Carol Miller
09/18/2025 | Press release | Distributed by Public on 09/18/2025 10:42
ICYMI: Miller Participates in Hearing to Discuss Tax-Exempt Hospitals' Benefits
September 18, 2025
Press Release
Washington, D.C. - On Tuesday, Congresswoman Carol Miller (R-WV) participated in an Oversight Subcommittee hearing aimed at providing background on the role and purpose of non-profit hospitals, the federal benefits these institutions currently receive through the tax code, and an assessment of whether these non-profit hospitals are operating in a manner that is consistent with the requirements of their tax-exempt status. A video and transcript of the Congresswoman's questions and provided responses can be found below.
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Congresswoman Miller began by highlighting the growing problem of rural hospitals being taken advantage of by large, tax-exempt hospitals.
"I appreciate the opportunity to discuss tax-exempt hospital statuses and what our hospitals are doing to fulfil their community benefit standard.
As many of you know, I represent the wild and wonderful state of West Virginia, which has one of the largest rural populations in the country.
Our rural hospitals go above and beyond to provide patients with the care they need. Many of these rural hospitals can provide such community services with savings from being tax-exempt entities.
I think this is a fair trade-off for hospitals to make - but I have recently been alarmed at a growing trend of urban tax-exempt hospitals reclassifying as rural to receive additional benefits meant to help treat our most vulnerable rural patients.
This spreads already limited resources even thinner at the expense of many of my constituents - and I am thankful for the work that two of our witnesses today, Dr. Bai and Mr. Whaley, have done to uncover more information about this trend," said Congresswoman Miller.
The Congresswoman then discussed concerns regarding tax-exempt, urban hospitals dually classifying as both urban and rural to access benefits intended for rural hospitals.
"Dr. Bai, critical access hospitals are often the only site of care for essential health services in their community, and often the benefit they provide to their communities seems obvious.
These rural hospitals have been shown to provide a higher share of health services as a percentage of community benefit than other types of hospitals, including nonprofit community hospitals, children's hospitals, and teaching hospitals.
According to your recent study about the rise in urban hospitals with rural status in Medicare, there has been a sharp increase of geographically urban hospitals dually classifying as both rural and urban to access benefits intended for hospitals serving our rural populations.
Your study further showed that three-quarters of these dually classified hospitals were non-profit, thus tax exempt. In your opinion, does this growing trend of dual classification lead to truly rural hospitals receiving even less resources to provide community benefits?" asked Congresswoman Miller.
"Absolutely. If Congress does not act to close the loophole, we're going to see more and more nonprofit hospitals dually classified taking advantage of the status. The result would be a smaller and smaller pool of money left for the truly rural hospitals located in rural areas, and that probably will not be the result Congress intended to see," said Dr. Bai.
Congresswoman Miller concluded by highlighting the growing deficit between the tax benefits received by these hospitals and the impact they have on their communities in their role as a non-profit, tax-exempt entity.
"Dr. Goldfarb, research suggests that the fair share deficit - or the difference between the value of tax benefits received and the value of community benefits provided by a non-profit hospital - continues to grow each year.
In fact, the fair share deficit at non-profit hospitals was estimated to be $11.5 billion per year from 2020 to 2022, suggesting that tax-exempt hospitals are spending significantly less on community investments and benefits than they receive through their tax-exempt status.
Is this correct? And, if so, what other factors should we consider in order to determine whether a tax-exempt hospital is truly acting in furthering its non-profit purpose?" asked Congresswoman Miller.
"Well, as I said earlier, I certainly defer to these expert economists here that can speak to that particular issue. It is quite clear, though, that this community benefit needs to be clarified. The DEI enterprise, the gender affirming care, they've all been included in this idea of a community benefit. And I think one can really challenge seriously the fact that these enterprises have [...] been divisive. Certainly the DEI enterprise, as I mentioned earlier, the Mayo clinic having that two day meeting, which just leads to more animosity, more divisiveness, more unhappiness in the staff. And yet that's a huge investment. A huge investment in resources, it's a huge investment in dollars, it's a huge investment in human capital to these activities. So I feel very strongly that that's why this needs to be clarified by Congress. And the community benefit needs to be outlined much more clearly than it is now," responded Dr. Goldfarb.
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