Here is a piece of the health care system most people never think about until they're the one being loaded onto a stretcher: right now, an ambulance generally only gets paid if it takes you somewhere. Treat you on your living room floor, stabilize you, decide you're fine to stay home — and the crew has done the right thing for free. Drive you to a hospital you didn't need, and the meter runs.
HB26-1069 is an attempt to fix that backwards incentive, and on Tuesday it cleared Senate Appropriations on a party-line 4-3 vote, sending it on to the full Senate.
Sen. Kyle Mullica (D-District 24), one of the bill's Senate sponsors and himself a familiar face in Colorado's emergency-medicine world, didn't undersell it. "I actually Think. I think this is one of the more underrated bills of the session, of the impacts that can have on healthcare and the cost of healthcare," he told the committee. "Unfortunately, the plans did push back, and so we made that amendment."
The amendment he's referring to, J002, narrowed the bill to Medicaid only, removing private insurance from the reimbursement change — as described in committee, a concession after insurers objected. With that change, the fiscal note stayed at $0, which is the kind of number that tends to keep a bill alive in an appropriations room.
Beyond the ambulance-payment piece, the bill defines a 'first responder' to include peace officers, firefighters, volunteer firefighters, emergency medical service providers, and mental health professionals responding in a professional capacity to a justifiable medical emergency. It also shifts the emergency medical and trauma services advisory council from *approving* new state rules to *recommending* them before the state board of health acts. And beginning January 1, 2027, it directs the Department of Health Care Policy and Financing to reimburse ambulance services for ground transport, for on-scene treatment that doesn't end in a transport, and for telemedicine evaluations aimed at avoiding an unnecessary hospital run.
The Republican no votes — Sen. Barbara Kirkmeyer (R-District 23), Sen. Larry Liston (R-District 10) and Sen. Byron Pelton (R-District 1) — reflected the recurring worry that ran through the afternoon's docket: out-year costs and whether the fiscal notes tell the whole story.
Kirkmeyer worked through a hypothetical to test the edges of the new billing rules — a child hit by a softball whose parents don't call an ambulance — and asked whether a patient could end up billed even without being transported anywhere. Mullica answered that some service or care would have to be provided before a bill could be generated, and, rather than misspeak on the specifics, offered to follow up with a firmer answer.
The bill is sponsored in the House by Rep. Lisa Feret (D-District 24) and Rep. Katie Stewart (D-District 59), and in the Senate by Mullica and Sen. Cleave Simpson (R-District 6). The committee voted to refer it to the Committee of the Whole; the yes votes came from Sen. Julie Gonzales (D-District 34), Sen. Chris Kolker (D-District 16), Sen. Jeff Bridges (D-District 26) and Sen. Judy Amabile (D-District 18).
As of now, HB26-1069 has become law — meaning the underrated bill made it all the way through.