Tax & Budget
July 2016

Medicaid provider tax fix must not hurt counties,
transit agencies
By Wendy Patton
Unless Ohio changes a tax that helps people without insurance
get health care, hundreds of thousands could have trouble
getting medical services. In making changes required by the
federal government, it is crucial to make sure local
governments and transit agencies – which also benefit from
this revenue – do not lose much-needed financial support.
The federal government has warned Ohio to change an element
in the base of the sales tax that supports Medicaid services. The
connection to local governments is that they “piggyback” on
the sales tax. If the sales tax is changed in certain ways, those
local entities would lose revenue on top of five years of
declining state support that has already brought serious
reductions in services people rely on.

Key findings
• The federal government tells

Ohio to fix its Medicaid
Managed Care Organization
tax, part of the sales tax that
also funds state and local
services.
• Revenues from this tax draw
hundreds of millions of federal
funds for Medicaid services into
Ohio.
• This tax also provides close to
$200 million a year to counties
and transit agencies.
• The state must find a fix that
protects health care yet does
not deepen cuts to local
government and public transit.

Medicaid managed care companies in Ohio pay sales tax on the
health care services they provide, and the tax that they pay is
calculated in to the Medicaid “capitation” rates, or the
payments they receive for delivering those services.1 The tax is referred to as an MCO (managed care
organization) tax. Collections from this type of tax, in Ohio and nationally, are used to draw down
hundreds of millions of dollars in federal matching funds for Medicaid services. In Ohio, the state
collects more than $850 million from this tax and draws in hundreds of millions of federal taxes. In
addition, counties and transit agencies that charge local sales taxes get about $200 million a year from
this tax.
Ohio is one of several states under federal orders to reconfigure this tax. The good news is that Ohio
can fix the tax structure in accordance with federal law. Other states have fixed their tax systems in a
manner that has satisfied the requirements of the federal government. Making sure the fix does not
hurt counties and transit agencies might be harder. Distribution of the local sales tax collections from
the MCO revenues is based on the residence of Medicaid enrollees. A solution that cuts Medicaid
MCOs from the sales tax base would hurt counties and transit agencies where many people are

1

Capitation is a fixed amount of money per patient per unit of time paid in advance to the physician for the delivery of
health care services. See American College of Physicians at https://www.acponline.org/about-acp/about-internalmedicine/career-paths/residency-career-counseling/understanding-capitation
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 Medicaid provider tax fix must not hurt counties, transit agencies

insured by Medicaid. Ohio must construct a solution that protects local tax bases, especially those in
the most fragile economies, from another round of state-imposed cuts.2
What are health care provider taxes?
Federal law allows states to use revenue from taxes on health care providers to help fund the state
share of Medicaid, which is jointly financed by state and the federal government. Medicaid is a form
of insurance that enables people who otherwise could not afford it to get medical treatment. The
federal government defines 19 forms of health services that can be subject to provider taxes,
including hospital and physician services, laboratory and X-ray services, nursing homes, and
intermediate care facilities for the developmentally disabled.3 Such taxes have become an integral
part of financing Medicaid, which helps a quarter of all Ohioans get health care. Every state except
Alaska has at least one Medicaid provider tax and nearly two-thirds of states – including Ohio – have
three or more.4
For every dollar in state revenue Ohio uses on Medicaid, the federal government provides, on
average, almost two additional dollars. For states to get this matching money, the federal government
requires that state Medicaid expenditures be supported by sources that will dependably yield the
required revenues. Health care provider taxes work well for this – as long as they don’t violate
federal guidelines aimed at preventing states from “gaming” the system. And that’s the problem
Washington has with Ohio, among other states.5
Provider taxes must meet three major requirements under federal Medicaid law: They must be
broad based and imposed on all health care providers within a specified class of providers; they must
be uniform, or applied at the same rate for all providers that pay the tax, and they must not
provide a direct or indirect guarantee that entities paying the tax get all of their payment back (in
other words, the health care provider paying the tax must not be “held harmless” from the impact of
the tax.) Some of these provisions may be waived under certain circumstances, but generally
speaking, provider taxes need to be redistributive, with the tax redistributing funds from nonMedicaid providers to Medicaid providers.6
Ohio’s provider taxes
Ohio has several health provider taxes. It administers a 2.7 percent hospital franchise fee, which falls
on the facility costs of non-Medicaid hospitals; a 5.5 percent fee on intermediate care facilities for the
developmentally disabled and nursing homes, based on number of beds; a 1.0 percent health insuring

