A program aiming to keep Montana’s ambulance services financially afloat is in jeopardy. The program would tax nonprofit and for-profit ambulance providers a little more than $6 million. The state would then use that money to draw down more federal Medicaid dollars, roughly $30 million.
“And then money would be redistributed back to ambulance providers,” said Republican Rep. Ed Buttery, who sponsored the bill that created the program last year.
But federal health officials say the state can’t implement the program. That’s because a provision in President Donald Trump’s so-called Big Beautiful Bill says states can’t create new provider taxes to get additional federal funding. Existing taxes are allowed to stay on the books.
State health officials are still asking the federal government to approve the plan because the legislation was passed before Trump’s bill. But the state submitted its request in December, well after the new law took effect.
The state health department told lawmakers it expects the plan to be denied.
Buttrey says ambulance services will likely struggle without the additional funding support.
“You may be getting basic life support in lieu of advanced life support. Another scenario is they simply don’t show up at all. So it’s pretty catastrophic for our rural communities.”
Buttrey says there’s still discussions happening between the state and federal officials. He’s holding out hope the program will be approved.
