Air Ambulance Bill Vetoed in Texas Despite Near Unanimous Support in Legislature

The legislation was inspired by a $55,000 air ambulance bill.

The legislation was inspired by a $55,000 air ambulance bill. Phil Whitten/Shutterstock


Connecting state and local government leaders

STATE AND LOCAL ROUNDUP | Wisconsin governor prohibits direct Tesla sales … Cuts to Alaska court system over abortion rulings … Former Michigan Gov. Rick Snyder turns down Harvard fellowship.

A Texas bill that passed 140-7 in the House and unanimously in the Senate was vetoed by Gov. Greg Abbott. The bill, introduced by Republican state Rep. Drew Springer, would have required air ambulance companies to enter into reciprocity agreements with each other, in an effort to prevent patients from receiving expensive bills for the service. The bill was inspired by Butch Nuding, a resident of Springer’s district, who purchased air ambulance coverage with a company that operated in rural areas of the state. When a relative needed an air ambulance, a different carrier was sent, and the family was billed $55,000. The reciprocity bill would require companies to honor the memberships that people requesting air ambulances have with other companies. “For most people a $50,000 surprise is a life-changing, unfortunately in a bad way, event. So we were looking at trying to figure out how to remedy that and help people,” said Springer. In his veto statement, Abbott said that the proposal would “unnecessarily intrude into the operations of private businesses and could very well reduce the availability of products that protect rural Texans from expensive air ambulance bills.” But the issue of air ambulance costs is raising national attention. Gerard Anderson, a professor of health policy and management at Johns Hopkins, said that there are “virtually no cost controls” on a system where the median charge per mile is $238. For families in rural areas far from hospitals, that can add up to a lot. "[Companies will] keep raising the price until there is a response. Maybe Congress will do something. Until that happens, you continue to raise your price because there are no constraints,” Anderson said. The industry trade group, the Association of Air Medical Services, said that underpayments for air ambulance services are forcing rates higher. “To preserve the ability of air medical services to provide access to critical levels of health care for millions of Americans, rates are raised to cover the losses incurred by providing services to Medicare, Medicaid, and uninsured patients,'' AAMS said. [KMID; Washington Post]

TESLA SALES | Wisconsin Gov. Tony Evers vetoed a provision in the state budget that would have allowed the car company Tesla to sell its vehicles directly to consumers without using dealerships. This is the third time such a measure has failed. Republican state Sen. Chris Kapenga included the provision, and while he owns a business that repairs Tesla, he argued that it is a hobby, and therefore not a conflict of interest. Instead, Kapenga called the provision a free-market reform that is necessary because “state law, which originates back to the 1930’s, prevents them from doing business here. This forces customers to drive to Illinois or Minnesota just to purchase or service their vehicle.” Gov. Evers said he rejected the Tesla provision because it represented “significant changes to existing motor vehicle dealership law and the consumer protections they provide to Wisconsin occurring late in the state budget process and without the opportunity for adequate public input and debate.” Tesla said that they “are disappointed Governor Evers acted against consumer interest...though our vehicles can still be purchased online, this decision hampers Wisconsin’s ability to impact climate change, bring jobs and revenue to the state, and clean up transportation pollution in our communities.” [Electrek; Milwaukee Journal-Sentinel]

ABORTIONS IN ALASKA | Alaska Gov. Michael Dunleavy cut $334,700 in funding to the Alaska court system due to rulings by the state Supreme Court that found the state is required to fund abortions not necesitated to save the life of the mother. “The Legislative and Executive Branch are opposed to State-funded elective abortions; the only branch of government that insists on State-funded elective abortions is the Supreme Court. The annual cost of elective abortions is reflected by this reduction,” reads a document from the Office of Management and Budget. Margaret Newman, a spokesperson for the Alaska Court System, said that judges will not be pressured by “the politics of the day” in response to the governor’s veto of their budget. “Legislators, governors, and all other Alaskans certainly have the right to their own opinions about the constitutionality of government action, but ultimately it is the courts that are required to decide what the constitution mandates. We assure all Alaskans that the Alaska Court System will continue to render independent court decisions based on the rule of law,” she said. The Alaska Supreme Court is now asking the state legislature to override the governor’s veto. [Must Read Alaska; KTUU]

HARVARD FELLOWSHIP UPDATE | Following backlash on social media over his appointment to a fellowship at Harvard’s Kennedy School of Government, former Michigan Gov. Rick Snyder has decided not to take the position. In a tweet, Snyder, a Republican, said that he would have liked to share his positive and negative experiences in government with students, but “our current political environment and its lack of civility makes this too disruptive. I wish them the best.” A Kennedy School lecturer, Timothy P. McCarthy, criticized the former governor’s use of the word civility. “Respect is one thing. Silence is another. And I worry that civility has become a weapon that is being used by people in power to silence those of us who speak truth to power,” he said. Harvard students and faculty had launched an online petition to revoke the fellowship, decrying Snyder’s leadership during the Flint water crisis. Over 20 lecturers from the Kennedy School also wrote a public letter asking for the school to reconsider the appointment. Kennedy School Dean Douglas W. Elmendorf wrote a letter to students saying that he “anticipated that students would have learned from engaging with and questioning Governor Snyder about his consequential role in decisions regarding Flint...but we and he now believe that having him on campus would not enhance education here in the ways we intended.” [Harvard Crimson; Boston Globe; Washington Post]

REFUGEE RESETTLEMENT | On the Fourth of July, New Jersey Gov. Phil Murphy announced that the state would resume oversight of refugee resettlement, three years after former Gov. Chris Christie said his administration would not participate in resettlement efforts, ceding control to the International Rescue Committee. Murphy also signed an executive order creating the Office of New Americans, designed to help immigrants and refugees make their homes in the state. “Immigrants are an integral part of our state, and enrich our communities socially, culturally and economically. Through these new measures, we will continue to sustain our progress to build a fair and inclusive state for all,” Murphy said. The moves are in line with many of Murphy’s actions over the past 18 months that have sought to reverse Christie-era policies. [; Insider NJ]

Emma Coleman is the assistant editor for Route Fifty.

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