Health care sales tax study on hold, search widening

A Fulton County commissioner’s request to consider funding health care with a new sales tax instead of property taxes turned into a broader exploration of ways to fund health care on Wednesday. But even that is on hold for more discussion.

Commission Vice Chair Bob Ellis proposed a resolution for county staff to develop a plan within 90 days to authorize creation of a Special Purpose Local Option Sales Tax. He cited the amount Fulton spends on health: more than $100 million a year, with at least $60 million of that going to subsidize Grady Memorial Hospital.

Now, that money comes from county property tax revenue.

But the county faces several big expenses in the next few years, such as the $2 billion price of a new jail, and existing health needs that are exacerbated by the closing last year of two hospitals that served the south end of Fulton County. County staff have already said property tax rates will likely need to rise, after dropping in recent years, to afford those expenses.

A half-cent sales tax would generate $180 million a year — and that will likely increase faster than property tax revenue, Ellis said.

But seeking to impose a sales tax, which would take a referendum, can take more than a year, Ellis said.

“It should be viewed as the start of a long conversation,” he said.

Wellstar Health System bought Atlanta Medical Center and its associated East Point hospital from Tenet Healthcare in 2016, as part of a $575 million deal that included three other hospitals. Wellstar said it invested more than $350 million in AMC, but in 2022 lost $107 million at the hospital and could not afford to keep it open.

Last year it closed both East Point and AMC, citing finances; but some local officials have called for Wellstar’s nonprofit status to be investigated, accusing it of abandoning minority communities it’s required to serve.

Grady, in downtown Atlanta, “has really served our county well” but can’t meet all the county’s needs, Ellis said.

Fulton County’s health services are used by many people who don’t live in the county, while Fulton property owners bear the burden of paying for them, Ellis said. Changing that to a sales tax would shift the cost to many out-of-county residents who shop here, he said.

Commissioner Marvin Arrington Jr. said he supported the general idea, but that county staff should be able to research more than just sales taxes.

“I would want them to explore all funding options,” he said. Arrington asked if Ellis would accept a friendly amendment to broaden the search.

“Sure,” Ellis said.

Commissioner Dana Barrett moved to hold the resolution for more discussion. That hold passed 4-1, with Ellis opposed.

Ellis’ proposal came the same day as commissioners heard a report on county health care needs done jointly by Fulton County, Morehouse School of Medicine and Ernst & Young.

The loss of primary health care when the hospitals closed also caused the loss of medical specialty care in the surrounding area, said Pamela Roshell, county chief operating officer for Health, Human Services & Public Works.

According to the report, life expectancy in central and south Fulton County, with large minority populations, is five years lower than in the majority-White, much wealthier north. Researchers attributed that largely to the lack of a major primary care site, resulting in overburdened providers and longer waits for care — often until treatable conditions become critical.

The study, which took about two months, uses much data gathered prior to the Wellstar hospital closures, said Adrian Tyndall, dean of Morehouse School of Medicine. Those closures moved an already underserved area “closer to the precipice,” he said.

Health services need quick action but also long-term plans, Tyndall said. The report recommends five general initiatives: redistributing health care assets for better access; treating the whole patient, not piecemeal conditions; improving technology to share information; reducing financial barriers to care; and removing cultural barriers by ensuring that providers match their patients.

Commission Chairman Robb Pitts said more of the report’s recommendations would be discussed in closed session.