The Power of A

Amid the over 2,000 pages of the Senate health care bill, there are two nonprofit governance issues contained that should be of note to all associations.  While they do not impact association governance, the issues are sure to remain in the political discussion even after the fate of the bill is decided.

The first deals with the Internal Revenue Service’s “community benefit standard” and hospitals.  The Senate bill uses the Senate Finance Committee language amending the tax code and creating four specific recommendations that nonprofit hospitals must satisfy to retain their nonprofit status.  These recommendations would include new billing and collections procedures, financial assistance policies for the underprivileged, stipulations on charges, and new community health needs assessments.   The goal for proponents is to ensure that nonprofit hospitals provide the community with benefits (hence the name) and do not act as for-profit hospitals with a tax protection.  Neither the Senate HELP Committee bill nor the House legislation contained community benefit language.

The American Hospital Association - the national organization that represents and serves all types of hospitals, health care networks, and their patients and communities - has created an issues paper on the community benefit standard and how nonprofit hospitals are currently complying with the standards.  It can be read here.

A second issue is the new requirement specifically aimed at nonprofit Blue Cross/Blue Shield (BC/BS).  While not a traditional nonprofit, some BC/BS plans were given nonprofit status because they provided specific types of community services and programs for the underprivileged.  However, with insurers under increased scrutiny due to rising premiums, BC/BS is singled out in the health care bill with their own community benefit standard: in order to maintain their nonprofit status the plans must spend at least 85 cents of every premium dollar on health services.  The District of Columbia passed a similar bill earlier this year designed to increase Capital Area Carefirst’s contribution to the DC community.

Quick Hits

The Senate opened debate (subscription) on the health care bill yesterday, with Sen. Mikulski offering an amendment to eliminate co-pays for women’s preventative health screenings and Sen. McCain offering an amendment to remove the $400 billion Medicare reduction… The CBO says the Senate bill would result in no premium increases for group plans, but increases for individual purchasers (not taking into account any subsidies)… Democrats have still not ruled out reconciliation for the health care bill… Seven interesting provisions in the Senate bill, according to Kaiser Health News… Democrats still wrestling with funding health care reform… New blogger disclosure rules go into effect today.