Sen. Chuck Grassley has a record of hammering nonprofit hospitals about whether they’re restricting care based on patients’ ability to pay and about how much care they provide for the uninsured in relation to the tax exemptions they enjoy. Now Grassley, the top Republican on the Senate Finance Committee, and Chairman Max Baucus are trying to force change. They are considering provisions as part of the health-care overhaul that would target nonprofits’ tax breaks, which were designed to help those hospitals provide charity care, according to the WSJ . Options include setting a minimum threshold of charity care that nonprofit hospitals must provide, limiting the amount they charge the uninsured and curbing instances of aggressive collection practices. Hospitals not meeting goals would be penalized with an excise tax, according to the ideas under consideration. The scrutiny of nonprofits and their tax benefits has heightened amid the drive to overhaul health care. In theory at least,

there should be less need for charity care if the number of uninsured Americans drops, as would be the goal if a revamped health system that requires universal coverage or something close to it. The hospital industry agreed earlier this week to cuts worth a projected $155 billion over 10 years. But other proposals, such as withholding Medicare and Medicaid payments from hospitals in the cases of patients readmitted for the same problem within a certain period of time, are still under consideration, says the WSJ. Some nonprofits are worried about any across-the-board changes that might be applied to the industry. “That’s awfully simplistic,” Bruce McPherson, president and chief executive of the Alliance for Advancing Nonprofit Health Care, told the WSJ. “Then it just becomes a numbers game.” A “softer” measure, where hospitals would be assessed individually, would be preferable, he said.

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Grassley Takes Closer Aim at Nonprofit Hospitals