Ambulance Services NAICS 621910

Nov 13, 2025 - ACA Insurance Premiums May Increase Significantly

• Affordable Care Act (ACA) premiums for 2026 may increase significantly because enhanced premium tax credits are set to expire at the end of 2025. Any transportation by ambulance must be covered under the ACA, but ambulance services may be negatively impacted if patients refuse services because they cancelled their insurance policies due to affordability issues. The credits were a key flashpoint fueling the month-long federal government shutdown, according to Investopedia, but a November 12 deal to reopen the government only pushes a decision on ACA premium tax credits to December. The expanded credits, first introduced by the Biden-era American Rescue Plan, increased the previous subsidy amount and eliminated the eligibility income cap. The credits are commonly credited with making Obamacare plans cheaper, doubling signups, and driving the uninsured rate to record lows, according to Investopedia. Center on Budget and Policy Priorities researchers found that without the enhanced premium tax credits, an average ACA enrollee will see their out-of-pocket premiums more than double, spiking by $1,000 a year. People in their sixties with middle incomes could pay $25,000 more.
• Seventeen US states had an ambulance provider tax in place in 2024, up from 15 in 2023, according to health policy research organization KFF. An ambulance provider tax is a tax levied by a state on ambulance services to help fund the state’s Medicaid program. Ambulance provider taxes enable states to draw down additional federal matching funds for Medicaid services, which may result in higher reimbursement rates for ambulance services. The higher reimbursements may partially or fully offset the tax on the ambulance services.

• President Trump has signed into law the $3.4 trillion One Big Beautiful Bill that is estimated by Healio to include $930 billion in Medicaid cuts over 10 years. Medicaid covers emergency ambulance services when provided by providers licensed by the state, according to the US Department of Health and Human Services. Nearly 12 million more people may be uninsured by 2034, with many losing coverage because of the Medicaid provisions in the bill, according to a US Congressional Budget Office analysis. For the first time in the Medicaid program’s nearly 60-year history, certain able-bodied adults aged 19 years to 64 years will be required to work, participate in job training, volunteer, or enroll in school at least 80 hours a month to maintain their Medicaid benefits. This will also be required for parents of children aged 14 years and older.
• Ambulance service industry employment increased moderately and average wages for nonsupervisory employees increased slightly during the first seven months of 2025, according to the US Bureau of Labor Statistics. Ambulance service industry sales are forecast to increase at a 5.76% compounded annual rate from 2025 to 2029, faster than the growth of the overall economy, according to Inforum and the Interindustry Economic Research Fund, Inc.