Safety Net Hospitals: 'Not a Green Light'
Even after Sebelius's reassurance, however, hospitals were still uneasy. According to Carl Graziano, spokesman for America's Essential Hospitals, even though the anti-kickback statute was no longer an issue, hospitals were concerned that "there may be other legal barriers to overcome, so [it is] not a green light."
The AHA legal advisory is clear:
"We believe that existing IRS precedent strongly supports a determination that providing this type of subsidy advances the charitable purpose of hospitals and that any benefit to insurers is incidental to achieving the larger public good of making health care available to those with financial need."
Providing subsidy support in the name of a charitable contribution, the advisory added, "is especially important for individuals residing in states that have chosen not to expand their Medicaid programs and could help fill the gap in making affordable coverage available to meet the needs in those communities."
Meanwhile, some hospitals have gone ahead and done so through charitable organizations. The University of Wisconsin Hospital and Clinics on Sept. 30 announced that it gave $2 million to United Way of Dane County to help low-income people purchase health plans on the state's exchange. The funds will help some 7,300 people, who now will pay only 2% of their premiums plus some out-of-pocket costs such as deductibles.