Air ambulance service agreement nixed by Texas Governor

AUSTIN (Nexstar) — Butch Nuding calls it “aggravating.” A proposal in the Texas Capitol that he inspired died at the Governor’s desk.

In 2016, his brother’s grandson, six years old at the time, was hurt falling off a slide and needed to be airlifted from the small West Texas town of Aspermont to a hospital in Lubbock.

“(He) landed on his head and fractured his skull and had two bleeding spots on his brain,” Nuding said.

The Nudings had previously purchased three different versions of coverage with an air ambulance company that operates in rural regions of the state. But despite the family’s memberships, the helicopter service did not show up.

“They sent another carrier and they picked the boy up and took him to Lubbock and they billed my niece’s family $55,000 for the trip,” Nuding explained.

Luckily, insurance paid the bill. But Nuding knows many families would have difficulty paying out thousands in air ambulance costs. He called his state representative to see what could be done.

“For most people a $50,000 surprise is a life-changing, unfortunately in a bad way, event,” State Rep. Drew Springer, R-Muenster, who represents the region Nuding lives. “So we were looking at trying to figure out how to remedy that and help people.”

Springer introduced House Bill 463, which would require private air ambulance companies to enter into reciprocity agreements.

“If you have one membership and another company sells a membership they have to honor that,” Springer explained.

The bill passed both chambers, first in the House, 140-7, and then unanimously in the Senate.

Gov. Greg Abbott vetoed the bill on June 15. In his veto statement, Abbott said the proposal was well-intentioned, but 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.”

“The Legislature and the federal government should find better ways to address the high costs of air ambulance services,” Abbott wrote. He also worried the implementation of the plan “likely runs afoul of federal law and could have unintended consequences.”

No major concerns were outlined in the bill’s legislative analysis.

While Abbott alluded to disruption of a free market economy, Springer said public safety should take priority.

“That’s where I would probably disagree with the Governor on, because when you’re upside down in your car and EMS is calling somebody to come get you, you may not even be coherent so you can’t say no I don’t have ‘XYZ’ send me ‘ABC,'” Springer said.

State Sen. Donna Campbell, R-New Braunfels, was one of the sponsors of the bill in the upper chamber.

“There’s a true problem and a false sense of security if a member thinks ‘if something happens to me a helicopter is going to come and take me to the health center or the trauma center’ and that may not be the case,” she said. “That was great cause of concern. I think that that went a long way to being the reason they had this bill.”

Campbell, an emergency room doctor, said requiring reciprocity agreements would prevent additional costs to the patient.

“As a physician it’s critical to get someone to the hospital quickly,” she said. “As an elected official, it’s my… responsibility to make sure that if an expectation by a large membership is that they will have a helicopter be able to take them out at a critical time, that the company is able to provide that.”

“I think we saw a mismatch there,” she said.

The legislation would have required coverage to be recognized in the county of the emergency, and not just the county of residence.

“Your membership fee will probably go up somewhat, maybe it goes up 50%, but if you’re paying $100 a year and now you go to paying $150 I think that is well worth it versus taking that one in five chance of being bankrupt if you have that $50,000 extra expenditure,” Springer added.

Nuding said the air ambulance company told him their pilot had reached maximum time on shift, forcing them to call in another carrier. The Federal Aviation Administration regulates pilots and sets limits on how long a pilot can be on the clock.

“If I’m in a car wreck and there’s only one ambulance in Stonewall County, does that mean that Kent County can’t send an ambulance to pick me up,” he said quizically. “You get someone to the hospital the fastest and the quickest way you can to save lives.”

Springer said he planned to refile the legislation and work with the governor’s office on the language.

The Nudings have since cancelled their air ambulance coverage.