Manatee County voters deserve right to decide sales tax hike for indigent care

March 14, 2013 

Four Manatee County commissioners demonstrated bold leadership by agreeing to place a half-cent sales tax increase before voters in a June referendum -- truly government "by the people." The county stands at a crossroads on the issue of indigent health care and cannot afford the luxury of delaying a decision.

The indigent health care-sales tax issue has been a topic of discussion for years now, put on the table back in 2008 when a county task force recommended the half-cent increase. That recommendation only came after more than 30 meetings over three years to discuss the indigent health care crisis, but the county commission opted to continue draining the trust fund that only partially reimbursed hospitals.

The indigent fund will be employ in 2015, and this is crunch time. Without this additional sales tax, which will generate $23 million annually, the county will be forced to come up with funds elsewhere -- likely with a property tax increase.

County Commission Chairman Larry Bustle and Commissioners John Chappie, Michael Gallen and Carol Whitmore understand the urgency of the situation, even as politically unpalatable as any tax increase is. Commissioners Vanessa Baugh, Betsy Benac and Robin DiSabatino voted against entrusting voters with this critical decision. Tuesday's commission vote came before a crowded chamber.

This issue should not have blindsided anyone, and there are reams of documents explaining the reasons behind the county's health care crisis and news reports detailing developments over the past five years and even earlier.

With Florida's Legislature on track to reject Medicaid expansion under the Patient Protection and Affordable Care Act, Manatee County cannot afford any more delays on this issue. Even under Medicaid expansion, every indigent would not be covered and hospital emergency rooms would still have to provide expensive care under federal law.

While Republican legislators suggest the state can come up with a better idea to cover about 1 million poor and uninsured residents who would have qualified for Medicaid under expansion, those same lawmakers have only been gnashing their teeth for the past few years about the federal health care program for the poor.

To expect those lawmakers to compose a detailed plan that must gain federal approval over the remaining 50 days of the session is wishful thinking and not sound public policy for Manatee County.

The sales tax increase is part of a three-point strategy to diversify the county's tax base while providing property tax cuts of 13 percent and 26 percent, depending on whether the property is in the unincorporated part of the county or one of the municipalities.

County Administrator Ed Hunzeker's proposal on indigent health care contains a cost-cutting measure to steer the poor away from emergency rooms and into primary and preventive services, early interventions, health education and case management. This idea also dates back to 2008 with the completion of a report entitled, "State of Health Care System in Manatee County: Findings and Analysis."

Commissioned by the Manatee Chamber Foundation, the impetus for the study arose out of great concern about the future challenges to the county's health system and the implications for the economic development. Hunzeker's plan addresses one of the report's findings: "The uninsured often rely on the ER because they lack a primary healthcare provider ..."

To critics who charge not enough information about this issue is available, we challenge them to visit the county's website -- -- and select the link, "Real property tax relief could be on the horizon." A number of explanatory reports are there, including "The 26/13 Plan -- Frequently Asked Questions."

Direct links to various reports are included with the web version of this editorial, at

Voters have a right to determine the outcome of this critical issue. To deny that is to deny democracy for political reasons.

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