Calling 911 isn’t something most people plan for; instead, circumstances force us to engage with a system we rarely think about. It’s one of those things we trust will be available, of acceptable quality, and, most importantly, will help us when we need it.

Recently, though, something has changed — people are planning for 911 calls, but not in the way one would expect. They aren’t mapping out the distance from the nearest ambulance station or ensuring their address is visible from the street. Instead, they’re considering alternatives to calling emergency medical services (EMS) because they’re afraid of the bill. Our friends and neighbors, even in life-threatening emergencies, are making decisions not based on their health but on their wallets.

Health care funding can be summarized in one word: complicated. I look forward to someone smarter than me writing a book that explains our so-called health care “system.” EMS agencies are built into this tangled funding structure, and no two systems operate the same way. Some receive partial tax funding, but all rely on billing patients (or, more accurately, Medicare, Medicaid, or patients’ commercial insurance companies) for services provided.

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In health care, providers negotiate with insurance companies to determine agreed-upon rates for services. If no agreement exists, the physician, hospital, or other provider is considered out of network, and patients typically bear more of the cost. This system allows insurers to control costs while giving patients a choice — but at a price.

Here’s the challenge for EMS and all emergency medical care: when someone experiences a medical emergency, they don’t get to choose which paramedics arrive or which emergency department they’re transported to. There isn’t time — when a patient has suffered cardiac arrest, a traumatic injury, or other health crisis — to shop for care. Moreover, local regulations govern which EMS agencies can respond to calls in specific cities and counties.

Since EMS providers are required to treat all patients, and patients have no say in their provider, insurance companies have no incentive to negotiate fair reimbursement rates. The result? EMS agencies are almost always out of network, allowing insurers to pay well below the actual cost of care — leaving patients stuck with the balance. This is surprise billing in action.

Colorado House Bill 25-1088, sponsored by Reps. Karen McCormick and Kyle Brown and Sens. Kyle Mullica and Mark Baisley, aims to fix this problem for both patients and EMS providers. The bill eliminates surprise billing for public EMS agencies while requiring insurers to pay fair, sustainable rates, based on and accounting for the unique costs of operating in different communities.

I encourage all Coloradans to contact their representatives and the governor’s office in support of HB 25-1088. When a medical emergency strikes, the only thing we should be thinking about is getting care for ourselves or our loved ones — not whether we can afford it. Your ability to pay should never determine your access to life-saving care, and HB 25-1088 is a critical step toward making sure it doesn’t.

Brandon Daruna is chief executive of Eagle County Paramedic Services. Daruna serves on the Colorado EMS System Sustainability Task Force, the Northwest Regional Healthcare Coalition Steering Committee, and the board for the EMS Association of Colorado. He is also an executive board member of the Central Mountains Regional Emergency Medical and Trauma Advisory Council (RETAC).