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CPBJ Extra Blog

HAP: Solve FMAP problem by raising cigarette tax

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Pennsylvania's federal medical assistance percentage is going down, so The Hospital & Healthsystem Association of Pennsylvania is suggesting that the state raise the ante on people who light up.

I’m guessing I lost you at FMAP, which is where my comprehension train initially derailed too. But then I read this and got back on track, and I think that will work for you, too.

And now, back to the budget. Here’s what HAP has to say.

“The Pennsylvania hospital community is aware of the daunting fiscal challenges facing the commonwealth, and appreciates the difficult decisions that a more than $1 billion revenue shortfall presents to the Governor and the General Assembly. In fact, hospitals were a key part of the revenue solution in the current fiscal year by agreeing to an increase to the portion of the Hospital Quality Care Assessment that goes to the state’s General Fund by $41 million.

“While HAP recognizes that House Bill 2328 is only the starting point in the journey to adopt the 2014–2015 state budget, hospitals are concerned that the legislation does not include the Governor’s proposed funding to replace lost federal dollars for hospital inpatient, outpatient, and capitation payments.

“The Governor’s original budget plan ensured hospitals would receive the $120 million in federal matching funds, which had been lost as a result of a reduction in Pennsylvania’s Federal Medical Assistance Percentage, or “FMAP”. By using the current fiscal year budget as the starting point, these critical funds have been eliminated from the plan.

“Instead of approving payment reductions that will impact health care delivery, state leaders should consider increasing the statewide cigarette tax to help address the fiscal challenges the commonwealth faces. Even approximately a 25 cent increase will generate the funds necessary to cover the lost FMAP monies. This tax is a viable option, and is one employed by many other states to avoid cutting critical health care services for our residents.”

I’m going to interject here to say that, while proffering no opinion on their proposal, I appreciate that HAP is suggesting an alternative instead of just saying, “Hey, don’t you dare cut our share!”

“In addition,” HAP concludes, “we ask lawmakers and the Governor to protect the use of tobacco settlement dollars for hospital uncompensated care and health care research. These funds help to offset the more than $1 billion a year that hospitals must absorb due to unpaid medical bills, and support the continuation of key health research initiatives.”

So, what do you think? Should legislators rachet up the cigarette tax to help hospitals?


I feel like we’re hearing about a lot of data breaches or potential data breaches lately -- in case you missed it, here’s one from Hershey Medical Center.


Surely this is a question you want the answer to: “Who Are the Newly Insured as of Early March 2014?”


According to the Kaiser Family Foundation, the number of Pennsylvanians in the coverage gap between Medicaid and marketplace subsidies is 281,290. I’m pretty sure both that I’ve seen a different figure from other sources and that Kaiser is about as credible as it gets.


I’m rather certain I’ve seen several other studies on narrow networks, but I still click on them: “Nearly half of exchange products offer narrow networks, McKinsey study says.”


This is an interesting look at individual enrollment outside the marketplaces, if you like numbers.


Finally, it appears that the American Medical Association is so upset that the SGA didn’t pass this year again that it is ordering a review of its lobbying.

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