2

Ohio’s local governments have collectively lost a billion dollars a year, adjusted for inflation, due to cuts in state
revenue sharing, elimination of the estate tax, phase-out of tax reimbursements and other tax policy changes. See Policy
Matters Ohio, “New Years Budget Resolution: Commit to Opportunity,” December 2015 at
http://www.policymattersohio.org/wp-content/uploads/2015/12/New-Years-Resolution-Commit-to-Opportunity3.pdf
3
Community Catalyst, Health Care Provider Assessments: A State-Based Funding Solution for Closing the Coverage
Gap http://www.communitycatalyst.org/resources/publications/document/ProviderAssessmentsforCTG_06.10.15.
4
States and Medicaid Provider Taxes or Fees, Kaiser Family Foundation, March 14, 2016 at http://kff.org/medicaid/factsheet/states-and-medicaid-provider-taxes-or-fees/
5
Centers for Medicare and Medicaid Services, Letter from Director Cindy Mann to state Medicaid Directors, June 25,
2014 at https://www.medicaid.gov/Federal-Policy-Guidance/downloads/SHO-14-001.pdf
6
California Legislative Analyst’s Office, Overview of MCO Tax, Selected Other Tax Increase Options, and IHSS Issues,
July 2, 2015 at http://www.lao.ca.gov/handouts/health/2015/Overview-of-MCO-Tax-070215.pdf
2

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 Medicaid provider tax fix must not hurt counties, transit agencies

corporation premium tax, a component of the domestic insurance tax, and the Medicaid MCO tax.7
The federal government’s concerns are limited to the MCO tax.
Since provider taxes were first used in the 1980s, federal rules governing them have changed several
times. Ohio’s Medicaid MCO tax in its current form was created in response to these changes. The
Deficit Reduction Act of 2005 closed a loophole that had allowed a provider tax to apply to a very
narrow base – Medicaid managed care organizations – and mandated a broad base that includes nonMedicaid providers. Ohio and a few other states solved this problem by placing the narrowly-based
Medicaid MCO tax into the base of an entirely different tax that was much broader than a health care
provider tax. (In Ohio’s case, it was the sales tax). Ohio’s rationale was that a broad general tax like
the sales tax is not a health provider tax and not subject to Medicaid law. The federal government
does not agree with that view. 8
Ohio implemented its current MCO tax in 2009.The statute specified that this new tax would be
eliminated if the federal government deemed it impermissible.9 Although the state is not entirely in
agreement with the federal government on this issue,10 that time has come. Ohio has until June 30,
2017, to find a solution.11 Failure to fix a violation can lead to a disqualification of state matching
funds, which would reduce the amount of money the federal government gives Ohio for Medicaid.
The Fix
The 2014 letter from CMS to state Medicaid directors was quite clear, warning that use of a broad tax
like the sales tax must not violate any basic health provider tax rules: it must be broad based,
uniform, and hold no payer harmless from the impact of the tax.12 Several states with taxes like
Ohio’s MCO tax have crafted solutions to this mandate. Like Ohio, Michigan included its Medicaid
MCOs in the state sales tax base and has worked to change it under the federal government’s
directives. In the spring of 2016, Michigan’s Senate passed linked bills – SB 987-990 – that would
7

Information on the rates of the hospital franchise fee, the nursing facility fee and the health insuring corporation
premium tax is from a memo of the Office of Budget and Management available at CCAO Statehouse Report June 30,
2016 at http://www.ccao.org/userfiles/SHR06302016.pdf
8 The July 25 letter from Cindy Mann to State Medicaid directors, says: “Taxing a subset of health care services or
providers at the same rate as a statewide sales tax, for example, does not result in equal treatment if the tax is applied
specifically to a subset of health care services or providers (such as only Medicaid MCOs), since the providers or users of
those health care services are being treated differently than others who are not within the specified universe.”
9
H.B. 1, starting October 1, 2009, imposes the sales tax on health care services provided by a Medicaid health insuring
corporation for Medicaid enrollees in Ohio, unless the tax is determined to be an ʺimpermissible health care-related taxʺ
for federal Medicaid purposes. The operating budget act also eliminates the tax if federal authorities determine that this
expansion of the Ohio sales and use tax base is impermissible and its imposition would result in a reduction in federal
financial assistance for Medicaid services. The act designates the corporations as the consumers of the services, rather
than the individual receiving the services. (http://www.lsc.ohio.gov/fiscal/greenbooks128/tpr.pdf)
10
The Ohio Office of Budget and Management wrote in a June 24, 2016 memo provided to the County Commissioners
Association of Ohio: “Federal regulations that govern health care related taxes do not apply if the tax is broad based (less
than 85% of the taxpayers provide or pay for health care) and individuals or entities providing or paying for health care
are treated the same as other taxpayers (e.g., the same tax rate). Because the Ohio sales tax is broad based (less than 85%
of the taxpayers provide or pay for health care) and the Medicaid MCOs are treated the same as other taxpayers (5.5%
rate) the state’s position has been – and remains – that the Ohio sales tax is not a health care related tax and therefore not
subject to federal jurisdiction.”
(http://www.ccao.org/userfiles/Fed%20Regulations%20may%20impact%20OH%20sales%20tax.pdf)
11
CMS letter of June 25, 2014, cited above.
12
CMS letter of June 25, 2014, cited above.
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 Medicaid provider tax fix must not hurt counties, transit agencies

