As state and local governments struggle to deal with budget deficits, they’re increasingly aiming their sights at large nonprofits that have long been exempt from property taxes. Earlier this year, for example, the Illinois Supreme Court heard a case challenging a law that exempts the state’s nonprofit hospitals from property taxes. And in 2015, the New Jersey Tax Court determined that a nonprofit hospital in the state wasn’t entitled to a property tax exemption, leading various cities to challenge the property tax exemptions of 35 other New Jersey hospitals.

Legislative changes are possible. Oregon, for instance, has several bills in circulation — one would create a study on ad valorem property taxation, which would tax nonprofits on a percentage of the assessed value or sales price of their property. And Massachusetts has considered several bills calling for “payments in lieu of taxation” by organizations exempt from property tax.