Over the last year, the newly enacted federal No Surprises Act protected 9 million insured people from surprise medical bills from out-of-network hospitals and air ambulances. But neither the new federal law, nor a Texas law that passed in 2019, protects patients from ground ambulance surprise bills. Each year, millions of insured patients who use ambulances are at risk of receiving an expensive out-of-network balance bill from the ambulance company. To provide a closer look at the problem, the U.S. PIRG Education Fund released a new report, “EMERGENCY: the high cost of ambulance surprise bills,” this week. 

In Texas and six other states, more than two-thirds of emergency ground transports could result in a balance bill, which can be pricey for those already dealing with a medical emergency. Nationally, ambulance surprise bills carry a median out-of-pocket charge of $450. It’s even higher in Texas where the median patient charge is $656.

In December 2021, Rachel Carnahan’s three-year-old daughter had to be rushed to the hospital in an ambulance after a fall. “She was thankfully OK,” said Carnahan, “But then, we got a bill for $1,082 from the ambulance company and we had to pay more than a thousand of it out of pocket because the city EMS doesn’t take insurance. We’re already tapped out financially and trying to buy our loved ones Christmas presents. This is the last thing we need and it’s just unfair.”  

Carnahan, a social worker at a children’s hospital, noted that this travesty played out even though she has a robust health insurance plan. “I just can’t understand why we have to pay this bill.” 

In 2021, the Texas Senate passed SB 999, prohibiting surprise ground ambulance billing of consumers by out-of-network providers and non-network providers, but the bill died in the House.