Bid to renew KC's extra health levy deserves scrutiny
The Kansas City Star
Nine years ago Kansas Citians narrowly approved a property tax increase to provide more public funds for indigent health care. It was a compassionate decision by voters.
But the world of health care has changed a great deal since then. Today, U.S. and Missouri officials are discussing grand plans to spend more federal funds on Medicaid patients through the Affordable Care Act, as well as offering insurance exchanges that could provide coverage for more Americans.
One thing, however, hasn’t changed: Truman Medical Centers and a few other medical care providers in Kansas City still want to keep receiving property tax revenue.
They are hoping the City Council will ask voters on April 2 to endorse a nine-year extension of the special 22-cent property tax on each $100 of assessed value.
The tax raises more than $15 million a year from homeowners and businesses. About $2.5 million annually goes to the Fire Department’s ambulance service and an additional $2.5 million a year to public health centers, while the remaining $10 million-plus is sent to Truman.
On Wednesday the City Council’s finance committee will discuss the request for the tax, which is in addition to the city’s already-existing 50-cent property health levy. Combined, both levies raise $50 million a year.
It’s a bit odd that the local health care providers want to impose a continued tax burden for nine more years on Kansas Citians, even as the potential for increased federal health care funding looms. The Municipal Revenue Commission last year called for a four-year renewal, although that was based on added Medicaid funds coming to Missouri, which is not yet certain.
Politically, health care officials have worked behind the scenes for months along with others, lining up support from Mayor Sly James and others on the council. At a Dec. 20 meeting at City Hall, council members asked softball questions about how the tax would be used and why it had to be renewed in 2013 when it doesn’t expire until 2014.
At the end of the hearing, James acknowledged that the council should not “take anything for granted” as it pursued the tax renewal.
At Wednesday’s meeting, Kansas Citians need to be given a more complete picture of why it could make sense to extend the tax. The council also should at least consider a shorter renewal period.
Officials at Truman and the public health centers are adamant about this point concerning the Affordable Care Act: No one knows for certain how it will be put into place over the next few years in Missouri. Two questions dominate the discussions.
- Will the state actually get hundreds of millions more in Medicaid funds?
Democratic Gov. Jay Nixon has vowed to fight for the funding from the federal government, but Republican legislators so far have balked at the move. They contend it would cost the state millions of extra dollars in the long run. That point, however, is undermined by studies showing the opposite — that expanded Medicaid funding would create jobs and tax revenues as well as result in healthier Missourians.
- Will a health insurance exchange be set up in Missouri?
Strident opposition to the Affordable Care Act has hampered creation of a state insurance marketplace, so it’s likely the U.S. government will design one for Missouri.
If Missouri does not adopt Medicaid expansion or progress on the exchanges is delayed, the squeeze will be on hospitals in earnest to keep their doors open to serve indigent patients in Kansas City and the state.
Still, the City Council and local health care providers must use this week’s hearing to start providing clear evidence they need a $135 million tax renewal over nine years.