The Senate Finance Committee last night voted 14-12 along party lines to approve the chairman’s mark of legislation to reform the tax code, which includes a provision to repeal enforcement of the Affordable Care Act’s mandate that most individuals have health insurance. The AHA, America’s Health Insurance Plans, American Academy of Family Physicians, Blue Cross Blue Shield Association, American Medical Association and Federation of American Hospitals this week urged congressional leaders not to include the provision, which the Congressional Budget Office estimates would decrease the number of individuals with health insurance by 4 million in 2019 and 13 million in 2027. Senate Majority Leader Mitch McConnell (R-KY) said he will bring the legislation to the Senate floor “for further debate and open consideration” after Thanksgiving. The House-passed version of the tax reform bill does not make any changes to the individual mandate, but would eliminate hospitals’ ability to access low-cost capital financing through tax-exempt private activity bonds and would make changes to taxpayers’ ability to itemize deductions for large medical expenses. In addition, both the House and Senate bills would eliminate advance refunding of outstanding tax-exempt bonds and impose a 20% excise tax on pay for certain employees of nonprofits.

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