institute a new version of the Medicaid MCO Tax with a broadened base and would eliminate another
provider tax on health insurers. The distribution of funds would be changed to eliminate any possible
interpretation of holding Medicaid health providers harmless from the impact of the tax. A new
financing arrangement would be arranged to pay state Medicaid matching funds. The bills have not
yet passed the Michigan House of Representatives, and would still have to be approved by the federal
government.13
Pennsylvania’s 5.9 percent gross receipts tax on the Medicaid revenues of its MCOs was also found
impermissible because it was not broad based (the Gross Receipts Tax does not apply to all MCOs,
just to Medicaid MCOs) and because it held the Medicaid MCOs harmless.14 The state fixed the
problem by broadening the MCO assessment (known as Pennsylvania’s Gross Receipts Tax) to all
entities that are MCOs as defined by Act 68 of 1998, rather than just Medicaid MCOs.15
California likewise fixed its MCO tax by broadening the base to include non-Medicaid providers
while lowering other taxes to offset the impact. It changed the distribution of MCO tax funds to uses
beyond Medicaid match alone. Established at 3.9 percent – like the state sales tax – California’s plan
provides for applicable taxing “tiers” based on number of enrollees during a base year period. This
does not meet the federal requirement for uniformity – by design. In the request for a waiver for this
and other provisions of the law, Governor Jerry Brown wrote:16
“Unlike the prior versions of California's MCO taxes, this new MCO tax is broadly applied
across full service health care plans and their various lines of business and not just MediCal lines of business. California modeled several aspects of the MCO tax on the CMS
approved California hospital provider fee.”
The waiver was approved by CMS, and the new tax started July 1, 2016.

Impact of Ohio’s MCO tax
Table 1 illustrates total MCO sales tax revenues and the Medicaid payments for services. In state
fiscal year 2018, tax collections from the Medicaid MCO tax will be just over a billion dollars. The
state uses $303 million to draw down federal matching funds for Medicaid services in the amount of
$756 million. The net impact of the tax on the MCOs is negligible because the tax payment is
calculated into the MCO capitation payment (that is, the payment for Medicaid services delivered).

13

State of Michigan, Senate fiscal office, summary of SB 987-990, May 24, 2016 at
https://www.legislature.mi.gov/documents/2015-2016/billanalysis/Senate/pdf/2015-SFA-0987-C.pdf
14
United States Department of Health and Human Services, Office of the Inspector General, “Pennsylvania’s gross
receipts tax on managed care organizations appears to be an impermissible health care related tax,” May 2014 at
https://oig.hhs.gov/oas/reports/region3/31300201.pdf
15
Pennsylvania Health Law Project at http://www.phlp.org/wp-content/uploads/2016/01/January-2016-HLN-Final.pdf ;
see also Pennsylvania House Committee on Appropriations fiscal note on HB 1322 at
http://www.legis.state.pa.us/WU01/LI/BI/FN/2015/0/HB1322P2628.pdf
16
http://www.pwc.com/us/en/state-local-tax/newsletters/salt-insights/assets/pwc-california’s-new-managed-careorganization-tax.pdf
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 Medicaid provider tax fix must not hurt counties, transit agencies

Table 1

MCO tax revenues and Medicaid payments to MCOs
Projected for State Fiscal Years 2018 and 2019

MCO tax revenues*
- State Medicaid payments to MCOs
- Federal Medicaid payments to MCOs
Net Impact on MCOs

FY 2018
$1.055 billion
($303) million
($756) million
$0

FY 2019
$1.097 billion
($317) million
($784) million
$0

Source: Policy Matters Ohio based on documents provided by the Office of Budget and Management to the County Commissioners
Association of Ohio (http://www.ccao.org/userfiles/Fed%20Regulations%20may%20impact%20OH%20sales%20tax.pdf.)

