Published Friday, January 22, 2010
Medical-providers tax would benefit fewer hospitals than it would help
By Walter C. Jones
Morris News Service
ATLANTA – Legislators who rejected a 1.6-percent tax on hospitals and health-insurance companies last year weren't eager to hear the same proposal included in this year's budget, as was shown by questions during an appropriation hearing Thursday.
Community Health Commissioner Rhonda Medows told the hearing of the joint House and Senate appropriations committees that she can't find any alternatives to fill a $506 million projected shortfall in the Medicaid program.
On one hand money is scarce with lagging tax collections, the exhaustion of federal stimulus funds and the end of money from the state's share of a national lawsuit settled against the largest tobacco companies. On the other hand, by accepting the stimulus funds, the state agreed not to reduce Medicaid benefits or the number of people eligible to receive them.
Plus, the state has cut all the expenses it can, she said.
"I have to tell you quite frankly, I don't see any way we can do any more of this where we can accomplish $506 million in this program," she told the lawmakers. "And that leaves the last thing to generate revenue."
State officials say taxing hospitals would "leverage federal funds" because the tax itself would become a cost that the state and federal government would have to include in what they pay the program. Of course, the state would merely be getting its own money back, but since the federal government pays roughly two dollars for every dollar the state pays, the cost increase would bring in more money from Washington than Georgia.
A preliminary analysis by the Governor's Office of Planning and Budget shows that 39 hospitals would see a net gain with the tax, headed by Atlanta's Grady Memorial at $13 million, and another 39 would break even. But 84 hospitals would lose money, the largest being the private Emory Hospital in Atlanta at $10 million.
Health-insurance companies would also pay the tax.
Legislators had plenty of questions about it, but they may eventually sink into a sense of resignation. The lawmaker Capitol insiders consider the most knowledgeable about Medicaid funding, Rep. Mickey Channell, vice chairman of the House Appropriations Committee, opposed the tax last year but was noncommittal Thursday in addressing Medows.
"You have described where we find ourselves in a box. I have looked at the budget in some detail. I agree with you," said Channell, R-Greensboro, noting that policy options are few. "Certainly I will agree with you the box is there. ...(However) I have not had a long line of people knocking my door down saying it's a great idea."
Jimmy Lewis, lobbyist for the Hometown Health coalition of small hospitals, said his organization won't automatically oppose the tax as it had last year because this time the governor is putting all of money collected back into Medicaid. Plus, some hospitals will be exempt, such as the Medical College of Georgia, rural facilities and those limited to psychiatric care.
"It requires a different level of examination this year than last," he said. "If we are, in fact, facing a budget deficit as big as it appears it is, then these tax proposals are going to be thrust upon us."
CHART
Below is an estimate by the Governor's Office of Planning and Budget of how individual hospitals would fare under a proposed 1.6-percent tax on the revenues of all medical providers. Numbers in parenthesis indicate a net cost to the hospital. The hospitals that treat a large number of Medicaid patients, like Grady Memorial in Atlanta, are more likely to benefit.
State officials say they intend to update this projection based on more current figures in coming days.
Grady Memorial Hospital $12,511,482
DeKalb Medical Center $7,427,694
Children's Healthcare of Atlanta at Scottish Rite $5,063,399
WellStar Cobb Hospital $2,378,702
Gwinnett Medical Center $1,920,754
Floyd Medical Center $1,666,270
Rockdale Medical Center $1,513,492
Children's Healthcare of Atlanta at Hughes Spalding $1,465,941
Sumter Regional Hospital East $1,452,103
Southern Regional Medical Center $1,438,591
Newton Medical Center $1,155,676
Meadows Regional Medical Center $789,891
Barrow Regional Medical Center $752,641
Tanner Medical Center/Villa Rica $614,835
Piedmont Newnan Hospital $565,159
Stephens County Hospital $445,920
Northeast Georgia Medical Center $405,336
Phoebe Putney Memorial Hospital $400,210
Donalsonville Hospital, Inc. $247,301
Dodge County Hospital $201,214
Evans Memorial Hospital $189,782
Trinity Hospital of Augusta $178,186
Higgins General Hospital $177,164
Roosevelt Warm Springs Institute for Rehabilitation $145,874
Minnie G. Boswell Memorial Hospital $136,223
Appling Hospital $133,843
Wills Memorial Hospital $108,179
Mitchell County Hospital $97,213
Washington County Regional Medical Center $90,270
