Texas is considering higher Medicaid reimbursement rates for ambulance services, with state officials reviewing a proposal that providers say could improve access to emergency medical care, particularly in rural areas.
During a public rate hearing Tuesday, ambulance providers supported the Texas Health and Human Services Commission’s proposal to increase reimbursement for certain services by up to 50%. If approved, the new rates would take effect in September.
“The proposed rates reflect the first meaningful adjustment to Medicaid reimbursement in nearly 17 years,” said Michael Furrh, president of the Texas EMS Alliance Board of Directors. “Adjusting Medicaid rates as proposed will improve the sustainability of EMS and ensure that most vulnerable Texans can continue to access high-quality, 911 medical response and ambulance transport.”
The proposal comes as the commission weighs cuts to other Medicaid services, including several medical supply programs.
State data show that nearly 95% of Texas counties contain areas classified as “ambulance deserts,” where residents are at least 25 minutes away from an ambulance station. Emergency medical service agencies also continue to recover from staffing shortages linked to the COVID-19 pandemic.
Eric Maloney, fire chief in Kerr County, said the Kerrville Fire Department provides emergency medical care across a 1,000-square-mile area and has experienced rising operating costs over the past decade, including expenses for staffing, fuel and equipment.
“These rising costs did not get matched by reimbursement rates, placing strain on our ability to maintain reliable and timely emergency medical services,” Maloney said.
Maloney added that the proposed increase acknowledges the needs of rural communities, where providers often cover larger territories with fewer resources, face recruitment challenges and serve more uninsured patients.
Texas has recorded 14 rural hospital closures in the past decade, and more than half of the state’s 154 remaining rural hospitals are considered at risk of closing. Officials warn that federal policy changes affecting hospital funding could increase that number.
Brett Coghlan, president of the Texas Ambulance Association, said ambulance providers play a central role in the state’s health care system.
“The new Texas Medicaid ambulance reimbursement rate would be a meaningful and immediate step towards stabilization of ambulance services across the state,” Coghlan said during the hearing. “This change will help preserve access to emergency care, particularly in rural and underserved communities where providers are operating on extremely thin margins and in some cases facing the risk of severe service reduction or closure.”
Rachel Harracksingh, director of the Texas Ambulance Association, urged the state to consider annual adjustments tied to inflation to prevent long gaps between rate increases.
“We don’t have a choice when it comes to providing service, especially if we’re doing 911,” Harracksingh said. “We pick up patients regardless of their ability to pay.”
