Statement attributable to Mindy Hatton, AHA’s senior vice president and general counsel. 1. This analysis was conducted to specifically look at federal tax exemption because that is what Congress has jurisdiction over; federal taxes and tax exemption. 2. Medicare and Medicaid underpayments are included in the E&Y analysis because they are included on the IRS Form 990 Schedule H on which hospitals report their community benefits. The Schedule H includes Medicaid and Medicare underpayments at cost, yet hospitals have to make up for Medicare and Medicaid shortfalls because those programs underpay hospitals based on the cost of providing care. Absent financial support by hospitals, the shortfalls would fall to the federal, state, or local government. 3. The report is based on 2013 data, as that is the most recent year for which tax information is available. While the ACA lowered some costs, it also increased others such as Medicaid shortfalls, as Medicaid coverage expanded. However, the need to respond to community needs — for instance to help curb the opioid epidemic — is greater than ever. 4. As the report states, since 2009 the AHA has annually collected Schedule Hs directly from hospitals rather than rely on outside sources and is timed to allow all hospitals the opportunity to submit their data.”