Table 2 shows MCO taxes collected by state and local government (counties and transit agencies are
the only local entities authorized to levy a sales tax). State funds of $303 million are used in 2018 to
draw down federal matching funds for Medicaid services. The remaining $558 million dollars go in
the state’s general revenue fund (GRF). Counties and transit authorities will collect an estimated $195
million dollars in fiscal year 2018 from this component of the sales tax base.
Table 2
Distribution of Ohio’s MCO tax revenues
Projected for State Fiscal Years 2018 and 2019
SFY 2018
MCO tax revenues
$1.055 billion
Uses of MCO tax collections
State
- State match for federal Medicaid funds
$303 million
- Net state funds placed in the GRF
$558 million
Local
$195 million

SFY 2019
$1.097 billion

$317 million
$578 million
$202 million

Source: Policy Matters Ohio based on documents provided by the Office of Budget and Management to the County Commissioners
Association of Ohio ( http://www.ccao.org/userfiles/Fed%20Regulations%20may%20impact%20OH%20sales%20tax.pdf). Note:
Assumes a combined state and local sales tax rate of 7.05 percent.

In Ohio, counties and eight transit authorities are authorized to impose a local sales tax on the state
tax base. Such taxes range from a half percent to 2¼ cents. The Department of Taxation distributes
collections from the Medicaid MCO tax component of the base to counties and transit authorities
based on the number of Medicaid enrollees living in those places or services areas. Dependence of
the local taxing jurisdiction has to do with number of enrollees and the amount of other sales tax
otherwise collected.
Table 3 illustrates the importance of the MCO tax in counties where the economy remains slow and
many residents are enrolled in Medicaid. The largest dollar distribution is to urban counties while the
highest dependence is in rural counties. The Appendix shows collections in all 88 counties in 2013,
2014 and 2015.
Counties in Ohio’s Appalachian region, some of the poorest places in the state, are the most reliant on
the Medicaid MCO sales tax collections. Nearly a quarter of Vinton County’s sales tax collections
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 Medicaid provider tax fix must not hurt counties, transit agencies

come from the MCO tax. Vinton County’s general revenues totaled $4.6 million dollars in 201417 and
of that, $306,050 – nearly 7 percent of total general fund revenues – came from the MCO tax.18
Those funds supported county emergency or safety staff, human service personnel, road repair, fire
and police vehicle operation and maintenance, and the other elements that underpin civic life.
Table 3
MCO tax revenues by county and MCO tax revenue as share of total sales tax revenue
in each county
Counties with the greatest reliance on the Medicaid
MCO tax base

CY 2015
MCO Tax
Distributed

Counties with the largest dollar amounts drawn from
the Medicaid MCO tax

MCO/Total
sales tax
revenues

County

CY 2015
MCO Tax
Distributed

MCO/Total
sales tax
revenues

$352,210
$574,302
$707,482

24.9%
21.7%
17.8%

1
2
3

Cuyahoga
Franklin
Hamilton

$21,020,069
$18,991,969
$12,712,740

8.2%
6.6%
7.2%

4

County
Vinton
Meigs
Perry
Scioto

$2,048,211

16.9%

4

Lucas

$9,813,248

10.4%

5

Adams

$693,757

16.9%

5

Montgomery

$7,220,243

9.2%

6

Morgan

$287,433

16.4%

6

Mahoning

$3,684,379

9.5%

7

Pike

$760,127

16.3%

7

Clark

$3,192,036

12.8%

8

Lawrence

$1,421,824

15.9%

8

Butler

$3,051,238

7.5%

9

Brown

$767,054

14.6%

9

Summit

$3,038,837

6.8%

10

Jackson

$755,797

13.7%

10

Trumbull

$2,738,395

10.6%

11

Clark

$3,192,036

12.8%

11

Lorain

$2,435,131

8.4%

12

Columbiana

$2,136,967

12.7%

12

Columbiana

$2,136,967

12.7%

13

Morrow

$486,982

12.7%

13

Licking

$2,073,818

6.4%

14

Hocking

$497,129

12.6%

14

Scioto

$2,048,211

16.9%

15

Highland

$807,226

12.4%

15

Stark

$1,875,577

6.5%

16

Crawford

$720,058

12.4%

16

Clermont

$1,873,393

7.2%

17

Pickaway

$994,315

12.2%

17

Muskingum

$1,783,611

9.3%

18

Gallia

$592,650

12.0%

18

Lake

$1,597,887

4.5%

19

Paulding

$220,272

11.4%

19

Ross

$1,553,973

10.1%

20

Coshocton

$626,890

10.8%

20

Lawrence

$1,421,824

15.9%

21
22

Trumbull
Ashtabula

$2,738,395
$1,117,688

10.6%
10.5%

21
22

Richland
Greene

$1,417,935
$1,331,450

6.2%
5.2%

  

