North Rhine‑Westphalia cities warn of ambulance cost crisis as state proposes partial insurer funding

The association of municipalities in North Rhine‑Westphalia (Städtetag) voiced strong concern over a financing dispute for ambulance services. Legal health insurers have refused to pay for “failed trips” – rescue missions that end without hospital transport – and some cities warned they could be forced to charge patients directly. The state government presented a compromise: insurers would temporarily cover half of the costs for such trips in 2026, but only while the share of failed trips stays below 15 % of total deployments.

The proposal, outlined by Health Minister Karl‑Josef Laumann, aims to bridge the funding gap while municipalities assess savings in their rescue services. Cities cited examples of potential charges, such as Essen’s aborted plan to bill €267 per call and the district of Steinfurt’s announcement of €1,173 for ambulance use plus €1,068 for a doctor’s visit. The Städtetag’s board warned, “Der Vorstand sieht die Folgen einer nicht kostendeckenden Finanzierung des Rettungsdienstes in den NRW‑Städten mit großer Sorge.” The association noted that millions of euros in short‑fall could not be covered without state or federal aid. The debate will be discussed at the Städtetag’s member meeting in Oberhausen, where the board will also be re‑elected.