Advancing the EMS profession
Online Legislative Service

Send an email to your representatives and ask for their support of these important issues. Visit the Online Legislative Service (open to all in EMS), Take Action on an issue, and send a templated email in just minutes. Our goal is to have 10,000 emails sent!

The “One Big Beautiful Bill Act” (OBBBA or H.R. 1) was signed into law on July 4, 2025. As discussions continue around its potential effects on the EMS community, NAEMT’s leadership and national partners have begun studying the potential impact of this new law on EMS agencies and the patients we serve. 
View a summary of major provisions that may impact EMS, and suggested actions EMS agency leaders can consider.

Prior to the law’s enactment, NAEMT actively advocated against the harmful impact that reduced Medicaid funding would have on the nation’s EMS system, as part of the Modern Medicaid Alliance. Now enacted, this law will reduce Medicaid spend over time by roughly $1 trillion and impact the ACA (Affordable Care Act) marketplace. These cuts are concerning and may create unease among patients, EMS practitioners, first responders, and community members.

OBBBA will alter the way states receive federal Medicaid funding, giving state governments a significant role in shaping how these changes are implemented. Some of the changes in the law will begin to impact patient Medicaid eligibility in 2026. However, many of the larger changes in state Medicaid funding won’t start to roll out until 2028, gradually ramping up over several years.

EMS agencies have time to assess OBBBA’s long-term impact to fully understand the implications. NAEMT will continue working with partners, elected officials, and state EMS advocates, to clarify the details and share information to assist with your local planning efforts.

NAEMT and our collaborators will work to mitigate certain policy changes before they take effect and will offer implementation guidance to support the EMS community. We are committed to keeping you informed as details become available.



Home / Advocacy / Key NAEMT Legislative Issues

Key NAEMT Legislative Issues

Advocating on behalf of the EMS community is central to NAEMT’s mission. We work to ensure that EMS has a strong voice in the development of federal policies, programs, and initiatives that impact our workforce, our patients, and the communities we serve. NAEMT advocates for legislation and regulations that provide EMS practitioners with the funding, training, equipment, and support necessary to deliver high-quality patient care while protecting their mental and physical well-being.

The following congressional requests represent NAEMT’s federal advocacy priorities for advancing the EMS profession and strengthening emergency medical services nationwide.

For additional information or questions, please contact advocacy@naemt.org.

H.R. 2538 / S. 3145 Comprehensive Alternative Response for Emergencies (CARE) Act Establish a CMMI pilot program to evaluate EMS Treatment in Place (TIP) services

House sponsors: H.R. 2538 – Rep. Mike Carey (R-OH), Rep. Lloyd Doggett (D-TX), Rep. Carol Miller (R-WV), Rep. Pat Ryan (D-NY)

Senate sponsors: S. 3145 – Sen. Susan Collins (R-ME), Sen. Peter Welch (D-VT)

Why it matters: Current Medicare policy generally only reimburses EMS when a patient is transported to a hospital. The CARE Act would allow EMS agencies to be reimbursed for treating appropriate patients at home or on scene, reducing unnecessary emergency department visits, improving patient experience, and lowering healthcare costs.

H.R. 4011 Community Paramedicine Act Create an HHS grant program to support Mobile Integrated Healthcare (MIH) and Community Paramedicine (CP) programs

Sponsors: H.R. 4011 – Rep. Emanuel Cleaver (D-MO), Rep. Diana Harshbarger (R-TN)

Why it matters: Community paramedicine programs help EMS providers deliver preventive and follow-up care, reduce avoidable 9-1-1 calls and emergency department visits, improve outcomes for patients with chronic conditions, and expand access to care in rural and underserved communities.

RESCUE Act Reimbursing Emergency Services for Critical Use of Emergency Blood Act Create a Medicare and Medicaid add-on payment for blood products administered by EMS agencies

PENDING INTRODUCTION

Why it matters: Prehospital blood transfusions save lives in patients experiencing severe hemorrhage, but EMS agencies currently receive no reimbursement for blood products administered before hospital arrival. This legislation would help make prehospital blood programs sustainable and accessible nationwide.

H.R. 3791 EMS Counts Act Require the Bureau of Labor Statistics to more accurately count EMS practitioners, including Firefighter/EMTs and Firefighter/Paramedics

House sponsors: H.R. 3791 – Rep. Glenn “GT” Thompson (R-PA), Rep. John Mannion (D-NY)

Why it matters: Current federal workforce data significantly undercounts EMS personnel. More accurate workforce data will improve federal planning, workforce development initiatives, and funding decisions affecting EMS nationwide.

H.R. 2220 Preserve Access to Rapid Ambulance Medical Treatment (PARA-EMT) Act Address nationwide shortages of EMTs and Paramedics through recruitment, retention, training, and wellness initiatives

Sponsors: H.R. 2220 – Rep. Marie Gluesenkamp Perez (D-WA), Rep. Brad Finstad (R-MN)

Why it matters: EMS agencies across the country face critical staffing shortages that contribute to longer response times and service disruptions. The bill would support workforce development, reduce barriers for military medics entering civilian EMS, and help address burnout and behavioral health challenges.

H.R. 2196 Honor Our Emergency Medical Services Act Extend authorization for the establishment of a National EMS Memorial in Washington, D.C.

Sponsors: H.R. 2196 – Rep. Richard Hudson (R-NC), Rep. Stephen F. Lynch (D-MA)

Why it matters: The memorial will honor EMS professionals who have made the ultimate sacrifice in service to their communities and recognize the critical role EMS plays in public health, emergency response, and national preparedness.

H.R. 3443 Modernizing EMS Delivery and Sustainability (MEDS) Act Address key EMS challenges related to workforce sustainability, medication shortages, blood product access, and hospital wall time

Sponsors: H.R. 3443 – Rep. Richard Hudson (R-NC), Rep. Debbie Dingell (D-MI)

Why it matters: The legislation would study EMS workforce compensation, improve access to essential medications and blood products, and address prolonged patient handoff delays that keep ambulances out of service and unavailable for emergencies.

H.R. 7623 Freedom House Ambulance Service Congressional Gold Medal Act Award a Congressional Gold Medal to the Freedom House Ambulance Service

Sponsors: H.R. 7623 – Rep. Summer Lee (D-PA), Rep. Mike Kelly (R-PA), Rep. Debbie Dingell (D-MI)

Why it matters: Freedom House Ambulance Service was the nation's first paramedic-staffed ambulance service and pioneered many of the prehospital care standards that shaped modern EMS. The bill recognizes its historic contributions to emergency medical care.

SIREN FY2027 SIREN Act Funding Request Provide $33 million for the Rural EMS Training and Equipment Assistance (REMSTEA) grant program

Why it matters: Rural EMS agencies face significant financial and workforce challenges. SIREN grants help agencies purchase equipment, recruit and retain personnel, improve training, and maintain lifesaving services in underserved communities.

EMS Caucus Join the Congressional EMS Caucus Promote awareness of EMS issues and support bipartisan federal policies that strengthen EMS systems nationwide

Co-chairs: Rep. Richard Hudson (R-NC), Rep. Debbie Dingell (D-MI)

Why it matters: The Caucus serves as a forum for educating Members of Congress on EMS workforce, reimbursement, preparedness, rural access, and patient care issues, helping ensure EMS remains a federal policy priority. Learn more.

To learn more about NAEMT’s 2026 federal legislative priorities, view our 2026 Congressional Requests document.

View & download PDF