Leggett is right to re-float ambulance fee, despite 2010 vote
County Executive Isiah Leggett’s proposal to resurrect a controversial fee for ambulance service is not “arrogant” nor does it constitute an “end run” around voters who, in 2010, rejected a similar proposal through referendum.
County Council member Philip Andrews leveled those charges against Leggett last week after the executive proposed reviving a bill to allow the county to seek reimbursement from insurance companies for the cost of ambulance rides, just as hospitals seek reimbursement from insurers for treating patients.
Despite the referendum of two years ago, Leggett’s re-floating of the plan is responsible given the manner in which the county’s fiscal situation has evolved since the vote. Montgomery now is facing a cost nobody reckoned on two years ago that of shouldering a large chunk of the cost of public teacher pensions that Maryland historically has paid.
It’s important to note, however, that the referendum was fed largely by a fear campaign conducted by volunteer firefighters opposed to the fee. Because of that, it’s incumbent on politicians who now support the measure to educate voters ahead of their decision lest 2010 repeat itself.
The pension shift, which the General Assembly was poised to pass this year before it adjourned without approving a budget compromise, would cost Montgomery $125 million in the next three fiscal years alone. The legislature almost certainly will reconvene in a special session to work out a budget deal. In the meantime, it also passed a bill this year that allows the state to give county income tax revenue directly to the school board if the county fails to meet annual required levels of education funding.
In an April 12 memo he sent to the County Council explaining his rationale for resurrecting the fee, Leggett rightly points out that, given the “unprecedented fiscal challenges” imposed on the county by the state, floating the fee again makes sense.
He also makes clear that, under the bill, county residents would not be billed, or pay out-of-pocket costs, for ambulance service. The county would seek reimbursement only from insurers. The only people who would directly pay for ambulance rides in Montgomery would be out-of-county residents who have no insurance, though they would be eligible for a hardship waiver, said Leggett’s spokesman, Patrick Lacefield.
If officials institute the fee, they must ensure that, in processing non-resident hardship cases, the person’s credit rating isn’t hurt if they fail to pay or can’t pay.
Billing insurers would generate roughly $72 million over the next four fiscal years that the county otherwise would not collect. That money would go to the county’s fire and rescue service.
To put it simply: Montgomery could collect this money, but isn’t. Instead, the taxpayers are shouldering the entire cost of providing ambulance service. What’s more, nearly all of Montgomery’s neighbors collect such reimbursements from insurers.
“It is fundamentally wrong for County taxpayers to foot the bill for costs that are covered by insurers in most jurisdictions in Maryland, the Washington Metropolitan area, and the nation,” Leggett wrote to the council.
He’s right. The alternative is spending cuts or tax hikes.
Yes, the voters rejected the fee in 2010. But times and attitudes change. In proposing to resurrect the fee, Leggett is not making an end run around the people because the fee this time as last — must be approved by the people’s elected representatives, the County Council, which approved the bill las time.
Indeed, the 2010 referendum was not simply a response to Leggett’s proposing the fee it also was a response to the council having passed it. The people shot down the fee by a margin of 54 percent to 46 percent in 2010.
If they continue to oppose it, then the council can vote down Leggett’s bill. But the executive is right to have put the proposal on the people’s radar again in tight fiscal times.