Kim Simmons


Policymakers and health care leaders have frequently questioned and critiqued whether nonprofit hospitals’ provision of community benefits is worth their favored tax status. While legislation and regulations have recently been enacted to address such concerns, the tax exemption standards continue to fail to promote the goals articulated in the Patient Protection and Affordable Care Act of 2010 (ACA) of reforming and improve health care delivery systems in the United States for all people. To better effectuate the purposes of the ACA, this article suggests that the Internal Revenue Service adopt minimum community benefit spending requirements that vary depending on the form of community benefit and the goals meant to be achieved by the benefit. By enacting such minimum requirements, society would be better able to ensure that the principles underlying the initial grant of tax exempt status to nonprofit hospitals are realized and better aligned with the forward-looking goals articulated in the ACA.