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“Our Fight for First Responder Funding”

Decades of below cost Medi-Cal reimbursement, combined with Medi-Cal expansion, is crippling our ability to recruit and retain qualified emergency medical technicians (EMTs) and paramedics. Unfortunately, this issue has been building long before the pandemic started, and it now threatens to undermine the stability of California’s emergency and non-emergency ambulance transport infrastructure.


To address our retention and recruitment issues, ambulance providers need a Medi-Cal increase that ensures a sustainable living wage for caregivers, now and into the future. 

First-responders and patient advocates throughout California are asking Governor Newsom and State leaders to increase the Medi-Cal base rate for ambulance transports, which is still below our cost of providing the service, but high enough to ensure we can offer sustainable living wages that attract new recruits and increase wages for current employees to improve retention.

Facts on Ambulance First Responder Funding

California is 46th in the Nation for Ambulance Medicaid Reimbursement

The cost of providing ambulance services in California is the highest in the nation, but the state’s $111 Medi-Cal reimbursement rate ranks 46th in the Country. Even our neighboring states have significantly higher Medicaid reimbursement rates, with Arizona reimbursing $408 for a Medicaid patient. 

California has not Funded a Medi-Cal Increase for Ambulance Services Since 1999

The last time ambulance providers received a Medi-Cal base rate increase was 1999. However, this increase was cut in 2013, and was never replaced in future budgets. Our Medi-Cal rate is the same today as in 1999, but when adjusted for inflation is equal to $63.00.

The Majority of Patients Reimburse Below Cost, or Pay Nothing for Ambulance Services

Current reimbursement rates for Medi-Cal and Medicare patients do not cover the costs of an ambulance transport. Indigent care, which is often provided for free, cost providers millions in losses a year, and commercial health insurers often deny coverage for our services or seek to pay rates below our costs or below a provider’s set local government rate. 

For ambulance providers to be able to offer competitive wages and benefits, we need sustainable funding and reimbursement through the Medi-Cal program. 


First responders are expected to respond to all emergencies, risking everything to provide life-saving support to those in need without being adequately reimbursed for their work.

The time is NOW to increase reimbursement rates.
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