1
2
3

Source: Policy Matters Ohio, based on Office of Budget and Management documents provided to the County Commissioners 
Association of Ohio and published in their June 24 & 30, 2016 “Statehouse Report”  

The largest impact in dollars is on urban and suburban counties. MCO tax collections are magnified
here by their role in financing public transit (Table 4). Hundreds of thousands of city dwellers depend
on public transit to get to work and the grocery store. Public transit has been badly cut by state
government, with GRF funding falling from $42 million a year in 2000 to $15 million in 2016.
17
18

Summarized annual financial statement, 2014, Ohio Auditor https://ohioauditor.gov/references/summarizedreports.html
Ohio Department of taxation, http://www.tax.ohio.gov/Portals/0/tax_analysis/tax_data_series/sales_and_use/MHICbycounty-

byyearcoversheet.pdf

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Transit agencies across the state are struggling. In northeast Ohio, for example, the Greater Cleveland
Regional Transit Authority (RTA) faces the loss of $18 million in revenue from the MCO tax.19 Yet a
$7 million shortfall there is already causing service cuts and fare increases.20 Table 4 shows the 2015
MCO taxes of the eight transit authorities in Ohio. The loss of these funds would be very difficult for
transit authorities and the people they serve.
Table 4
MCO tax collections by transit agency, and MCO taxes as a share of total sales tax
collections
Transit Authority

Greater Cleveland Regional Transit Authority
Central Ohio Regional Transit Authority
Laketran Transit Authority
Western Reserve Transit Authority
Greater Dayton Regional Transit Authority
Portage Area Regional Transit Authority
Stark Area Regional Transit Authority
Metro Regional Transit Authority
Transit Authority Total

CY 2015 MCO Sales
Tax Distributed

$16,816,055
$7,635,959
$399,472
$823,578
$3,610,122
$314,198
$937,788
$3,038,837
$33,576,009

MCO/Total
sales tax

8.2%
6.1%
4.5%
9.6%
9.2%
6.1%
6.5%
6.9%
7.4%

Source: Policy Matters Ohio, based on Office of Budget and Management documents provided to the County Commissioners 
Association of Ohio and published in their June 24 & 30, 2016 “Statehouse Report”  

Statewide, the share of the MCO revenue in the local sales tax base increased from $81 million in
2013, about 5 percent of the local sales tax base that year, to $148 million in 2015, about 7.5 percent.
As enrollment increased with Medicaid expansion so has MCO tax revenue. In dollar terms, this
represents growth of almost 83 percent to counties and transit authorities. Growth continues to be
robust: The MCO tax is forecast to bring $195 million to these local governments in 2018 and $202
million in 2019. 21
The problem Ohio and other states must fix in their MCO tax structure has nothing to do with the
Affordable Care Act, Medicaid expansion or state Medicaid programs; it has to do with federal rules
that have changed within a joint federal-state financing system, and state responses to those changes.
Other states have aligned with federal requirements, ensuring solid, adequate finances for health
services, and Ohio can do the same. What is different about Ohio, and critical to any solution here, is
that the finances of local governments that depend on a local sales tax for important local public
services must be protected from harm.

