LEE COUNTY, Ky. (LEX 18) — Emergency medical services across Kentucky are fighting for survival, as they say inadequate insurance reimbursements are forcing local taxpayers to foot the bill or risk losing ambulance services entirely.
House Bill 447, currently under consideration in the Kentucky legislature, would require insurance companies to reimburse ambulance services at rates set by local governing authorities rather than the lower rates currently paid.
"It needs to pass. Insurance companies do not pay us what they need to be paying," said Trish Cole, director of Lee County EMS. "Medical supplies are going up every year. Equipment is crazy expensive. Fuel, payroll."
She says financial strain has created a staffing crisis that extends beyond individual counties.
"There's a shortage of EMTs and paramedics, and that's no fault of the counties, it's the fault of the insurance companies not paying what is due to us," Cole said.
Lee County Judge Executive Steve Mays says it's an issue his county has been working to address for years.
"I would hate for somebody to call 911 and say we need an ambulance, my dad's having a heart attack, my mom's having a heart attack, whatever, and them saying, we don't have an ambulance. I can't live with that," Mays said.
That nightmare scenario almost became reality in Lee County. In 2024, the fiscal court passed an 8% insurance premium tax to help keep the ambulance service operational.
"We knew it wouldn't be popular, but we had to do it to save the ambulance service," Mays said. "We don't like to do a tax, but this was life or death."
The judge executive says the tax has made a difference so far, but HB 447 would provide long-term relief for EMS agencies statewide.
Some Kentucky counties have already temporarily lost ambulance services. Officials in Lee County say that cannot happen in their community.
"If we don't have an ambulance service, we're talking about calling someone from another county, and it may take them 30 minutes to get here. And minutes matter," Cole said.
Without legislative change in Frankfort, local officials worry about the future of emergency medical services.
"Everybody has to have an ambulance service, you just have to," Mays said.
The judge executive says if House Bill 447 passes, they may be able to lower the insurance premium tax.
However, opponents of the bill have raised concerns about the cost to working families. The Kentucky Association of Health Plans estimates the reform effort could cost a Kentucky family of four around $60 extra per year.
