Ambulance Services NAICS 621910

May 6, 2026 - Municipalities Consider Bringing Service In-house

• Some municipalities hope to reduce emergency service costs by bringing ambulance services in-house but the efforts have proven difficult, according to Bridge Detroit. Detroit, for example, would need about $20 million to bring its EMS services fully in-house. Acquisition of more city-owned and operated equipment could take years even if the funding could be identified, officials for the city’s administration say. Detroit Budget Director Donnie Johnson encouraged a plan with a phase-in approach where contracts with EMS services are maintained in the interim. Elisa Malile, chief of staff to the fire department, said that facilities are also a factor in the planning. More space for maintenance and storage will be needed if the city-owned fleet is increased, and the department would have to evaluate building onto neighborhood fire stations.
• The Trump administration’s proposed new rules for Affordable Care Act (ACA) plans would shift more health care costs to Americans in 2027, according to The New York Times. 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 plans would have much higher deductibles that could lead to larger medical bills. People who rely on the Affordable Care Act for their health insurance coverage could choose plans with much lower monthly premiums under the proposal but that could leave them exposed to medical expenses totaling thousands of dollars more than current ACA plans do before their insurance would kick in, according to The New York Times. The proposal would allow one kind of health plan to raise the annual deductible to more than $15,000 for an individual and $31,000 for a family. The individual deductible would be eight times the average for someone with employer-provided insurance.

• 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.
• Ambulance service industry employment and average wages for nonsupervisory employees increased slightly during the first two months of 2026, according to the US Bureau of Labor Statistics. Ambulance service industry sales are forecast to increase at a 5.69% compounded annual rate from 2026 to 2030, faster than the growth of the overall economy, according to Inforum and the Interindustry Economic Research Fund, Inc.