North Carolina 2025 Session Status: Passed House Bipartisan · 8 R · 8 D · 1 I cosponsors

HB 489 — Insurance Coverage Emergency Ambulance Transportation.

Last action — Regular Message Sent To Senate

  1. ✓
    Introduced
  2. ✓
    In Committee
  3. 3
    Passed House
  4. 4
    Passed Senate
  5. 5
    To Executive
  6. 6
    Enacted

This bill has passed the House. Introduced March 24, 2025. It now moves to the second chamber.

Next likely step: consideration and a floor vote in the Senate.

Prognosis

Likely to advance 74% · high confidence

Where this bill stands today.

Odds of enactment

Moderate

How often bills like it became law.

  • Passed House

    Current position in the legislative process.

  • 17 sponsors

    3 primary, 14 co-sponsors signed on.

  • Bipartisan support

    Sponsored across 3 parties (8 R · 8 D · 1 I) — cross-party backing.

  • Cleared a recorded vote

    Passed 1 recorded vote so far.

Prognosis reads this bill's own signals — stage, sponsorship breadth, committee status, recorded votes and cross-state momentum. Odds come from a model trained on which bills have become law.

Bill Text

What changed in the latest version

85 added · 86 removed

Plain-language change summary

In the updated version of House Bill 489, a new definition was added for "Emergency Emergency medical condition," clarifying that this condition includes acute symptoms that could threaten an individual's health or that of a pregnant woman and her unborn child. Additionally, the section defining "Emergency medical transportation" was expanded to specify that it covers transportation to a healthcare facility, but the specific mention of ground ambulance transportation between healthcare facilities was removed. These changes are important as they refine the definitions to ensure clarity in what constitutes an emergency and the types of transportation covered, which can significantly impact how emergency services are accessed and reimbursed.

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GENERAL ASSEMBLY OF NORTH CAROLINA SESSION 2025 H 2 HOUSE BILL 489 Committee Substitute Favorable 4/29/25 Short Title:
GENERAL ASSEMBLY OF NORTH CAROLINA SESSION 2025 H 1 HOUSE BILL 489 Short Title:
Representatives Loftis, Potts, Huneycutt, and Lambeth (Primary Sponsors).
For a complete list of sponsors, refer to the North Carolina General Assembly web site.
March 25, 2025 A BILL TO BE ENTITLED AN ACT TO PROVIDE FOR A MINIMUM ALLOWABLE REIMBURSEMENT RATE UNDER HEALTH BENEFIT PLANS FOR EMERGENCY AMBULANCE SERVICES PROVIDED BY AN OUT-OF-NETWORK AMBULANCE SERVICE PROVIDER.
Health, if favorable, Insurance, if favorable, Finance, if favorable, Rules, Calendar, and Operations of the House March 25, 2025 A BILL TO BE ENTITLED AN ACT TO PROVIDE FOR A MINIMUM ALLOWABLE REIMBURSEMENT RATE UNDER HEALTH BENEFIT PLANS FOR EMERGENCY AMBULANCE SERVICES PROVIDED BY AN OUT-OF-NETWORK AMBULANCE SERVICE PROVIDER.
(1a) "Emergency Emergency medical condition" means a condition.
*H489-v-1* General Assembly Of North Carolina Session 2025 (1a) "Emergency Emergency medical condition" means a condition.
– A medical condition manifesting itself by acute symptoms of sufficient severity, including, but not limited to, severe pain, or by acute symptoms developing *H489-v-2* General Assembly Of North Carolina Session 2025 from a chronic medical condition that would lead a prudent layperson, possessing an average knowledge of health and medicine, to reasonably expect the absence of immediate medical attention to result in any of the following:
– A medical condition manifesting itself by acute symptoms of sufficient severity, including, but not limited to, severe pain, or by acute symptoms developing from a chronic medical condition that would lead a prudent layperson, possessing an average knowledge of health and medicine, to reasonably expect the absence of immediate medical attention to result in any of the following:
(1) Four hundred percent (400%) of the most recent published Medicare rate for the ambulance service or services by the Centers for Medicare and Medicaid Services under Title XVIII of the Social Security Act for the same services provided in the same geographic area.
(1) Four hundred percent (400%) of the most recent published Medicare rate for the ambulance service or services by the Centers for Medicare and Medicaid Page 2 House Bill 489-First Edition General Assembly Of North Carolina Session 2025 Services under Title XVIII of the Social Security Act for the same services provided in the same geographic area.
Page 2 House Bill 489-Second Edition General Assembly Of North Carolina Session 2025 (i) All of the following apply to emergency medical transportation services provided by an ambulance service provider:
(i) All of the following apply to emergency medical transportation services provided by an ambulance service provider:
(j) Nothing in this section shall be construed to prevent a self-funded group plan regulated under the Employee Retirement Income Security Act (ERISA) from opting into the provisions of this section." SECTION 1.(b) Subdivisions (3) and (4) of subsection (g) of G.S.
(j) Nothing in this section shall be construed to prevent a self-funded group plan regulated under the Employee Retirement Income Security Act (ERISA) from opting into the provisions of this section." SECTION 1.(b) Subdivisions (3) and (4) of G.S.
Section 1(a) of this act is effective October 1, 2025, and applies to insurance contracts issued, renewed, or amended on or after that date and ambulance services provided on or after that date.
Section 1(a) of this act is effective October 1, 2025, applies to insurance contracts issued, renewed, or amended on or after that date and ambulance services provided on or after that date.
House Bill 489-Second Edition Page 3
House Bill 489-First Edition Page 3
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Action History

