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Stopping Profiteering in "Not-for-Profit" Hospitals
Stopping Profiteering in "Not-for-Profit" Hospitals Thursday, April 10th, 2008http://www.progressivestates.org/dispatch
Stopping Profiteering in "Not-for-Profit" HospitalsIt's counter-intuitive, but many US not-for-profit hospitals have bigger profits than their for-profit counterparts. Last week, a Wall Street Journal article discussed the growth of profits in the not-for-profit hospital sector and the welcome attention this is garnering from federal policymakers. As reported, the combined net income of the 50 largest not-for-profit hospitals across the US increased nearly eight-fold from 2001 to 2006 to a staggering $4.27 billion. 77% of the 2,033 not-for-profit hospitals in the US routinely make money, compared with 61% of for-profit hospitals. In return for their not-for-profit status and $12.6 billion in tax exemptions, these hospitals must provide a "community benefit". Many people assume this means charity care, or free care for the uninsured and indigent, but the term is so loosely defined that some hospitals have been reporting the wages they pay to employees as a community benefit. Another problem is that ostensibly non-profit hospitals have entanglements with for-profit subsidiaries that line the pockets of staff and affiliated professionals affiliated with these supposedly non-profit hospitals. To shed light on not-for-profit hospitals and the community benefits provided, the IRS will require hospitals to break-down their community benefit contributions starting in 2009. The new reporting standards are welcome, but minimum standards for providing charity care are a must next step. What Can States Do? All of Maine's community hospitals are non-profit. However, as highlighted by a report from Consumers for Affordable Health Care, concerns that the hospitals were generating consistent profits even while hospital costs were increasing in Maine at rates far above regional and national rates, helped lead to enactment of Chapter 249. This 2005 law requires Maine hospitals to disclose financial information about each tax exempt entity as well as for-profit entities in which a hospital has a controlling interest. To ensure communities are getting value for the tax exempt status of not-for-profit hospitals, Community Catalyst's Hospital Accountability Project offers research, fact sheets, and model legislation for state policy . Resources include:
Voter Identification Laws: The Specter of Fraud Helps the Right Wing Shape the ElectorateSince the federal Help America Vote Act (HAVA) established the requirement that first time voters present some form of identification before voting in a federal election, voter identification requirements of all sorts have been enacted across the country. Currently 26 states have laws that are more restrictive than the HAVA mandate, and 21 states require ID from voters every time they vote. These laws have been passed by arguing they are necessary to prevent voter fraud, even though all evidence suggests that such fraud is extremely rare and poses no threat to the integrity of our voting systems. Instead, these fraud arguments have merely been a partisan tool, used for decades, to suppress turnout among new groups entering the electorate in large numbers and threatening the power of those currently in charge, whether they be minorities, immigrants or students. Evidence of Suppressed Voter Turnout: Sadly, the evidence suggest that these efforts to reduce turnout and shape the electorate for partisan gain are most likely effective and have the greatest impact on poor, less educated, elderly and minority voters. One scholar has estimated that requiring photo identification from all voters would disenfranchise 20 million people. Indiana and Georgia currently have such a photo identification requirement in order for a vote to be counted. A challenge to the Indiana law has been heard by the US Supreme Court and a decision is expected by June. Voter identification laws have also become a favorite tool of anti-immigrant forces and in the 2007-2008 legislative sessions 18 states have introduced bills to require that voters prove they are US citizens. Fortunately for voters, the only one of these bills to be passed into law so far applies to just one town in Delaware. Defeating Bad Bills: Legislators in many states are still pushing to impose new voter ID requirements in states that lack them, and continue to argue for making existing requirements more stringent by narrowing the types of ID that can be used. Happily, it seems that at least temporarily the wave of new voter ID laws in waning as more bills are being voted down than up. However, we expect that if the Supreme Court rules as expected, and allows Indiana’s photo ID requirement to stand, there will be an even stronger push from conservative forces on this issue in the coming legislative session. Here’s what has been active in the current session:
Victories on National Popular Vote, Paid Family Leave and Overseas VotingA few key legislative victories in the last week worth noting:
