Wyoming seeks federal approval to treat air ambulances like a public utility; idea aims to cut costs for patients

"Wyoming, the reddest of Republican states and a bastion of free enterprise, thinks it may have found a way to end crippling air ambulance bills that can top $100,000 per flight," Markian Hawryluk reports for Kaiser Health News. "The state’s unexpected solution? Undercut the free market by using Medicaid to treat air ambulances like a public utility."

Wyoming relies disproportionately on air ambulances because of its sparse population and often difficult terrain. But patients there (and across the nation) have been facing huge surprise bills as profit-seeking investors have inundated the industry. The Airline Deregulation Act, which bars states from regulating any part of the air industry, has prevented other states from bringing prices under control, Hawryluk reports.

"So, Wyoming officials are instead seeking federal approval to funnel all medical air transportation in the state through Medicaid, a joint federal-state program for residents with lower incomes," Hawryluk reports. "The state officials plan to submit their proposal in late September to Medicaid’s parent agency, the Centers for Medicare & Medicaid Services; the plan will still face significant hurdles there. If successful, however, the Wyoming approach could be a model for the nation, protecting patients in need of a lifesaving service from being devastated by a life-altering debt."

"The free market has sort of broken down. It’s not really working effectively to balance cost against access," Franz Fuchs, a policy analyst for the Wyoming Department of Health, told Hawryluk. "Patients and consumers really can’t make informed decisions and vote with their dollars on price and quality."