Phoebe Worth Medical Center $84,041
Mountainside Medical Center $74,969
Liberty Regional Medical Center $72,755
Coliseum Medical Centers $68,774
Hart County Hospital $31,670
Oconee Regional Medical Center $23,847
Grady General Hospital $22,131
Irwin County Hospital $19,868
Upson Regional Medical Center $11,848
Memorial Health University Medical Center $5,313
Anchor Hospital $0
Bacon County Hospital $0
Bleckley Memorial Hospital $0
Brooks County Hospital $0
Calhoun Memorial Hospital $0
Candler County Hospital $0
Charlton Memorial Hospital $0
Chatuge Regional Hospital $0
Clinch Memorial Hospital $0
Coastal Harbor Treatment Center $0
Coliseum Psychiatric Center $0
Devereux Georgia Treatment Network $0
Early Memorial Hospital $0
Effingham Hospital $0
Hillside Hospital $0
Inner Harbour Hospital $0
Jeff Davis Hospital $0
Jenkins County Hospital $0
Laurel Heights Hospital $0
Louis Smith Memorial Hospital $0
Lower Oconee Community Hospital Inc. $0
Macon Behavioral Health System $0
Medical College of Georgia Hospitals and Clinics $0
Miller County Hospital $0
Monroe County Hospital $0
Morgan Memorial Hospital $0
Mountain Lakes Medical Center $0
Peach Regional Medical Center $0
Peachford Behavioral Health System of Atlanta $0
Polk Medical Center $0
Putnam General Hospital $0
Ridgeview Institute $0
Roosevelt Long Term Acute Care Hospital $0
Screven County Hospital $0
Southwest Georgia Regional Medical Center $0
St. Simons-By-The-Sea $0
Sylvan Grove Hospital $0
Turning Point Hospital $0
Warm Springs Medical Center $0
Willingway Hospital $0
Wildwood Lifestyle Center & Hospital ($7,514)
Berrien County Hospital ($21,648)
Athens Regional Medical Center ($29,772)
Northside Hospital ($47,246)
Coffee Regional Medical Center ($53,855)
Flint River Community Hospital ($63,692)
Memorial Hospital of Adel ($66,353)
Burke Medical Center ($98,786)
Jefferson Hospital ($104,576)
Tattnall Community Hospital ($107,958)
North Georgia Medical Center ($126,796)
Murray Medical Center ($126,900)
Habersham County Medical Center ($168,450)
McDuffie Regional Medical Center ($171,312)
West Georgia Medical Center ($180,057)
Southeast Georgia Health System-Camden Campus ($200,082)
Smith Northview Hospital ($200,522)
Elbert Memorial Hospital ($201,194)
BJC Medical Center ($211,050)
Chestatee Regional Hospital ($213,674)
Decatur Hospital ($214,528)
Perry Hospital ($236,793)
Emanuel Medical Center ($247,529)
Central Georgia Rehabilitation Hospital ($251,119)
Taylor Regional Hospital ($274,706)
Dorminy Medical Center ($281,966)
Memorial Hospital of Bainbridge ($293,595)
Cobb Memorial Hospital ($299,711)
Walton Rehabilitation Hospital ($306,079)
WellStar Paulding Hospital ($323,523)
Fannin Regional Hospital ($331,365)
Emory-Adventist Hospital ($333,264)
Satilla Regional Medical Center ($360,291)
Gordon Hospital ($430,126)
Coliseum Northside Hospital ($442,496)
Union General Hospital ($456,189)
Crisp Regional Hospital ($458,948)
Walton Regional Medical Center ($515,971)
Select Specialty Hospital of Augusta ($519,041)
Saint Mary's Hospital ($529,778)
Houston Medical Center ($655,738)
Wesley Woods Geriatric Hospital ($667,520)
Emory Johns Creek Hospital ($718,862)
DeKalb Medical Center at Hillandale ($756,407)
WellStar Windy Hill Hospital ($791,553)
Doctor's Hospital (Columbus) ($802,177)
WellStar Douglas Hospital ($862,837)
Colquitt Regional Medical Center ($898,549)
Hutcheson Medical Center ($937,365)
Palmyra Medical Centers ($972,415)
Northside Hospital-Cherokee ($1,002,534)
Hughston Hospital ($1,147,509)
Shepherd Center ($1,217,809)
Fairview Park Hospital ($1,254,391)
South Fulton Medical Center ($1,323,140)
Gwinnett Medical Center - Duluth ($1,402,637)
Spalding Regional Medical Center ($1,406,155)
Henry Medical Center ($1,451,887)
Tanner Medical Center-Carrollton ($1,510,080)
Cartersville Medical Center ($1,566,061)
Emory Eastside Medical Center ($1,665,575)
Northside Hospital Forsyth ($1,673,131)
Hamilton Medical Center ($1,769,891)
Tift Regional Medical Center ($1,772,652)
Piedmont Fayette Hospital ($1,875,872)
Saint Francis Hospital ($1,950,388)
Redmond Regional Medical Center ($2,068,185)
Saint Joseph's Hospital ($2,244,373)
East Georgia Regional Medical Center ($2,475,455)
North Fulton Regional Hospital ($2,490,091)
John D. Archbold Memorial Hospital ($2,528,673)
Medical Center ($2,578,434)
Candler Hospital ($2,633,247)
South Georgia Medical Center ($2,744,597)
Southeast Georgia Health System-Brunswick Campus ($2,875,286)
Children's Healthcare of Atlanta at Egleston ($2,924,366)
Doctor's Hospital of Augusta ($3,122,859)
WellStar Kennestone Hospital ($3,718,354)
Atlanta Medical Center ($3,805,364)
University Hospital ($4,834,949)
Saint Joseph's Hospital of Atlanta ($5,638,681)
Emory University Hospital Midtown ($5,819,541)
Medical Center of Central Georgia ($7,713,518)
Piedmont Hospital ($9,124,003)
Emory University Hospital ($9,896,268)
Net Impact to Hospitals ($76,709,272)
