The “Healthcare Access Protection Initiative” (HAPI) ordinance, pending in the Cook County Finance Committee proposes the creation of annual financial assistance (or charity care) thresholds, which are tied to a percentage of total hospital expenses. If hospitals fail to meet these thresholds, the ordinance would impose a fine to make up the difference between the charity care provided and the amount required.
As the past chairman of the National Association of Counties’ Hospital Task Force, I am familiar with the unfair burden placed on the safety net hospitals when private hospitals shirk their share of providing charitable care, yet I believe this proposed ordinance would ultimately decrease care for the poor and uninsured.
I am against the HAPI ordinance because I do not believe that imposing a new tax on hospitals in Cook County is the appropriate method to ensure access to care for all. Many private hospitals are already struggling, and imposing strict charity care requirements could result in health care service reductions and hospital layoffs, potentially affecting thousands of jobs. Any reduction in services at private hospitals would only increase the burden on the public healthcare system and hospital closures would inflict permanent damage to our regional healthcare safety net.
The reported referral of low-income and uninsured patients to our public hospitals by not-for-profit hospitals is troublesome because these institutions are granted a tax exemption by the state in exchange for charity care. Despite this frustration, it does not make sense to impose a charity care requirement which may hobble area hospitals. It is extremely difficult to gauge a hospital’s service to uninsured and underinsured patients.
I understand the intent of the commissioners sponsoring this legislation, but I do not believe they have grasped the full range of consequences the HAPI ordinance could have—instead of increasing access to healthcare, these requirements could have the opposite effect for county residents by placing hospitals in a dire financial situation that forces them to close down or decrease services. |
