ROCKVILLE — Montgomery County legislators on Tuesday morning rejected a pitch to charge health insurance companies for ambulance services.
In a 5-to-3 vote, county council members decided to keep ambulance rides free for people in Montgomery County, as well as in parts of The District and PG County that sometimes score help from nearby MoCo fire and rescue units (like the one housed on Georgia Avenue). (more…)
County council members on Tuesday announced a bill that would quash MoCo exec Ike Leggett’s proposed fees for emergency medical services.
Instead of charging health insurance companies for ambulance services, which Leggett pitched earlier this year, council member Phil Andrews (D-District 3) proposed to use red-light and speed camera fines to cover the ambulance tab.
“The county executive has posed the ambulance fee as the only way we could fund the purchase of new equipment for the fire and rescue service,” Andrews said in a press statement. “This bill shows a way that we could fund the purchase of much-needed equipment without implementing an ambulance fee, which most people in this county do not want.”
Under state law, MoCo must use speed-monitoring revenue on new public-safety programs, not to cover existing expenses. However, Andrews’ proposal would use half of that revenue to buy new gear for fire and rescue services. A quarter of it would go to countywide pedestrian-safety programs; 15 percent to the PD’s traffic-safety programs; and 9 percent to municipal pedestrian-safety programs.
It’s unclear how much money those speed- and red-light cameras haul in each year, though individual snapshots cost speed demons $40 each; red-light runners catch a $75 fine. Under Leggett’s plan, health insurance companies would be hit with a bill of $300 to $800 for each ambulance trip; uninsured patients roll for free.
According to Leggett’s advocates, health insurance companies already charge policy holders for ambulance services, and the county would be collecting nearly $15 million that’s already been paid for. Opponents worry that fees would dissuade the uninsured from dialing 9-1-1 during an emergency.
Council member Don Praisner (D-District 4), who sits on the public-safety committee with Andrews and at-large Dem Marc Elrich, previously dumped on Leggett’s pitch. Insurance forms could confuse patients, he said. On the flip side, Elrich said the county was stuck between a rock and a hard place.
“Everyone needs to take a sober look at where the county budget is,” Elrich told his colleagues last month.
The council’s public-safety committee takes its licks at Andrews’ idea on Dec 4.
Photo courtesy of the MoCo PD.
ROCKVILLE — Last Thursday morning, the County Council’s Public Safety Committee held a worksession to discuss the proposed new ambulance fee. A procedural meeting, the Committee heard that the Fire and Rescue Commission had voted 4-3 to oppose the measure. They received technical amendments to the proposed legislation from Ike Leggett’s office. And they got answers to questions they had posed to the Executive after their July 24 worksession on the bill. On hand were representatives of volunteer rescue squads in Montgomery County.
Fire and Rescue Commission chair Kevin Maloney reported that at the previous night’s meeting, his commission had narrowly voted 4-3 to oppose the measure. “This process worked,” he said. “Maybe the outcome didn’t come out the way some wanted, but the process worked. . . It didn’t become a fractious discussion; it was a positive discussion.”
Next up: a delegation from the County Executive’s office. Leggett’s office had sent along a series of proposed amendment to the measure. According to Deputy County Attorney Marc Hanson, it seems that the original language of the bill would have actually allowed private insurers to refuse to pay claims for ambulance fees. It took a letter from private insurer GEHA to point this out.
Leggett’s office offered amendments that make explicit an assumption that had been embedded in the measure: that County residents’ taxes are being treated, in essence, as “prepayments” for any ambulance fees the County might impose. This follows a similar system already in place in Columbus, Ohio, according to Kathleen Boucher, the County’s assistant chief administrative officer.
At their July 24 worksession on the proposed ambulance fees, the Public Safety Committee had asked Leggett’s office a few questions. Among other questions, the Committee had asked about the possibility that imposing an ambulance fee would discourage people from using the ambulance when they need it. Opponents of the measure have pointed to this as a key argument.
According to attorney Ted Wolfberg, who is working on this issue as outside counsel for the County, this is a “laudable and legitimate policy debate.” But the studies opponents cite don’t actually support that position. While the studies do point out that income affects health care use, he reported, the studies don’t make a connection to ambulance fees.
Council Member Marc Elrich said, “I agree with how you read these studies, they just don’t indicate that fees have a deterrent effect. . . . If you do not have insurance . . . the magnitude of the ambulance fee is just a small portion of what you’re about to be hammered with. . . . people will still be afraid of going to the emergency room because if you don’t have insurance, you’re in deep, deep trouble.”
Council Member Don Praisner agreed, “I think this question is irrelevant. Neither side can prove to me [what will happen].”
However, John Bentovoglio, counsel for the Bethesda Chevy Chase Rescue Squad, pointed out that in Fairfax County, the year they imposed an ambulance fee — ambulance calls went down. “We are concerned about [the fee's] impact on people,” he said.
Council members expressed the most concern about what the possible paperwork and other administration might look like. “The devil is in the detail in this thing,” said Elrich.
Committee Chair Phil Andrews said that there would also be one more worksession — “which may be the final one” — at which the committee will get into the fiscal assumptions behind the bill, and just how efficient an ambulance fee will be at raising revenue.
Brad Rourke is publisher of Rockville Central.
Copyright (c) 2008 by Rockville Central. Reprinted with permission. Images courtesy of Flickr users Greger010977 and London Mummy.
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