TAMPA — Now that Congress has approved a health care overhaul that will extend medical care to more low-income Americans, Hillsborough County officials are wondering: What does this mean for the half-cent sales tax that pays for indigent health care?
Some say the county program could be eliminated.
"It merits consideration if in fact the federal program is going to replace what we do at the local level," County Commissioner Al Higginbotham said. "At this point we just don't know. But it's sure crossing everybody's mind."
Tampa City Council Chairman Tom Scott, who is running for mayor, weighed in on the issue Monday.
He sent a memo to County Commission Chairman Ken Hagan suggesting that the board consider repealing the health care tax once existing clients can take advantage of the federal program.
That money could instead go to transportation improvements, he said. And that means the county could lower its proposal for a 1-cent sales tax to pay for rail, expanded bus service and road improvements. That tax proposal is likely to go before voters in November.
"Instead of putting the 1-cent sales tax on the referendum, they can put a half-cent sales tax on the ballot," Scott said. "That makes it easier for voters to support."
County Commissioner Mark Sharpe said there's no point in linking the two taxes. "They're separate issues," he said.
Tampa Mayor Pam Iorio, a champion of the transportation tax proposal, agreed.
"They both need to stand alone: the transit tax with its merits and its own timetable, and the health care tax with its own analysis and another timetable," she said.
Launched in 1992, Hillsborough's health care program for low-income residents has been heralded as a national model.
At its peak, it brought in more than $100 million a year in sales taxes. Revenue in 2009 was down to $89 million but demand for services rose, with participation going from about 32,000 in 2008 to 34,000 in 2009.
A task force created last year to review the program's finances and services has been closely watching the federal health care discussion and how it might affect the county's program.
Sharpe serves on that task force, and said he will encourage the group to talk in more detail about the future of the program.
"There's no sense in having double coverage," he said. "It seems to me if we're getting ready to have this very large tax at the federal level to mandate coverage, then why would we need to have a local tax that does the same thing?"
Details about how the federal legislation will affect the county remain unknown, said Dave Rogoff, the county's director of health and social services.
Some county health care costs might go down, but others will go up, such as the required contribution to Medicaid. The bill approved Sunday expands eligibility for Medicaid in 2014.
"We would still need monies to pay for that," Rogoff said.
Advocates of the county program say regardless of any federal law, the tax and its services will remain necessary. They suggest that any money saved can be directed to other offerings, such as dental care, preventive care and mental health services.
"If I were a county commissioner, what I would do is ask, 'What do the people of the county need that can be provided by the health plan now that it's freed up from some of its financial obligations?' " said Steve Freedman, a retired professor of pediatrics and political science who serves on the county's health care advisory board. "My first reaction would not be, 'Gee, let's defund the program and shut it down.' "
Like other county commissioners, Jim Norman said he also believes it's too early to make decisions about the indigent health care program.
First of all, he's not convinced that the federal program will be enacted, pointing out that Florida Attorney General Bill McCollom is among those challenging the constitutionality of provisions in the bill that require people to have health insurance.
"For the entire state of Florida, this Obama health care thing is going to be so costly and so intrusive that we will fight it until the last court date," said Norman, a Republican running for the state Senate.
However, he said, if the federal program does go into effect, the opportunity to lower local taxes by eliminating the county program emerges as a silver lining.
"We should now definitely take the first steps to look at it," Norman said. "We would finally be serving the taxpayers of Hillsborough County by giving them some real tax relief."
Janet Zink can be reached at firstname.lastname@example.org or (813) 226-3401.