Bill Overview
Title: Non-Profit Hospital Tax Exemption Transparency Act
Description: The bill imposes additional community benefit standards for tax-exempt hospital organizations. A hospital organization must have a board of directors drawn from the community in which it is located and must provide medical care for patients who pay their bills through public programs, including Medicare and Medicaid. The organization may not limit the number of patients served at any clinical site it owns or controls and must spend specified amounts on (1) training, education, or research designed to improve patient care; (2) improvements to facilities and equipment; and (3) free or discounted care. The Inspector General for Tax Administration of the Department of the Treasury must conduct a review of the financial assistance policies of tax-exempt hospital organizations. The Government Accountability Office must review and report on the effectiveness of the Internal Revenue Service in enforcing compliance of tax-exempt hospitals with the new community benefit standards.
Sponsors: Rep. Spartz, Victoria [R-IN-5]
Target Audience
Population: People impacted by changes in non-profit hospital operations globally
Estimated Size: 190000000
- The bill affects non-profit hospital organizations which hold tax-exempt status, influencing how they operate concerning community benefits.
- All patients who depend on these hospitals for medical care, especially those covered by public programs such as Medicare and Medicaid, will be impacted.
- Populations benefiting from training, education, or research funded by the hospitals will see changes.
- The uninsured or underinsured individuals who rely on free or discounted care from these hospitals will experience changes related to this bill.
- Healthcare providers within these hospitals may face changes in their workplace environment, especially in terms of the resources available for training and research.
Reasoning
- The scope of the policy primarily affects non-profit hospitals and the surrounding communities they serve. The target population involves patients who utilize services at these hospitals, notably those who rely on Medicare and Medicaid, uninsured or underinsured individuals, and medical staff operating under potentially updated financial and training contexts.
- Given the substantial number of individuals who receive care from non-profit hospitals, the policy is likely to have indirect benefits on the broader healthcare system, potentially elevating service quality through enhanced training, research, and facilities upgrades.
- The budgetary constraints imply the need for strategic implementation mainly aimed at areas with a high reliance on non-profit healthcare services. The overall goal appears to be not just service provision but also fostering systemic improvements and transparency.
- The diversity in the population receiving care from non-profit hospitals necessitates an array of simulated interviews to capture different perspectives, from the needy receiving discounted care to the staff experiencing policy-driven workplace changes.
Simulated Interviews
Retired (Detroit, Michigan)
Age: 58 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 10.0 years
Commonness: 8/20
Statement of Opinion:
- I'm relieved about potential improvements in the hospital's service availability, especially since I rely on Medicare.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 6 | 5 |
| Year 5 | 7 | 5 |
| Year 10 | 7 | 5 |
| Year 20 | 6 | 4 |
Nurse (Houston, Texas)
Age: 32 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 20.0 years
Commonness: 5/20
Statement of Opinion:
- This will provide more training opportunities and improve patient care standards.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 8 | 6 |
| Year 3 | 8 | 6 |
| Year 5 | 9 | 6 |
| Year 10 | 9 | 6 |
| Year 20 | 8 | 5 |
Single Mother (Atlanta, Georgia)
Age: 41 | Gender: female
Wellbeing Before Policy: 4
Duration of Impact: 15.0 years
Commonness: 6/20
Statement of Opinion:
- I'm hopeful this will ease the stress of balancing health expenses.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 5 | 4 |
| Year 3 | 6 | 4 |
| Year 5 | 7 | 4 |
| Year 10 | 7 | 3 |
| Year 20 | 6 | 3 |
Part-time Teacher (Seattle, Washington)
Age: 66 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 20.0 years
Commonness: 7/20
Statement of Opinion:
- Ensuring continued access to services is crucial, especially for veterans.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 7 | 6 |
| Year 5 | 8 | 5 |
| Year 10 | 8 | 4 |
| Year 20 | 7 | 4 |
Research Assistant (Los Angeles, California)
Age: 24 | Gender: other
Wellbeing Before Policy: 7
Duration of Impact: 10.0 years
Commonness: 5/20
Statement of Opinion:
- The funding for research and education could kickstart my career.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 7 |
| Year 2 | 8 | 7 |
| Year 3 | 9 | 6 |
| Year 5 | 9 | 6 |
| Year 10 | 9 | 6 |
| Year 20 | 8 | 5 |
Retired (Rural Alabama)
Age: 72 | Gender: female
Wellbeing Before Policy: 3
Duration of Impact: 5.0 years
Commonness: 4/20
Statement of Opinion:
- I'm concerned about access, hoping it improves under this policy.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 4 | 3 |
| Year 2 | 5 | 3 |
| Year 3 | 5 | 3 |
| Year 5 | 6 | 2 |
| Year 10 | 4 | 2 |
| Year 20 | 3 | 2 |
Freelancer (Chicago, Illinois)
Age: 29 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 10.0 years
Commonness: 8/20
Statement of Opinion:
- Hopefully, this will maintain the charitable services I rely on.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 7 | 5 |
| Year 10 | 7 | 4 |
| Year 20 | 6 | 4 |
Hospital Administrator (Baltimore, Maryland)
Age: 55 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 5.0 years
Commonness: 9/20
Statement of Opinion:
- Initially skeptical but can see potential benefits with proper guidance.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 6 |
| Year 2 | 6 | 6 |
| Year 3 | 7 | 5 |
| Year 5 | 7 | 4 |
| Year 10 | 6 | 4 |
| Year 20 | 6 | 3 |
Medical Researcher (New York, New York)
Age: 37 | Gender: male
Wellbeing Before Policy: 7
Duration of Impact: 20.0 years
Commonness: 5/20
Statement of Opinion:
- Proposed policy enhances funding, which is critical for my research.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 8 | 7 |
| Year 3 | 8 | 6 |
| Year 5 | 9 | 6 |
| Year 10 | 9 | 5 |
| Year 20 | 8 | 5 |
Full-time Caregiver (Phoenix, Arizona)
Age: 50 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 10.0 years
Commonness: 6/20
Statement of Opinion:
- Processing regulations can be tough but could lead to better services.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 7 | 4 |
| Year 5 | 7 | 4 |
| Year 10 | 6 | 3 |
| Year 20 | 5 | 3 |
Cost Estimates
Year 1: $250000000 (Low: $200000000, High: $300000000)
Year 2: $250000000 (Low: $200000000, High: $300000000)
Year 3: $250000000 (Low: $200000000, High: $300000000)
Year 5: $250000000 (Low: $200000000, High: $300000000)
Year 10: $250000000 (Low: $200000000, High: $300000000)
Year 100: $250000000 (Low: $200000000, High: $300000000)
Key Considerations
- The extent to which hospitals can practically implement the additional community benefit standards without significant disruption.
- The potential for improved health outcomes due to increased access to non-profit hospital services for Medicare and Medicaid patients.
- The oversight costs for the Treasury and GAO may pose budgetary challenges.