For Immediate Release

May 30, 2025          

For further Information:

Howard Paul — (303) 829-5678 — [email protected]

Priya Telang — (313) 820-2428 — [email protected]

In a move that’s shocked legislators, healthcare providers, and consumer advocates, Governor Jared Polis today vetoed a patient protection bill that received unanimous support from the bipartisan General Assembly. HB25-1088, sponsored by Representative Karen McCormick, Representative Kyle Brown, Senator Kyle Mullica, and Senator Mark Baisley, would have ensured patients received no surprise “balance bills” after seeking ambulance care.

Balance billing occurs after an insurance carrier – which usually has sole discretion for deciding how much of an ambulance bill it will pay – underpays a claim for service. Ambulance agencies then must either balance bill the patient for the difference between the cost of service and the insurance underpayment or write off the balance.

It is believed that this is the first time in history that a Colorado governor has ever vetoed a bill that received unanimous legislative approval.

“This unprecedented veto begs the question, ‘Whose interests are the most important here?” said Rep. Karen McCormick. “Consumer protection groups like the Colorado Consumer Health Initiative (CCHI) and AARP, health care providers like the EMS Association of Colorado (EMSAC) and physician groups, and organizations like Colorado Counties, Inc., the Colorado State Fire Chiefs, and others all strongly supported this bill. Big insurance carriers that, according to Division of Insurance reports, had a combined net income of more than $422 million in 2023 alone opposed these protections for Colorado families.”

Governor Polis’s veto doesn’t just ignore the unanimous policy decision of the General Assembly, but it also runs counter to nearly a dozen other states that have passed similar legislation during the past three years. California, Texas, Arkansas, and Washington – states that tend not to agree on many policy decisions – are among those that have enacted laws similar to the protections that HB25-1088 would have afforded struggling Colorado families.

Big insurance carriers claimed in legislative hearings that HB25-1088 would increase healthcare premiums for consumers. However, there has been no evidence of that in other states that have adopted similar laws. In Louisiana, which passed a similar law in 2023, healthcare premiums in 2024 went up by less than the nationwide average. Texas’s Teachers Retirement System, the largest public benefits system in Texas with nearly two million members, did not increase premiums for TRS-Care plan in 2024 or 2025.

“We are disappointed in the Governor’s decision to veto HB 1088,” said Sen. Kyle Mullica. “My fellow legislators and I are working for and listen to our constituents. We know what a burden surprise medical bills can put on families and presented the administration with a proven solution that would also have protected Coloradans’ access to care. Today’s action is a huge disappointment.”

Supporters of HB25-1088 were dismayed that Governor Polis cited insurance carriers’ unsubstantiated claims as a chief reason for vetoing the bill.

“There is no reason this bill should be vetoed, especially since studies show that pulling public ambulances into health insurance plans has little to no impact on premiums. This bill would have been a win-win for public ambulance providers, who often face funding shortfalls, particularly in rural areas, and for consumers, who are going to continue receiving out-of-network bills,” said CCHI Policy Director Isabel Cruz. “It's incredibly frustrating that we will have to come back to the General Assembly, yet again, since it passed unanimously with incredible bipartisan support.”

EMSAC President Tom Anderson noted that because people use ambulance service much less frequently than they visit doctors’ offices or get prescriptions filled, it’s illogical to think that the HB25-1088 protections would have led to high increases in healthcare costs. “Ground ambulance services comprise 0.3% of insurers’ annual spending. We’re a ‘rounding error’ to these companies that make billions of dollars in profit every year, in part by underpaying claims and shifting the financial burden to the patients themselves – precisely at a time when patients most need and rightfully expect their insurance carrier to come through for them,” said Anderson.

In 2019, Colorado led the nation in passing HB19-1174. The bill provided sweeping protections to most healthcare consumers, but the only ambulance patients protected were those who received emergency transports provided by private ambulance agencies. Seventy-five percent of Colorado ambulance agencies are public ambulance agencies not subject to HB19-1174 – and patients have no ability to choose which agency responds to their 9-1-1 call. HB25-1088 would have expanded balance billing protections and applied insurance reimbursement requirements to all ambulance transports.

Other states have now eclipsed Colorado in protecting ambulance patients from balance bills. Last year, a multidisciplinary advisory committee made recommendations to Congress on balance billing protections for ambulance patients with federally regulated health plans. HB25-1088 included many of the recommendations Congress is considering.

Legislators have no opportunity to override the veto because it was issued after their session adjourned for the year. However, several have vowed to resume the fight.

“I was a skeptic about this approach initially, but I am convinced that HB25-1088 is the right solution,” said Rep. Kyle Brown. “We’ll tackle this issue early during the next legislative session. We look forward to once again receiving overwhelming support from the General Assembly and hope the administration will work with us to end surprise billing for ambulance services once and for all.”

“Coloradans will face unnecessary financial challenges this year because of the administration’s unilateral decision to veto the General Assembly’s unanimous, bipartisan solution,” said Sen. Mark Baisley. “I’m frustrated by the action and by our inability to address this now. It makes me even more determined to right this wrong moving ahead.”

In the meantime, Coloradans who receive balance bills after ground ambulance transports are encouraged to express their dissatisfaction in the HB25-1088 veto by contacting Governor Polis’s Constituent Services Help Line at (303) 866-2885.

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The Emergency Medical Services Association of Colorado (EMSAC) is a nonprofit society of emergency medical service professionals. Founded in 1973, it is one of the oldest state EMS organizations in the nation and works to assure the best care for victims of trauma and those suffering from medical emergencies.

Colorado Consumer Health Initiative is a nonpartisan, nonprofit, membership-based group advocating for equitable access to high-quality, affordable health care. CCHI serves Coloradans whose access to health care and financial security are compromised by structural barriers, affordability, poor benefits, or unfair business practices of the health care industry.