Volunteers with the Bethesda Chevy Chase Rescue Squad transport a patient in 2010. The group of mostly volunteers led the fight against an ambulance fee that County Executive Isiah Leggett is once again proposing. (Jahi Chikwendiu/THE WASHINGTON POST)

An ambulance fee is back on the agenda in Montgomery County.

On Thursday, Montgomery County Executive Isiah Leggett (D) proposed legislation to to reinstitute the fee, which was struck down by referendum in 2010.

Leggett says he expects to the ambulance fee to raise $14 million to $17 million and to help make up for a likely loss in state funding.

Patients would be billed for the ambulance fee, which Leggett says would be covered by health insurance. People without health insurance and people below a certain income threshold would be exempt from the fee, which would range from about $300 to $800 depending on several factors, including the severity of the injury and the distance traveled.

The bill was submitted to the Montgomery County Council on Thursday evening, according to Leggett’s staff.

The legislation will likely pit Leggett against the county’s volunteer firefighters, who opposed the fee the last time around, and pit council members against one other. In a 5-4 vote, the County Council approved similar legislation in 2010 after hours of heated debate.

After dueling campaigns that involved hundreds of volunteer and career fire and rescue personnel, the law failed in a referendum. Leggett said the circumstances are different this time, because the state legislature is in the midst of adding significant costs to the county.

The General Assembly approved changes to the formula deciding how much counties must allocate each year for school funding, and Leggett said he expects that the legislature will soon enter a special session to approve a shift of teacher pension costs to the counties. Both measures will create substantial costs to the county in the long term, and Leggett said he wanted a stable source of revenue to help mitigate the effect.

“It would be irresponsible not to put this as an option given the financial conditions we’re in today,” he said.

During this year’s General Assembly session, Leggett administration officials floated the idea of state legislation that would allow the county to approve an ambulance fee that couldn’t be struck down by referendum.

Del. Brian J. Feldman (D-Montgomery), who is chairman of the county’s house delegation, said state legislators did not seriously consider the legislation. “I think there was resistance . . . [to] essentially reversing a referendum decision,” he said.

Leggett said that because the County Council approved the bill in 2010, he expects the body will do the same this time.

But two council members who approved the bill in 2010 — Michael Knapp (D-Upcounty) and Duchy Trachtenberg (D-At Large) — are gone. Their replacements — Craig Rice (D-Upcounty) and Hans Riemer (D-At Large) — did not respond to requests for comment on Thursday.

The opinions of some council members appear to be the same as in 2010. Council member George L. Leventhal (D-At Large) described the fee as a “benign revenue source.” Council President Roger Berliner (D-Potomac-Bethesda) said that although he opposes the fee, he wants to give Leggett the opportunity to justify the fee.

Meanwhile, council member Phil Andrews (D-Gaithersburg-Rockville) said what Leggett is doing is “a disrespect to voters.”