Research RoundupRising Inequality: In a state-by-state analysis of rising income inequality, the Center on Budget and Policy Priorities finds that since the late 1990s, incomes of the bottom fifth of families has declined by 2.5% among the bottom fifth of families, even as the top fifth has seen a 9.1% increase. In recent years, Mississippi, Alabama, New Mexico, Connecticut and Indiana have seen the greatest increases in income inequality. Costs of E-Verify: In a major study of the E-Verify pilot project to verify the eligibility of Americans to work, the Congressional Budget Office found that expanding the program to cover every workplace would cost $40 billion over ten years, largely in enforcement costs and lost tax revenue due to employers paying more undocumented immigrants under the table and no longer withholding taxes for the government. The implications are that expanded E-Verify use will cost states a similar magnitude of state income, unemployment and other payroll tax losses. Business Costs of Health Insurance: A new Rand study finds that health insurance costs for small business are rising faster than for larger ones, with small businesses seeing a 30% increase in percentage of payroll going to health care costs between 2000 and 2005. Surprisingly, few smaller firms dropped coverage in the period studies, although it's unclear whether they can sustain coverage if costs continue to rise. Gains from Drug Treatment: Expanding drug treatment for arrestees would yield $46 billion in benefits to society, according to a new study by the Urban Institute. Unfortunately, current rules in most states limit eligibility for most arrestees participation in community-based treatment programs, so policy changes are needed to achieve these cost savings. Rural School Needs: Low-income rural students are more at risk of becoming high school dropouts than their city and suburban peers, but rarely get the media or policy attention to address their needs, according to a new study by the Center for American Progress. Trying to Make Ends Meet: A new study by the NC Budget and Tax Center finds that a typical North Carolina family with children must earn $41,184 to actually afford needed housing, food, childcare, health care, transit and other necessities-- yet 37% of families in the state fall below that income threshold, usually because they are paid a living wage at work. Closing Corporate Loopholes Doesn't Cost Jobs: Two useful state reports countering the myth that tax giveaways are key to job creation:
Pioneering Renewable Energy in the Rocky Mountains: Colorado has become a leader in clean energy investment, generation and use and a new report by Alice Madden, the state's General Assembly Majority Leader and sponsored by the Center for American Progress, details those successes and how the state achieved this leadership in recent years. Please email us leads on good research at research@progressivestates.org ResourcesStopping Profiteering in "Not-for-Profit" HospitalsCommunity Catalyst - Hospital Accountability Project The Access Project - Hospital Billing and Collection, Recommendations for Non-Profit Hospitals' Provision of Uncompensated Care Consumers for Affordable Health Care - Off the Charts: Unsustained Hospital Cost Growth in Maine Voter Identification Laws: The Specter of Fraud Helps the Right Wing Shape the ElectorateBrennan Center for Justice – Voter ID Brennan Center for Justice – Policy Brief on Alternatives to Voter ID Demos – Challenges to Fair Elections – Voter ID Brennan Center for Justice – The Truth about Voter Fraud American Prospect (April 2008) – The Republican War on Voting Social Policy (Fall 2007) – History of Partisan Attacks on the Voting Process NCSL – Requirements for Voter Identification Cal Tech/MIT Voting Technology Project – Research Materials on Voter Identification Lonna Rae Atkeson et al. – New Barriers to Participation: Application of New Mexico’s Voter Identification Law Victories on National Popular Vote, Paid Family Leave and Overseas VotingIL National Popular Vote Progressive States Network - National Popular Vote - A Voter Turnout and Civil Rights Issue FairVote - The Electoral College National Popular Vote - Every Vote Equal: A State-Based Plan For Electing The President By National Popular Vote NJ Paid Leave Progressive States Network - Paid Sick Days & Paid Leave Bills Approved in D.C. and New Jersey NJ S 786, New Jersey Paid Leave Act Minnesota Overseas Ballot Reform MN HF1259 - Minnesota overseas ballot reform bill New PSN ResourcesProgressive States Network has begun producing issue-specific updates in some of our key policy areas. These updates are designed to give legislators and advocates especially interested in particular policy areas more information on legislative moving in the states, new resources being published, and other news to help you in your work. In recent weeks these updates have included:
Additional resources produced by PSN staff in recent weeks include:
3 Steps Forward1. CA: Assembly approves paid sick days bill 2. US: Bill advances to suspend Medicaid cost-shift rules 3. IL: Plan to double income tax for some clears Illinois House panel 2 Steps Back1. US: Fed financial regulation plan would shrink states' powers 2. US: Immigration and Customs Enforcement spending billions on mass deportations EventsYoung Elected Officials National ConveningApril 23th The largest gathering of young progressive elected leaders in the country will meet. On April 23rd, PSN's Policy Director, Nathan Newman, will be participating in two training sessions, one on building progressive tax structures at the state and local level and a second on immigration reform. Good Jobs First ConferenceMay 7th & 8th
Registration is now open for Good Jobs First's national conference on May 7 and 8 near BWI Thurgood Marshall Airport, located between Baltimore and Washington, DC. Come meet the nation's top campaigners, researchers and experts on economic development accountability and smart growth for working families. MastheadThe Stateside Dispatch is written and edited by: Nathan Newman, Policy Director Please shoot us an email at dispatch@progressivestates.org if you have feedback, tips, suggestions, criticisms, or nominations for any of our sidebar features.
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