In a confidential email sent to fellow Ohio tea party leaders and obtained by The Associated Press, Tom Zawistowski laid out a strategy for invoking a little-known IRS provision that allows citizens to challenge executive salaries and the nonprofit statuses of charitable hospitals.
In a phone interview Tuesday, Zawistowski called it "hilarious" that tea party groups that came under extra scrutiny by the IRS are now using an IRS law to target others.
Zawistowski identifies the hospitals as big backers of expanded Medicaid. His email said tea party groups will "make Medicaid personal" by publicizing large salaries of those seeking federal money to help the poor.
"I think it's hilarious, and I think it'll be fun to get some other groups who have maybe been on the sidelines and questioning us to see how they like being investigated," he said.
The effort follows a Sunday veto by Republican Ohio Gov. John Kasich of a provision in the state budget that would have blocked his administration from expanding Medicaid to additional low-income residents.
In a news conference ahead of that veto, Kasich and Republican House Speaker William Batchelder, whose chamber backed the vetoed roadblock, said they hoped to settle differences on a broader Medicaid expansion by year's end.
"The goal is to change the narrative," Zawistowski wrote. Rather than have people wondering why tea party groups don't want to help the poor, they should wonder why hospitals need more federal tax dollars to care for the poor when they've got plenty of cash on hand, he wrote.
Not-for-profit hospitals are under constant IRS scrutiny and do not fear the effort, said Ohio Hospital Association Vice President Scott Borgemenke.
"For years and years, the law hasn't changed and the status hasn't changed," he said. "We continue to be within federal law. From that standpoint, we're not worried our status is in jeopardy at all."
Zawistowski recognized the irony even in the email. Tea party groups have blasted the IRS, complained to Congress, rallied and sued over the agency's targeting of conservative groups seeking tax-exempt status. Multiple investigations into the practice are causing a political firestorm in Washington.
"I think you are going to love this," Zawistowski told tea party leaders in his email.
Zawistowski said by phone that Kasich has "hauled out" hospital CEOs at pro-Medicaid rallies that are making millions of dollars. In his emails, he singles out the $2.5 million salary of Cleveland Clinic CEO Toby Cosgrove, whose nonprofit hospital had more than $9 billion in assets in 2011.
"This guy's making $2 million a year, pleading poverty to help poor people," he said. "It just seems a little disingenuous to us in the tea party who volunteer for nothing. We're curious to see their definition of poverty."
Borgemenke said hospital CEOs' salaries are decided by community boards, which weigh the performance of the institutions, look at similarly situated businesses, and sometimes run nationwide searches.
"The old axiom is the hunted become the huntees, right?" he said. "We've got billions of dollars of uncompensated care" that isn't covered by Medicaid reimbursement. He said hospitals even sustained a $500 million cut in this year's budget.
Roughly 366,000 Ohioans would eligible for coverage beginning in 2014 if the state expands Medicaid, a key component of Democratic President Barack Obama's federal health care law.
Kasich's push to take advantage of the law was among reasons Zawistowski, executive director of the Portage County TEA Party, tried in April to take over the Ohio Republican Party. His bid against a Kasich-backed candidate was unsuccessful but Zawistowski and his backers vowed to continue their fight.
Kasich opposed the federal health care overhaul, but has said expanding Medicaid is the best way to make sure Ohio gets back federal tax dollars to help the needy.