The House of Representatives today voted 227-205 to approve the Tax Cuts and Jobs Act (H.R. 1), legislation to reform the tax code. Among other changes, the bill would eliminate hospitals’ ability to access low-cost capital financing through tax-exempt private-activity bonds and advance refunding bonds. In addition, the bill would impose a 20% excise tax on pay for certain nonprofit hospital employees. In the area of changes to the personal tax code, the bill would repeal the itemized deduction of medical expenses beginning next year, and eliminate the deduction for contributions to Archer medical savings accounts. The bill does not make any changes to the Affordable Care Act’s individual mandate or individuals’ ability to itemize deductions for charitable giving. AHA had urged Ways and Means leaders to reject proposals that would eliminate tax-exempt private-activity bonds, and expressed concern about the 20% excise tax for certain hospital employee compensation and deduction for people with high medical costs. The Senate Finance Committee continued to mark up its own tax reform bill today. 

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