19

Ginger Christ, “RTA facing catastrophic loss in 2017,” The Plain Dealer, July 7, 2016 at
http://www.cleveland.com/metro/index.ssf/2016/07/rta_facing_catastrophic_revenu.html#incart_2box
20
Ginger Christ, “Rate increases and service cuts coming to RTA in August,” The Plain Dealer, June 7, 2016 at
http://www.cleveland.com/metro/index.ssf/2016/06/fare_increases_and_service_cut.html
21
County Commissioners Association of Ohio, Statehouse Report June 24 and June 30, 2016 at
http://www.ccao.org/userfiles/SHR06302016.pdf
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A good option would be to broaden the base of the MCO tax, but leave it within the sales tax base so
it strengthens local public finance. Other provider taxes could be adjusted to mitigate impact, as in
other states.
If the MCO tax is removed from the base of the sales tax, it should be recalibrated to raise funds to
replace revenues in the budgets of public transit agencies and counties. This would mean boosting
Ohio’s annual GRF support for public transportation from about $15 million in 2017 to about $50
million, with $35 million earmarked for the regional transit authorities. Local government fund
distributions could be boosted by between $150 million and $200 million a year and distributed on
the same basis as current local MCO sales tax collections, to protect county budgets.
State government needs to do more than this for local government in Ohio. The budget for 2018-19
needs to restore health and human service levies eroded by loss of tax reimbursements; boost funding
for cities, villages, townships, counties and special districts that have lost, on average, 50 percent of
state local government funds; and restore the estate tax on Ohio’s wealthiest estates – those over a
million dollars – with most of the funds returned to the community. These state fiscal actions should
remain a priority. This history of damage to local finances, however, highlights why it is essential
that the solution crafted for Ohio’s MCO tax does not further damage Ohio’s communities and local
public services.
Summary and conclusion
Ohio has a number of options to fix the problem identified by the federal government in its MCO tax.
The tax could be applied to all managed care organizations instead of only those that provide
Medicaid services, as it has been in other states. This change would not hurt the local entities that
depend on Ohio’s MCO tax for non-Medicaid purposes.
However Ohio responds, there is no reason a solution to the federal problem needs to result in a cut to
local revenues. Local governments have already been cut too deeply in Ohio. Ohio’s counties provide
many important services in which state funding plays too small of a role. For example, Ohio ranks
50th among states in state support of children’s services, leaving poor counties struggling to protect
the most vulnerable. The state budget supports adult protective services at a level far below public
needs, leaving most of the provision of protective services to the counties at a time when the
population is rapidly aging and more people need protection.
Since 2010, the state has cut almost a billion dollars a year in resources of local governments through
cuts in revenue sharing and changes in tax policy. Any “fix” that exposes local public services to
further loss is not a solution to the MCO tax problem. It just shifts the problem to localities. It is the
responsibility of state government to fix the MCO tax problem in ways that bring state health care
taxes into conformance with federal standards without hurting Ohioans who depend on local services.
The lesson from other states is that this can be done.

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APPENDIX TABLE 1 - Page 1 of 2
MCO tax collections by calendar year, and share of total sales tax collections, by county
County

State Total
Adams
Allen
Ashland
Ashtabula
Athens
Auglaize
Belmont
Brown
Butler
Carroll
Champaign
Clark
Clermont
Clinton
Columbiana
Coshocton
Crawford
Cuyahoga
Darke
Defiance
Delaware
Erie
Fairfield
Fayette
Franklin
Fulton
Gallia
Geauga
Greene
Guernsey
Hamilton
Hancock
Hardin
Harrison
Henry
Highland
Hocking
Holmes
Huron
Jackson
Jefferson
Knox
Lake
Lawrence
Lawrence

2013 MCO Tax

$80,799,940
$492,581
$657,767
$263,119
$820,342
$564,274
$267,208
$680,881
$513,970
$1,574,105
$157,671
$312,810
$1,752,098
$911,622
$480,928
$1,108,326
$366,503
$465,232
$12,846,229
$386,681
$218,847
$404,012
$422,426
$858,482
$375,437
$6,502,720
$251,122
$400,179
$191,181
$695,537
$488,360
$5,554,903
$313,641
$270,806
$172,506
$169,473
$533,950
$317,398
$97,865
$526,504
$517,541
$825,497
$317,077
$927,926
$970,877
$970,877

MCO share

4.9%
13.6%
4.3%
3.9%
8.5%
7.6%
3.3%
4.6%
11.0%
4.5%
4.8%
5.9%
7.7%
4.0%
6.7%
7.0%
6.7%
8.8%
5.4%
5.1%
4.2%
0.9%
3.0%
4.7%
5.0%
4.3%
3.9%
8.8%
1.5%
3.0%
6.0%
4.0%
2.5%
6.8%
3.7%
4.5%
9.1%
9.5%
1.6%
6.1%
10.6%
7.3%
5.2%
2.9%
11.9%
11.9%

