‘Even shaving one minute off an EMT trip for severe cases can generate huge economic benefits.’ Well, New York’s congestion pricing did just that

New York City’s congestion pricing program has been sold, and fought over, almost entirely for its ability to clear traffic out of Manhattan. A new NBER working paper points to a benefit that rarely comes up in that fight: faster ambulances, plus a wider list of externalities the public debate tends to leave out.

The paper, released this month by six economists including Brad Humphreys of West Virginia University, draws on roughly 1.6 million EMS incidents citywide, narrowed to a Manhattan sample near the boundary for its main results. It finds total EMS travel time inside the congestion relief zone fell 63–70 seconds, or by roughly 5%–6%, after the toll took effect on Jan. 5, 2025. The economists measured the impact by comparing ambulance runs on either side of 60th Street (where the congestion zone starts or ends depending on how you’re looking at it) rather than the zone against the rest of the city over time.

“Our research design is sort of spatial,” Humphreys told Fortune. “We match EMT trips on either side of 60th, above and below, in and out of the congestion zone, because they should be really similar in terms of other characteristics of whatever’s going on with those emergency calls.”

Why a minute matters

Humphreys argued the time savings aren’t trivial, pointing to research tying ambulance response time to survival odds in the most severe cases.

“There is economic research that shows that even shaving one minute off an EMT trip for severe cases can generate huge economic benefits, because it’s a life or death situation,” he said. “If you’ve got somebody who’s had a stroke or a heart attack, the value of that is tremendous.”

Travel time to the incident fell only 7 seconds to 9 seconds, but the the bigger gain of 54 seconds to 59 seconds came in transport from the scene to the hospital, after paramedics had already stabilized the patient.

The mortality link comes from a 2013 study by economist Elizabeth Wilde: Each additional minute of EMS response time raises the risk of a 90-day mortality by roughly one percentage point, or an 8% to 17% relative increase, depending on the time horizon. Wilde’s data covered response time broadly, not transport time. Thanks to New York City’s excellent public data, Humphreys said another study should be in the works regarding the direct, long-term economic effects of savings people’s lives by getting them to the hospital that much faster.

“Future work should seek to quantify these downstream health effects directly,” Humphreys said.

Despite the naysayers, there’s no car displacement at all, and actually more bikes and pedestrians

One common argument made by naysayers against congestion pricing is that it doesn’t reduce driving, it just relocates it. Humphreys said that didn’t hold up.

“We don’t find any displacement effect,” he said. “We don’t find that those EMT calls slowed down north of 60th, or anywhere. Basically people just stop driving. They just stop driving in general.”

The paper’s camera data—from NYC street cameras that snap images every 15 minutes, analyzed by machine learning—found pedestrian counts up roughly 14% and bike counts up nearly 20% near the boundary, alongside a 21% drop in passenger vehicles and 18% drop in trucks, which is consistent with broader MTA data showing fewer vehicles and faster travel times since the toll began.

“We don’t sell that hard in the paper,” Humphreys said of the bike increase, “but that’s another positive externality—people were using bikes more, probably because it’s safer to ride in the congestion zone.” The paper’s literature review cites prior accident reductions from congestion pricing in London (2%–5%), Stockholm (5%–9%), and Milan (20%+).

Humphreys also flagged foot traffic’s commercial upside as unstudied: “Increased foot traffic should be associated with increased commercial activity,” he said, adding “that’s a future research topic.” It should be noted this is in line with the city’s and state’s own economic data as well: On the one-year anniversary of congestion pricing, the state governor’s office released data showing an in increase of foot traffic from 2024, which led to a 6% increase in sales tax receipts.

A directive that complicated the data

The paper’s biggest technical wrinkle came from outside the tolling policy—and outside the political fight about the toll’s survival that dominated early 2025 headlines. In March 2025, FDNY began requiring ambulances to transport patients to the nearest hospital rather than a preferred one, which on its own changes how long transport takes.

“A couple of our co-authors live in New York City… and we did some Google News searching and identified that policy as an important confounder,” Humphreys said. “Somebody would undoubtedly say, ‘You’re getting these declines because of that policy change, not the congestion price.’ We felt it was important to address that.”

The boundary-based design was built to be less exposed to that kind of citywide shock than a standard before-and-after comparison, which picked up the directive’s effects and showed transport times rising after March 2025.

Humphreys’ broader argument is the debate fixates on the toll itself while ignoring costs and benefits absent from any E-ZPass statement—air pollution, noise, street wear.

“Lower traffic means less air pollution, and that has huge health consequences,” he said, flagging air quality as ripe for a dollar estimate. “The EPA has a clear methodology for valuing improvements in air quality,” he said, while also referring to the other side effect of traffic: honking. “There’s evidence that noise pollution reduces property values,” he said.

Thanks to this study, Humphreys said the positive impact on ambulances and emergency response times should absolutely be taken into accounts as more cities across the country and around the world consider implementing congestion pricing.

“Nobody’s ever done a full cost-benefit analysis of it,” Humphreys said, “but our results suggest that we probably should… all they see is, ‘I’m getting charged to drive into Manhattan.’ They don’t see you’re getting all these benefits. It’s not just the charge.”

This story was originally featured on Fortune.com