People are waiting outside the Lyndon B. Johnson Hospital in Houston. For years, states have been taxing hospitals and other providers of health service providers in order to create federal agents and to finance their Medicaid programs. Now states can lose their ability to boost or implement up-to-date taxes. (Brandon Bell | Getty Images)
Calculate the tax and output costs of the US house Approved last week Goals that have used a strategy to strengthen the Medicaid dollars that they receive from the federal government. The measure would restrict the taxes that medical providers collect or freeze, and possibly leave the states with larger holes in their Medicaid budgets.
As a result, the states would choose to either replace the lost federal benefit with state dollars, scale services or insure fewer people.
Medicaid is a common state program, mainly for people with low incomes. For the customary Medicaid population – children and their supervisors, people with disabilities and pregnant women – the federal government passes the state medical editions on a slids that are up to 77% for the poorest for the poorest.
Consider a state that receives half of its Medicaid financing from the Federal Government. If this state collects 100 million US dollars by tax providers, it can employ $ 50 million of sales to achieve $ 50 million in Bundesmatching funds with which he can expand Medicaid’s cover to more people. Subsequently, the remaining income of $ 50 million and employ this money can achieve 50 million US dollars in federal funds in order to pay the providers more for the care of Medicaid patients.
Forty-nine-forty-all-all over the strategy except Alaska. In 2018, the last year for which data are available, there are states supported For provider taxes to finance 17% of their Medicaid editions, compared to 7% in 2008, accordingly The US government’s obligation to do the government.
As part of their efforts to reduce the expenditure for Medicaid from Bund in the next decade by around 625 billion US dollars, the Republicans of the Republicans have proposed to limit the taxes of the state provider and to freeze them to boost states to boost them or to implement up-to-date ones to react to inflation. According to applicable law, states can boost taxes of up to 6% for the net income of tax providers. The GOP measure would also add the work requirements for Medicaid recipients, a step that would save money by reducing the roles.
A report From the household office of the congress, the cross -party research low of the congress, the elimination of the federal government’s taxes could save hundreds of billions of dollars over the next ten years.
Many conservatives say that taxes are a accounting knitting that enables states to deduct money from the federal government without ending their true proportion of the Medicaid program. Some even have the providers tax as “referred to”Money laundering”Scheme.
“States play the system and create complex tax systems that shift their responsibility for investing in Medicaid and Rob federal taxpayers” Press release.
Brian Blase, President of the Paragon Health Institute, a conservative political group that works with Republicans to formulate Medicaid’s cuts, described the taxes of providers as “a way of how states and providers can tear down the federal government”.
“States must have a certain accountability for the expenditure in their programs,” said Blasen.
However, the supporters of these taxes, including the state medical directors and even hospitals who pay taxes, describe them as legal and legitimate financial instruments that have helped the providers to cover critical services and to finance their Medicaid programs for years. The result of the removal of these taxes or freezing, it is said that it will be hospital closures and service abbreviations.
“We do not want to pay these taxes, but the alternative is that resources or access to care are not available for this community,” said Jason Pray, Vice President for Legislative Affairs in the necessary hospitals of America, an association that represents around 350 hospitals. “The state would most likely have to tax individuals in order to compensate for this in order to keep the services at the same level and to keep the resources at the same level.”
According to bladder, the provider taxes allow hospitals to achieve profits from the additional federal agreement funds that flow back to them, which represents a kind of “corporate care”.
But Pray said that hospitals often lose money in his association. By enabling the states, payments to hospitals and other providers who serve Medicaid patients, the tax enables hospitals to remain open in the long term and not to receive a wind case.
Also pray that in the past the support for taxes was overpartery.
“The Republicans have shown for years that they support provider taxes and understood the value of them,” he said.
For years, the Republicans have shown that they support provider taxes and understood the value of them.
– Jason Pray, Vice President for legislative matters in the necessary hospitals of America
Edwin Park, a research professor at the McCourt School of Public Policy from Georgetown University, pointed out that some hospitals pay the tax and do not come back much because they only serve a few Medicaid patients. The hospitals that benefit the most of this are the so -called safety network hospitals that look after many patients with low income, he said.
Park said he was concerned that the states, as soon as the strategy is at the table, have to lower their Medicaid editions to compensate for their budgets.
Jay Ludlam, deputy secretary of North Carolina Medicaid, is also worried about it. In North Carolina, said Ludlam, almost all tax revenue that the state submits from providers helps paying Medicaid services.
“The money goes to the providers if they offer services. It is not something special. It is just a different way to control yourself and put money into the program,” Ludlam told Stateline. “If it means that there will be less money in Medicaid … we have to reduce the authorization, reduce services, reduce provider rates to maintain the program.”
Stateline reporter Shalina Chatlani can be reached schatlani@stateline.org.