2014 MCO Tax

$110,616,745
$601,626
$751,028
$297,288
$993,938
$723,257
$304,297
$856,293
$633,812
$2,173,390
$175,971
$390,090
$2,216,350
$1,242,794
$625,946
$1,551,618
$490,598
$569,193
$18,465,704
$446,689
$246,419
$547,992
$689,234
$1,030,554
$487,091
$12,833,373
$336,578
$505,280
$284,999
$854,366
$600,328
$7,662,579
$367,782
$325,827
$204,625
$200,786
$679,360
$403,054
$108,074
$574,991
$667,813
$1,070,087
$381,007
$1,215,945
$1,233,874
$1,233,874

MCO share

6.1%
15.6%
4.8%
4.1%
9.7%
9.2%
3.7%
5.0%
13.2%
5.9%
4.6%
7.3%
9.4%
5.2%
8.1%
9.5%
8.7%
10.5%
7.5%
5.6%
4.6%
1.1%
3.2%
5.4%
6.0%
5.4%
4.8%
10.9%
2.2%
3.6%
6.0%
5.2%
2.9%
8.0%
3.7%
5.3%
10.9%
11.2%
1.7%
6.2%
12.9%
9.0%
5.7%
3.6%
14.1%
14.1%

2015 MCO Tax

$148,019,949
$693,757
$907,048
$382,673
$1,117,688
$847,961
$366,618
$1,026,323
$767,054
$3,051,238
$220,081
$457,990
$3,192,036
$1,873,393
$839,043
$2,136,967
$626,890
$720,058
$21,020,069
$523,611
$294,893
$909,505
$606,022
$1,272,547
$602,667
$18,991,969
$495,906
$592,650
$424,333
$1,331,450
$729,818
$12,712,740
$473,305
$392,310
$247,354
$242,453
$807,226
$497,129
$140,452
$728,640
$755,797
$1,323,181
$496,964
$1,597,887
$1,421,824
$1,421,824

MCO share

7.5%
16.9%
5.4%
5.0%
10.5%
10.2%
4.2%
5.4%
14.6%
7.5%
6.3%
8.2%
12.8%
7.2%
9.9%
12.7%
10.8%
12.4%
8.2%
6.1%
5.2%
1.8%
3.9%
6.2%
7.3%
6.6%
6.4%
12.0%
3.0%
5.2%
7.3%
7.2%
3.3%
9.0%
4.8%
6.2%
12.4%
12.6%
2.0%
7.3%
13.7%
9.6%
7.2%
4.5%
15.9%
15.9%

Source: Policy Matters Ohio, based on Ohio Department of Taxation
http://www.tax.ohio.gov/Portals/0/tax_analysis/tax_data_series/sales_and_use/MHICbycounty-byyearcoversheet.pdf

9

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 Medicaid provider tax fix must not hurt counties, transit agencies

APPENDIX TABLE 1 – Page 2 of 2

MCO tax collections by calendar year, and share of total sales tax collections, by county
County
Lawrence
Licking
Logan
Lorain
Lucas
Madison
Mahoning
Marion
Medina
Meigs
Mercer
Miami
Monroe
Montgomery
Morgan
Morrow
Muskingum
Noble
Ottawa
Paulding
Perry
Pickaway
Pike
Portage
Preble
Putnam
Richland
Ross
Sandusky
Scioto
Seneca
Shelby
Stark
Summit
Trumbull
Tuscarawas
Union
Van Wert
Vinton
Warren
Washington
Wayne
Williams
Wood
Wyandot

2013 MCO Tax
$970,877
$1,362,073
$422,454
$1,479,031
$4,627,826
$246,983
$1,940,061
$447,944
$474,220
$381,298
$195,761
$556,282
$151,402
$4,222,485
$178,178
$296,837
$1,175,065
$112,146
$197,472
$162,736
$508,588
$518,564
$554,855
$618,849
$378,200
$145,999
$1,046,566
$1,068,578
$462,362
$1,489,823
$470,412
$344,165
$1,242,634
$1,525,434
$1,480,102
$480,843
$215,945
$203,394
$242,090
$495,592
$532,142
$387,237
$297,606
$389,244
$123,844

MCO share
11.9%
4.9%
4.7%
5.7%
6.1%
4.5%
6.1%
6.0%
2.2%
16.9%
2.8%
3.6%
7.1%
6.0%
12.4%
9.2%
6.9%
5.8%
2.8%
9.0%
14.5%
7.2%
13.1%
3.4%
7.8%
2.9%
5.0%
7.7%
4.6%
13.4%
6.1%
3.9%
4.8%
3.9%
6.3%
4.2%
1.7%
4.9%
21.0%
1.5%
4.5%
4.0%
5.8%
2.2%
3.4%

