay any out-of-pocket expense relating to any emergency medical services transport because residents are deemed to have paid any co-payment, deductible, or uninsured portion of the cost of each emergency medical services transport through taxes paid to the County. Tax revenues the County receives must be treated as payment, on behalf of County residents, of the balance of each resident’s portion of the emergency medical services transport reimbursement charge that is not covered by the resident’s insurance.

This language guarantees that county residents will never pay out of pocket. Only insurers will pay.

With this protection in place, I believe the primary question is: Who should pay the approximately $17 million in fire and rescue services this fee would cover? Should it be residents? Local businesses? Or insurance companies?

Residents who are in tune with the tax increases and spending cuts we have had to make in recent years know that the County Executive and County Council are not crying wolf about our fiscal difficulties.

I understand that the voters rejected a reimbursement law at the ballot box two years ago. Supporting this new law is not a position I take lightly, but I believe fully that I am doing just what I was elected to do—make sound decisions to benefit the whole community and not back down in the face of adversity.

This bill may also go to referendum, where the voters can reconsider the issue. I am confident that when voters understand that this new law protects them from paying any bills or fees, they will support it.

I hope you will, too. I welcome comments on my blog or my Facebook page.

This post is contributed by a community member. The views expressed in this blog are those of the author and do not necessarily reflect those of Patch Media Corporation. Everyone is welcome to submit a post to Patch. If you'd like to post a blog, go here to get started.

jag May 19, 2012 at 06:35 PM
"and are you going to help us when the insurance company argues that the ambulance ride was unnecessary - because you didn't die after all - and refuses to reimburse us for the ride?" Jim, you don't pay for the fee and then seek reimbursement from your insurer. If you have insurance that covers ambulance transportation then the county files a claim for your insurer to meet their financial obligation. It drives me nuts to think about the 100+ million dollars the county has neglected to claim over the years and instead needlessly taxed me for the service. I assume all our neighboring counties in VA and MD as well as DC handle the collections the same way. That'd be awful if those residents have to fill out the paperwork for claims. Dealing with insurers sucks.
ED May 22, 2012 at 12:18 AM
I have yet to see anyone bring up their car insurance or their home owner's insurance - both of which rates are set by your location. Some of the first questions at any hospital are "was this a car accident", "was this a workman's comp accident", "did this happen at a home"? Health insurance does not pay for any service that may be covered under another policy. I agree that this should not have been introduced after a recent referendum. I was appalled when Nancy Floreen stated "I checked my health insurance policy and it was covered" or when Councilmember Rice stated that his father read the newspaper and supported the fee when it came to referendum, but his mother watched TV and opposed it. Does the Council really think the voters are complete idiots that can not be trusted? If that is true, how did they get elected - by idiots? Councilmembers Andrews, Berliner, and Leventhal are the only Councilmembers that gave the voters any respect. I have a lot of problems with this fee and can only hope it comes up as a referendum again. Unlike some of our Councilmembers, I will respect whatever the majority of voters want - although I may decide to leave because all of these taxes and fees are just not worth the services I receive.
Up Is Up May 25, 2012 at 05:20 PM
Actually the fire and rescue costs were a part of our tax base, unfortunately the overspending in the county has created a deficit and now they blame the insurers. You must respect a referendum, I voted for the tax originally, however it was voted down, live with what the voters have declared. If you want to charge the insurance company, then please give the 18M back to the voters in tax rebates. The county needs to find ways to cut spending, plain and simple. Hans Riemer did not get the message. If you think insurers will absorb 18M and not change fees you know nothing about insurance. I can tell you from being in business, my insurance costs go up if claims submitted by my employees are greater than my premiums. I understand the region concept, but reality is reality.
ilkunta May 25, 2012 at 07:01 PM
up is up :wonderfully said. I have no doubt insurance premiums will now go up since amb fees must be paid.
Online addict May 25, 2012 at 07:45 PM
Go after the insurers! Reimer and the council are doing what is best for all county residents. It would be like having your car totalled and not getting a check from your insurance company because you were afraid your rates would go up. Have to agree that the fire and rescue folks are crying wolf, but I am not so sure what their dog is in the fight; but when they came by my house for the yearly donations they made it seem Iike my ambulance fees would skyrocket but when I asked why, they made lots of non-sensical arguments, which I knew were boilerplate garbage....I wrote my yearly checked, smiled and thought it's a good thing we have a rock-solid County Council to see through the smoke screen....


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