  1. Regular Message Sent To Senate

  2. Regular Message Received From House

  3. Passed 1st Reading

  4. Ref To Com On Rules and Operations of the Senate

  5. Passed 2nd Reading

  6. Passed 3rd Reading

  7. Reptd Fav

  8. Cal Pursuant Rule 36(b)

  9. Placed On Cal For 05/06/2025

  10. Reptd Fav

  11. Re-ref Com On Rules, Calendar, and Operations of the House

  12. Reptd Fav Com Substitute

  13. Re-ref Com On Insurance

  14. Serial Referral To Finance Stricken

  15. Passed 1st Reading

  16. Ref to the Com on Health, if favorable, Insurance, if favorable, Finance, if favorable, Rules, Calendar, and Operations of the House

  17. Filed

Sponsors

Sponsorship breakdown

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3 sponsors · 14 co-sponsors · 162 not signed on

Sponsors (3)

Co-sponsors (14)

Not signed on (162)

162 members have not signed on to this bill.

Show all 162 →

"Not signed on" means a member has not sponsored or co-sponsored this bill — it does not imply opposition. Members flagged Voted No have a recorded No vote on this bill.

Whip count is in markup. Polling the chamber and every recorded vote this session. Only the first open is slow. It’s instant for you after this. Calling the roll · Tallying · Engrossing

