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[33] Medicaid Enhancement Tax First established in 1991, the Medicaid Enhancement Tax (MET) is a 5.4 percent tax on charges hospitals make for inpatient and outpatient services minus bad debts, charity care, and certain other discounts

This includes parking lots, health system vehicles and employees personal vehicles parked on the premises, as well as surrounding streets and sidewalks

The Federalists defended the new Constitutions ability to remedy these potentially deadly defects: the requirements for ratifying and amending the Constitution were reduced from unanimity to a supermajority of state conventions