2014 MCO Tax
$1,233,874
$1,647,286
$515,180
$1,802,397
$6,245,460
$335,410
$2,542,093
$853,496
$670,299
$502,940
$229,052
$668,875
$193,202
$5,489,992
$237,003
$368,216
$1,497,022
$139,443
$272,538
$184,842
$584,604
$686,390
$635,792
$891,331
$443,074
$168,682
$1,215,864
$1,282,250
$593,945
$1,803,357
$585,247
$352,731
$1,332,429
$2,200,803
$2,020,136
$529,825
$290,355
$232,583
$306,050
$712,901
$710,126
$545,725
$362,151
$562,228
$151,517

MCO share
14.1%
5.6%
5.7%
6.6%
7.8%
5.7%
7.6%
8.6%
2.9%
20.5%
3.3%
4.1%
6.8%
7.5%
14.7%
10.5%
8.4%
5.2%
3.4%
10.3%
15.5%
9.0%
15.8%
4.6%
8.6%
3.8%
5.8%
9.0%
5.6%
15.3%
7.1%
3.6%
4.9%
5.2%
8.3%
4.3%
2.2%
5.6%
24.4%
2.1%
5.6%
5.3%
6.3%
2.8%
3.9%

2015 MCO Tax
$1,421,824
$2,073,818
$634,575
$2,435,131
$9,813,248
$515,110
$3,684,379
$1,237,290
$966,579
$574,302
$274,114
$851,077
$234,719
$7,220,243
$287,433
$486,982
$1,783,611
$168,566
$442,561
$220,272
$707,482
$994,315
$760,127
$1,256,791
$552,574
$194,921
$1,417,935
$1,553,973
$752,458
$2,048,211
$717,651
$455,242
$1,875,577
$3,038,837
$2,738,395
$662,694
$451,317
$292,458
$352,210
$1,287,284
$858,999
$805,642
$433,515
$857,382
$190,429

Source: Policy Matters Ohio, based on data provided by the Ohio Department of Taxation
http://www.tax.ohio.gov/Portals/0/tax_analysis/tax_data_series/sales_and_use/MHICbycounty-byyearcoversheet.pdf

10

MCO share
15.9%
6.4%
6.9%
8.4%
10.4%
8.3%
9.5%
10.2%
4.0%
21.7%
3.6%
4.9%
3.4%
9.2%
16.4%
12.7%
9.3%
7.1%
5.3%
11.4%
17.8%
12.2%
16.3%
6.1%
10.0%
4.5%
6.2%
10.1%
6.7%
16.9%
8.4%
4.6%
6.5%
6.8%
10.6%
5.1%
3.3%
6.6%
24.9%
3.5%
6.2%
7.1%
7.5%
4.3%
4.9%

www.policymattersohio.org

 Medicaid provider tax fix must not hurt counties, transit agencies

APPENDIX TABLE 2
MCO tax collections by calendar year, and share of total sales tax collections, by transit authority 
Transit Authority
Central Ohio Regional Transit Authority
Greater Cleveland Regional Transit
Authority
Greater Dayton Regional Transit
Authority

2013 MCO Tax

MCO
share

2014 MCO
Tax

MCO
share

2015 MCO
Tax

MCO
share

$4,357,254

4.0%

$5,675,477

5.0%

$7,635,959

6.1%

$10,276,983

5.4%

$14,772,563

7.5%

$16,816,055

8.2%

$2,111,243

6.0%

$2,744,996

7.5%

$3,610,122

9.2%

$231,993

2.8%

$303,986

3.6%

$399,472

4.5%

$1,525,434

3.9%

$2,200,802

5.2%

$3,038,837

6.9%

Portage Area Regional Transit Authority

$154,712

3.4%

$222,833

4.6%

$314,198

6.1%

Stark Area Regional Transit Authority

$598,532

4.6%

$666,214

4.9%

$937,788

6.5%

Western Reserve Transit Authority

$485,015

6.1%

$635,523

7.6%

$823,578

9.6%

Transit Authority Total
$19,741,166
4.8%
$27,222,395
6.4%
$33,576,009
Source: Policy Matters Ohio, based on Ohio Department of Taxation data at 
http://www.tax.ohio.gov/Portals/0/tax_analysis/tax_data_series/sales_and_use/MHICbycounty-byyearcoversheet.pdf 

7.4%

Laketran Transit Authority
Metro Regional Transit Authority

 

11

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