Colorado's surprise billing law does not currently limit out-of-network billing for ambulance services, and new analysis shows the true costs to consumers and insurers.

State Rep. Kyle Brown - D-Louisville - represents Colorado House District 12.

He said lawmakers will likely need to step in, because people who need emergency care don't have time to shop around, or figure out if they're calling an in-network ambulance.

"It's important for us as a state to make sure that ambulance services are well compensated for what they do," said Brown, "and that patients don't end up with a gigantic bill."

Nearly six in ten of the most common ambulance services billed at much higher out-of-network rates, according to the Center for Improving Value in Health Care report.

The price tag for basic services range from $300 to $1,000, and some patients have been hit with surprise bills as high as $2,500.

Ambulance costs also vary depending on who's paying. Commercial insurance companies paid as much as three times what Medicare paid between 2018 and 2023.

Brown noted that Medicare prices are generally viewed as a benchmark rate for services.

"So this data that has been put together is really helpful," said Brown, "because it helps us to understand what insurance companies are currently paying for these services, as a relationship to what Medicare would also pay."

Colorado was the first state in the nation to pass a surprise billing statute in 2019, which Brown noted helped pave the way for the No Surprises Act passed by Congress in 2021.

"But Colorado's statute doesn't protect people from surprise bills in the ambulance setting," said Brown. "And so we need to pass legislation to protect consumers from surprise billing in the ambulance space."




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Starting this year, changes to California's "lemon law" will make it harder for consumers to get a refund or a replacement vehicle.

The changes mean instead of just taking the car to the dealer for repairs, you're now going to have to formally notify the manufacturer via email or certified mail and include your name, the vehicle ID number, a summary of the problems and a demand for a refund or replacement.

Rosemary Shahan, president of the nonprofit Consumers for Auto Reliability and Safety, said if you do not take the step, you forgo lemon-law protections.

"They're going to feel like they can ignore you and refuse to fix the problem," Shahan contended. "Or just do a real, cheap, temporary Band-Aid kind of fix until the warranty expires, and then they'll tell you how much they want you to pay for the repair out of your own pocket."

Gov. Gavin Newsom said he signed Assembly Bill 1755 reluctantly in order to cut down on lemon law lawsuits clogging the courts. Shahan noted lawmakers agreed to the changes only after General Motors and Ford threatened to support a ballot initiative capping attorneys fees in consumer lawsuits, something vigorously opposed by consumer attorneys, who are big political contributors.

The governor did negotiate a new bill, soon to be introduced, to allow manufacturers to opt in or out of the new program. Supporters of the changes, including General Motors, Ford and Stellantis, are expected to opt-in, while opponents such as Honda, Toyota and Tesla may decide to uphold the old protections.

Shahan noted the new lemon law said consumers who have negative equity, meaning they owe more on the lemon car than it is worth, can be forced to come up with the difference before the manufacturer will buy it back.

"The manufacturers will say, 'Oh, we'd be happy to buy back your lemon but first you have to come up with whatever the negative equity is before you can give us clear title to the car,'" Shahan asserted. "Most people can't afford to pay out of pocket, so they're going to be stuck with a lemon car."

The new lemon law also rescinds protections after six years, making longer warranties unenforceable, and consumers will now have only one year to file a claim, down from four.

With 2025 at hand, Minnesotans might be mapping out the concerts they want to attend or things they want to buy in the new year but the presence of hidden fees could give them second thoughts.

New state laws aim to address it. A pair of statutes taking effect Jan. 1 were drafted in response to consumer complaints about so-called "junk fees." One said businesses must disclose the full price of products and services upfront, eliminating surprise charges at checkout. Policy experts said it can cover hotel stays and food deliveries. The second law has similar pricing transparency requirements for live events.

Rep. Lucy Rehm, DFL-Chanhassen, feels it is a "win-win."

"When all businesses disclose their full prices up front, consumers can make these fair and informed comparisons," Rehm explained. "I think it'll foster trust and competition. So, I think it's good for businesses as well as consumers."

State officials estimate hidden and deceptive fees cost the average Minnesota family more than $3,000 a year. There was bipartisan support for the new rules but, similar to rule-making efforts at the federal level, business voices like the U.S. Chamber of Commerce described the approach has "micromanaging" and will not do much to address transparency issues in pricing.

Rehm countered Minnesota's new laws will especially benefit small businesses, which are typically upfront about the final price. Meanwhile, she added, the changes can help ensure all Minnesotans, feeling the pinch of ticket costs, have better access to events offering cultural enrichment.

"We have a thriving arts community here," Rehm pointed out. "We want people to be able to go to concerts and enjoy the arts."

There are exemptions under Minnesota's new junk fees law, including shipping-related costs and automatic gratuities for food and beverage establishments. Vendors at Minneapolis-St. Paul International Airport have longer to comply, until June 1.

Travel agencies say Americans are still embracing overseas trips, including destinations where the itinerary is loaded with learning opportunities about local culture.

There are tips for Nebraskans on where to book and how to stretch their dollar. Those who help consumers plan their vacations report a strong appetite for experiences where cultural immersion is the main attraction.

Brittany Duffy, travel expert at EF Go Ahead Tours, said it might mean going off the beaten path more in towns and villages, as opposed to sticking with the common tourist sites in the heart of a major city across the globe.

"Not just checking a trip off their list, but really becoming more connected and seeking that personal growth opportunity and having those unforgettable moments," Duffy explained.

She pointed out guided tours, in places like Latin America and Scandinavia, can bring you to under-the-radar spots, like family-run farms serving dinner. Companies like EF Go Ahead Tours have flexible financing requiring a small deposit, with additional interest-free payments spread out well in advance of your trip. The University of Nebraska experts also recommended seeking out hostels for lodging as a way to keep travel costs lower.

Duffy emphasized timing is another key tool in keeping vacations budget-friendly and accessible.

"Considering traveling in the shoulder season, April, May, October, November," Duffy advised. "You still see really pleasant weather but you got smaller crowds and lower prices."

Research firms say younger adults are increasingly booking vacations, including solo trips, while older adults said travel is becoming too expensive. But baby boomers are still open to flying elsewhere if they can find value, such as doing so during off-peak seasons.

Experts said lower costs should not come at the expense of personal safety. One example would be using public transportation late at night in unfamiliar areas. They said calling a taxi is better in such situations.


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