Who should cover ambulance rides?

Behind the sad personal story that KFF Health News opened their piece with, there is an interesting policy question of who should pay for ambulance rides, and what limits should apply. As background, the No Surprises Act "says that for most emergency services, patients can be billed for out-of-network care only for the same amount they would have been billed if it were in-network." However, it appears that ground ambulances were not included in the emergency services covered by the law. As a result, calling for an ambulance ride could trigger an expensive out-of-network bill. Patients do not choose which ambulance service provider is dispatched, and even if patients could select the service, such a choice does not seem practical in light of an emergency.

It seems that 20 states have legislated patient protection against surprise out-of-network bills for ambulance services, but the other states have not. One concern is that "forcing insurers to pay more would lead to higher health coverage costs for everyone." It is probably the case that such policy of requiring insurers to cover ambulance rides would not lead to an immediate and massive jump in premiums, but there remains the policy question of whether the change might cause people to become too cavalier with expensive rides. Still, patients delaying emergency room treatments out of a fear of financial costs may cost the system even more.