Americans have come to rely upon, and perhaps take for granted, the availability of emergency medical services. The local hospital emergency department serves most urgent medical needs arising from injury or illness, while trauma centers address these issues and more serious injuries. Emergency departments and trauma centers play a key role in issues of public health and national security, be it in response to a pandemic or other disaster.1 However, the United States’ system for the delivery of emergency medical services, in particular trauma center services, faces challenges in the areas of funding and reimbursement, access, coordination of services, geographic/regional disparity, and the ability to respond in the event of a pandemic, disaster or other catastrophic event. Both the House and the Senate health care reform bills, in varying ways, attempt to address these and other issues. As a result, any final legislation likely will create opportunities for facilities and states to capture funds that will benefit both providers and patients.