More than $100 million in Fulton County property tax goes each year to fund health care, including more than $60 million to subsidize Grady Memorial Hospital.
Bob Ellis, vice chair of the Fulton County Commission, wants to change that — by shifting the funding source from property taxes to a county-wide special sales tax. That could include funding services to replace the two hospitals in south Fulton that Wellstar Health System closed last year.
“I think that’s the kind of thing that, you know, could be on the table, right?” he said.
Ellis is sponsoring a resolution, up for commissioners’ consideration Wednesday, for county staff to develop a plan within 90 days for authorizing such a tax. A one-cent sales tax would bring in $363 million a year, the resolution asserts.
Ellis said Monday the tax wouldn’t necessarily be a full penny, but should provide stable funding for as much or more service as the county now pays for.
His proposal comes amid discussion of how to mitigate the closure of two hospitals that served south Fulton County. Wellstar 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.
The closures threw a greater burden on Grady in downtown Atlanta, now the only hospital in Fulton County serving the area south of Interstate 20. But that means longer ambulance rides for south Fulton residents, whether to Grady, hospitals in north Fulton or surrounding counties, Commissioner Marvin Arrington Jr. noted. That will inevitably lead to more deaths, he said.
In early March, County Commission Chairman Robb Pitts and state legislators filed federal complaints against Wellstar, alleging the hospital closures were tantamount to “health care redlining” — denying services primarily to needy patients and people of color, while keeping open its hospitals in whiter, more affluent areas.
The resolution cites the gaps in care left by the hospital closures.
In mid-March, county staff projected that Fulton property taxes would have to rise steadily over the next six years to meet proposed spending on health care, a new jail and other projects, employee raises and election funding. The most discussed item was health care, specifically the Wellstar hospital closures.
Some south Fulton cities are talking about creating their own hospital taxing districts, an idea the county as a whole considered but rejected in 2014.
Arrington has said state law allows the county to fund a hospital authority with property taxes, matching funds from south Fulton cities. He said he would propose doing just that “until it passes.”
Fulton County put more than $100 million toward health care in 2022, the resolution says.
“You tally it up, it’s probably closer to $150 million or so,” Ellis said. Support for Grady is the largest share.
“I think last year we funded Grady about $70-something million,” he said. About $60 million of that came through an annual appropriation from the county General Fund, with commissioners voting additional money after the AMC closures. Since 1978 the county has given Grady nearly $3 billion, according to the resolution. DeKalb County also provides some Grady funding, but not nearly as much as Fulton, Ellis said.
Fulton County is renegotiating its funding contract with Grady, which the resolution describes as vital for indigent care.
The county also put $17 million into mental health and $10 million to fund the county board of health, both of which were inadequately funded by the state, Ellis said.
Meanwhile combined health care funding from Cobb, DeKalb and Gwinnett counties totaled about $29 million last year, the resolution says.
The upshot is that Fulton already puts much more into health funding than other counties do, Ellis said.
“It’s a pretty significant tax burden, and it’s all borne by property taxpayers,” he said. While Fulton’s property tax rate is roughly comparable to nearby counties, at least for now, property taxes for school districts and cities substantially increase that burden, he said.
Some services, like courts, must be funded with property taxes, but using that source to pay for health care is not mandatory, Ellis said. A sales tax dedicated to health care would provide stable long-term funding, he said.
The resolution notes that sales taxes of a cent or less already support MARTA, Fulton and Atlanta schools, and transportation infrastructure.
“I just think it’s time to open up that conversation,” Ellis said. “I think it’s a more practical means than looking at additional millage rates on our property tax base to fund such things.”
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