Votes

Second Reading

Passed 111 Yea · 0 Nay · 9 Other
Party YeaNayPresentNot Voting
Democratic 39005
U 2000
Unaffiliated 6000
Republican 64004
Total 111009
% of votes cast 93%0%0%8%
How each member voted (120)
Member Party Vote
CharlesSmith — Yea
vonHaefen — Yea
Campbell — Yea
Reeder — Yea
C. Smith — Yea
F. Jackson — Yea
Abe Jones Democratic Yea
Aisha O. Dew Democratic Not Voting
Allen Buansi Democratic Yea
Allison A. Dahle Democratic Yea
Amber M. Baker Democratic Not Voting
Amos L. Quick, III Democratic Yea
B. Ray Jeffers Democratic Yea
Becky Carney Democratic Yea
Beth Helfrich Democratic Yea
Brandon Lofton Democratic Yea
Brian Turner Democratic Not Voting
Bryan Cohn Democratic Yea
Carolyn G. Logan Democratic Yea
Cecil Brockman Democratic Yea
Cynthia Ball Democratic Yea
Dante Pittman Democratic Yea
Deb Butler Democratic Yea
Eric Ager Democratic Yea
Garland E. Pierce Democratic Yea
Gloristine Brown Democratic Yea
James Roberson Democratic Not Voting
Jordan Lopez Democratic Yea
Julia Greenfield Democratic Yea
Kanika Brown Democratic Yea
Laura Budd Democratic Yea
Lindsey Prather Democratic Yea
Marcia Morey Democratic Yea
Maria Cervania Democratic Yea
Mary Belk Democratic Yea
Mike Colvin Democratic Yea
Monika Johnson-Hostler Democratic Yea
Phil Rubin Democratic Yea
Pricey Harrison Democratic Yea
Renée A. Price Democratic Yea
Robert T. Reives, II Democratic Not Voting
Rodney D. Pierce Democratic Yea
Sarah Crawford Democratic Yea
Shelly Willingham Democratic Yea
Terry M. Brown Jr. Democratic Yea
Tim Longest Democratic Yea
Tracy Clark Democratic Yea
Vernetta Alston Democratic Yea
Ya Liu Democratic Yea
Zack Hawkins Democratic Yea
A. Reece Pyrtle, Jr. Republican Yea
Allen Chesser Republican Yea
Ben T. Moss, Jr. Republican Yea
Bill Ward Republican Yea
Blair Eddins Republican Yea
Brenden H. Jones Republican Yea
Brian Biggs Republican Yea
Brian Echevarria Republican Yea
Celeste C. Cairns Republican Yea
Charles W. Miller Republican Yea
Chris Humphrey Republican Yea
Cody Huneycutt Republican Yea
David Willis Republican Yea
Dean Arp Republican Yea
Dennis Riddell Republican Yea
Destin Hall Republican Yea
Diane Wheatley Republican Yea
Donna McDowell White Republican Yea
Donnie Loftis Republican Yea
Donny Lambeth Republican Yea
Dudley Greene Republican Yea
Edward C. Goodwin Republican Yea
Erin Paré Republican Yea
Frank Iler Republican Yea
Harry Warren Republican Yea
Heather H. Rhyne Republican Yea
Howard Penny, Jr. Republican Yea
Hugh Blackwell Republican Yea
Jarrod Lowery Republican Yea
Jay Adams Republican Yea
Jeff Zenger Republican Yea
Jeffrey C. McNeely Republican Yea
Jennifer Balkcom Republican Yea
Jerry "Alan" Branson Republican Yea
Jimmy Dixon Republican Not Voting
John A. Torbett Republican Yea
John M. Blust Republican Yea
John R. Bell, IV Republican Yea
John Sauls Republican Yea
Jonathan L. Almond Republican Yea
Joseph Pike Republican Yea
Julia C. Howard Republican Yea
Karl E. Gillespie Republican Yea
Keith Kidwell Republican Yea
Kelly E. Hastings Republican Not Voting
Kyle Hall Republican Not Voting
Larry C. Strickland Republican Yea
Larry W. Potts Republican Yea
Mark Brody Republican Yea
Mark Pless Republican Yea
Matthew Winslow Republican Yea
Mike Clampitt Republican Yea
Mike Schietzelt Republican Yea
Mitchell S. Setzer Republican Yea
Neal Jackson Republican Yea
Paul Scott Republican Yea
Phil Shepard Republican Yea
Ray Pickett Republican Not Voting
Sam Watford Republican Yea
Sarah Stevens Republican Yea
Stephen M. Ross Republican Yea
Steve Tyson Republican Yea
Ted Davis, Jr. Republican Yea
Todd Carver Republican Yea
Todd Johnson Republican Yea
Tricia Ann Cotham Republican Yea
William D. Brisson Republican Yea
Wyatt Gable Republican Yea
Carla D. Cunningham U Yea
Nasif Majeed U Yea

Official roll call →

Subjects

healthcare health-insurance
Cross-referencing the record. Reading this bill against every other bill in the corpus by meaning, not keywords. Only the first open is slow. It’s instant for you after this. Matching · Ranking · Engrossing

Frequently asked questions

Who sponsors HB 489?
HB 489 is sponsored by Shelly Willingham (Democratic), Bill Ward (Republican), Lindsey Prather (Democratic), Howard Penny, Jr. (Republican), Ben T. Moss, Jr. (Republican), Jeffrey C. McNeely (Republican), Carolyn G. Logan (Democratic), Pricey Harrison (Democratic), Carla D. Cunningham (U), Becky Carney (Democratic), Mary Belk (Democratic), Donny Lambeth (Republican), Cody Huneycutt (Republican), Larry W. Potts (Republican), Donnie Loftis (Republican), Cecil Brockman (Democratic), and Charles Smith (Democratic).
What is the current status of HB 489?
This bill has passed the House. Introduced March 24, 2025. It now moves to the second chamber.
Where can I track HB 489?
Track HB 489 free on One Click Politics — get push/email alerts when it moves.

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