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McNULTY BLASTS ATTEMPT TO TAX HOSPITALS
(Washington, DC): – At this morning’s hearing of the House Ways & Means Committee to review the tax-exempt hospital sector, Congressman Michael R. McNulty (D-Green Island) attacked suggestions that not-for-profit hospitals lose their tax-exempt status. 209 of the 211 acute care hospitals in New York State are currently tax-exempt.
Following the hearing, McNulty said, “The majority party has so botched the economy of the country that we now have the largest budget deficits in our history and the national debt has ballooned to $7.8 trillion.
“On top of that, they are proposing a partial privatization of Social Security which would require the assumption of another $2 trillion in debt.
“Now they've realized the severity of our fiscal situation. They know they desperately need revenue. And where do they turn? To the wealthy individuals and corporations which benefited from their huge multi-trillion dollar tax cuts?
“No!
“Their solution: Let's tax not-for-profit hospitals, which deliver health care to poor people!
“Their agenda is clear: Turn Social Security over to Wall Street, and turn hospital care over to the profiteers.
“That is an agenda I intend to fight -- every step of the way.”
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STATEMENT BY REPRESENTATIVE MICHAEL R. McNULTY (NY-21)
COMMITTEE ON WAYS AND MEANS
HEARING ON THE TAX-EXEMPT HOSPITAL SECTOR
THURSDAY, MAY 26, 2005
New York State is home to 211 acute care hospitals, 209 of which are not-for-profit. Every day, these hospitals treat patients who lack health insurance or are underinsured, providing almost $1.6 billion per year in uncompensated care, the cost of which is only partially subsidized. In my district alone, that figure is approximately $20 million a year. Beyond the provision of charity care, it is the mission of these hospitals to provide to their communities free services - from education seminars to free transportation to free health screenings. The commitment to their communities is overwhelming.
Here are just a few of the special things my hospitals do as community service projects that have a real impact on the health of my constituents:
- Albany Medical Center has accepted the mission of being the designated provider for an expansive region covering 23 counties in upstate New York, for many of the most costly services for the most critically ill and medically complex patients. They are the region's designated AIDS provider, have the only level 4 neonatal intensive care unit, the only pediatric intensive care unit, and the only heart transplant program in the region. These services are not ones that for-profit hospitals would take up. The Medical Center also provides free seminars (lyme disease, gynecological cancer) and free health screenings (prostate cancer, skin cancer, mammograms) for thousands of people every year. I could continue. Let me move to another hospital in my district.
- Amsterdam Memorial Hospital's Zonata Pink Ribbon Collaboration provide mammograms and breast care for uninsured and underinsured residents in two counties where breast cancer is the number one cancer diagnosed in women.
- Bassett Hospital of Schoharie County does free prostrate, breast health, glaucoma, hearing, and hypertension screenings and has a community stroke support group.
- Ellis Hospital's Give us a Hand Project helps children with diabetes and the people that surround them understand the challenges of a child living with diabetes.
- Seton Health's Mommy project teaches teenage mothers-to-be how to balance adolescence and parenthood and how to be caring, responsive caregivers of their new children. At Seton Health, PRESENCE Group volunteers minister to the dying by providing an around-the-clock vigil at the time of death.
- The St. Clare's Hospital Asthma Disease State Management Program works collaboratively with community physicians to offer one-on-one asthma education and to promote and implement National Institutes of Health guidelines, resulting in patients maintaining a healthier lifestyle.
- St. Mary's Hospital's Mobile Geriatric Outreach Program meets the psychological/social needs of people over the age of 60 suffering with mental illness in community settings in Montgomery and Fulton counties.
- St. Peter's Hospital's Pair of Hearts Program educates and motivates women at risk of heart disease to make permanent lifestyle changes that will lower their risk of disease.
When it comes to my hospitals' core mission of providing care to all, in the absence of universal coverage, most hospitals are left to cover the cost of providing care to the uninsured or underinsured through pluralistic payment mechanisms from government payers, third-party payers, and directly from patients. There are 3 million uninsured individuals in New York State. Hospitals in New York maintain the core mission of providing care to all, regardless of ability to pay, despite being in poor financial health overall. Audited financial data from 95% of New York State's hospitals show hospitals collectively lost $391 million caring for patients in 2003, resulting in an aggregate operating margin of negative 1.0%
To help illustrate New York hospitals' commitment to treating all patients with compassion, from the bedside to the billing office for ALL, regardless of ability to pay, in 2004, our state hospital association, the Healthcare Association of New York State (HANYS') Board of Trustees developed and adopted financial aid/charity care guidelines for voluntary consideration by hospitals. Across the state all 209 not-for-profit hospitals have updated, revised, and publicized their financial aid policies to reflect the HANYS guidelines and to further underscore their charitable mission to care for all who need health services.
The continually evolving guidelines address the necessity of hospitals providing adequate and clear notice to patients and their families on their hospital bill and for assisting those in need of financial aid-defined as low-income, uninsured, or underinsured families with incomes at least up to 200% of the federal poverty level (FPL). Many hospitals have adopted more generous policies, providing assistance to those with incomes up to 300% of the FPL. Above all, the guidelines are clear that "fear of a hospital bill should never get in the way of a New Yorker receiving essential health services."
And the financial aid is real. Approximately 75% of hospitals provide discounts to eligible individuals from a Medicaid rate or ensure that discounts from charges are less than or equal to the Medicaid rate or prevailing third-party rate.
Other principles contained in the guidelines include:
- Hospitals must have financial aid policies that are consistent with the mission and values of the hospital and that take into account each individual's ability to contribute to the cost of his or her care and the hospital's financial ability to provide the care.
- Financial aid policies should be clear, understandable, and communicated in a manner that is dignified and in languages appropriate to the communities and patients served.
- Debt collection policies-by both hospital staff and external collections agencies-must reflect the mission and values of the hospital.
- Financial assistance provided by the hospital is not a substitute for the responsibility of government and employers to find solutions to expand access to health care coverage for all New Yorkers.
- Financial aid policies do not eliminate personal responsibility. Eligible patients may or may not be expected to access public or private insurance options to qualify for financial aid. However, all patients are expected to contribute to their care based on their individual ability to pay.
The hospitals in New York State are virtually all not-for-profit and commitment to serving patients whether or not the patients can pay for part or all of the essential care they receive. Their reach and commitment to their communities extends far beyond the scope of what for-profit hospitals would do, and their tax-exempt status needs to be protected.
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