2018-19 Budget Review: Replacing the Medicare Managed Care Organization (MCO) Tax

By Jason Warner, GOPC Manager of Government Affairs

This is the first in a series of articles taking a closer look as specific items contained in the Governor’s proposed budget for FY2018-19, which the legislature must pass by June 30, 2017.

Last year, the Center for Medicare and Medicaid Services (CMS) issued a ruling that stated that after July 1, 2017, Ohio’s sales tax on Medicaid Managed Care Organizations (MCO’s) would no longer be a permissible source for state funds to draw down federal matching dollars for Medicaid. This represents a significant challenge for both the state, but also local governments and transit authorities which rely on sales tax receipts to support a wide range of services.

The Governor’s proposed budget would replace the MCO sales tax with a new Health Insuring Corporation (HIC) assessment which is similar to a plan that was instituted in California and was approved by CMS last year.

While this new assessment will assist the state in continuing to draw down federal Medicaid matching funds, it is not a sales tax. As a result, local governments and transit authorities will not have any local revenue generated as a result of the new HIC assessment.

House Bill 49 proposes a transitional aid fund for local governments and transit authorities to be paid out in a single lump sum in October of 2017. All 88 counties and eight transit authorities will receive a calculated 4th Quarter 2017 replacement aid amount based on what they would have received in revenue for that three month period. In addition, the transit authorities and 80 counties are to receive an amount based on the size of their sales tax revenue the Medicaid tax collections were, and how their overall sales tax collections compare to the state average. The remaining eight counties will not receive a payment from this calculation because the receipts from the tax represented too small a proportion of the overall revenue derived from the sales tax. (Those eight counties are Delaware, Erie, Geauga, Hancock, Holmes, Medina, Union and Warren counties.)

In total, the state will appropriate nearly $207 million to these local government entities as a part of the transition away from the MCO sales tax. However, in testimony to the House Finance Committee, Office of Budget and Management Director Tim Keen stated that the administration did not believe that long-term or permanent replacement of the revenue was in order as the MCO sales tax had only existed since 2010.

The full list of proposed transitional aid amounts can be found here.

Visit GOPC’s Transportation Modernization page to learn more about this important issue area

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