Hospitals unhappy with proposed 'hospital tax' COUNTY BOARD | Moreno wants them to pay for failing to meet free care goals
Saturday, November 14, 2009
by Lisa Donovan
With Cook County commissioners expected to roll back the sales tax a
half penny on the dollar -- and make it stick this time -- a simmering
discussion may very well boil over about a proposed hospital tax, as
one group calls it, to continue delivering health care to the poor and
The debate pits Commissioner Joseph Mario Moreno, a Democrat whose
district largely encompasses the Southwest Side, against hospitals in
Chicago and the suburbs.
Under the legislation Moreno sponsored, larger nonprofit health-care
facilities would be subject to what he calls a "fee," but sounds more
like a penalty, if they do not provide free care to the poor or
uninsured equal to 4.5 percent of the hospital's annual expenses.
Moreno is concerned that revenue losses from a potential sales tax
rollback would hurt Cook County government, a $3.1 billion operation
with roughly $850 million going to the county's health-care system this
"This is to discourage hospitals from referring patients who have no
ability to pay to the public health system," driving up the county's
medical tab, Moreno said. He estimated that half of the 1 million
people who go through the county's health-care system each year aren't
insured and don't qualify for Medicare or Medicaid.
Moreno says his proposed ordinance is particularly important now as
unemployment climbs and, along with it, the number of uninsured.
Kevin Scanlan, president and CEO of the Metropolitan Chicago
Healthcare Council, a trade and lobbying group, fired back: "It appears
the commissioner wants to replace one tax with another tax, and that's
His trade and lobbying group, which represents 94 hospitals in an
eight-county region, says Cook County can't legally impose an
"This could be the straw on the camel's back that could cause them
to close," Scanlan said, noting that at least one Chicago neighborhood
hospital could be shuttered because of the requirement.
On the backs of struggling hospitals, the "tax" would generate $340 million annually, according to the hospital group.
"That's all baloney,'' says Moreno. He stresses that if the
hospital's charity care matches that 4.5 percent, they won't have to
write a check to the county at all.
"We have legal opinions, and they say we can do it."
Moreno also explains the threshold would be lower -- 2.3 percent --
for so-called "safety net hospitals," smaller community hospitals such
as St. Bernard and St. Anthony, operating in Chicago's inner city, that
are already helping fill in the health-care gap by providing care to
"Most if not all safety net hospitals meet or exceed the 2.3 percent requirement," he said.
"It's incumbent on the larger hospitals ... to help us to alleviate the stress."
The measure is in the County Board's Finance Committee. Moreno said
a public hearing will be held before it comes up for a vote -- as early
as January, a month before the Feb. 2 primary election.