Picture this: you’re walking out of the grocery store and you miss the curb, stumble and with grocery bags in hand, you can’t catch yourself. You hit your head on the concrete and are dazed and bleeding significantly. An ambulance is called, and you are rushed to a hospital where your head wound is treated and you’re checked for a concussion and other injuries.

A month later, your bill arrives while your brain is still a bit foggy from your severe concussion, and your head wound is still healing. You discover you owe thousands of dollars for your ambulance ride because the ambulance provider was out-of-network with your insurance.

This is the reality for hundreds of Coloradans who have sought out ambulance services in Colorado.

A recent study found that more than half of ground ambulance rides result in surprise bills, with patients paying an average of $435 out-of-pocket, more than three times the cost of in-network rides. Patients are often left with surprise out-of-pocket bills that are much higher: a Denver resident was saddled with a $1,500 bill after a health emergency in 2023.

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When Colorado and our federal leaders were passing surprise billing laws, public ground ambulances, interfacility transfers and non-emergency ambulance rides were left out. This leaves patients vulnerable at their most fragile moments, leading to crushing medical debt and delaying care. No one should be forced to make the choice between seeking care or financial devastation.

Our legislators are working to close that loophole with House Bill 25-1088, expanding on surprise billing protections to include all ground ambulance transports and protecting Coloradans. This bill ensures patients with state-regulated plans are protected from balance billing and makes sure your health insurance does its part, and ambulance providers are reimbursed at a reasonable rate.

Ground ambulances are a vital, often lifesaving part of our health care system. Yet, they also face unsustainable funding gaps, with only 39% of their costs covered by billing revenue, relying on taxpayer funding or volunteer labor to make up for the gap. Rural ambulance services, in particular, are struggling to survive.

You don’t get the luxury of choosing an ambulance provider in an emergency; it’s unreasonable and unrealistic to put the onus on patients to decline care during an emergency or when a provider says they need to take an ambulance. The existing loopholes put providers and patients in a tough place. Patients should not be hit with large, unaffordable bills when they’re already vulnerable and cannot control the situation, and ambulance providers need to be paid fairly to be sustainable.

In Colorado alone, out-of-network ambulance charges forced consumers to shoulder nearly $16 million in costs in 2022. That’s millions of dollars taken directly from the pockets of Colorado families who were simply trying to get the care they needed.

No one should hesitate to call 911 because of fear about what the ride might cost or be hit by a surprise bill because they were transferred between facilities by ambulance, based on the doctor’s orders. These situations are hard enough. Surprise bills make them that much worse. Our legislators have the opportunity to fix that for Colorado families with HB25-1088. For the sake of Coloradans, we hope they will.

Priya Telang is communications manager at Colorado Consumer Health Initiative.