The Senate voted 51-49 early Saturday to approve tax reform legislation, which includes provisions that would repeal enforcement of the Affordable Care Act mandate that most individuals have health insurance, eliminate hospitals’ ability to access low-cost capital financing through advance refunding bonds, and impose a 20% excise tax on pay for certain nonprofit hospital employees. The legislation now must be reconciled with the House-passed bill, which would not repeal the individual mandate but would eliminate tax-exemption for private-activity bonds, as well as advance refunding bonds, and the medical expense deduction for people with high medical costs. House and Senate leaders are expected to name conferees tonight. “We are pleased that the Senate bill did not eliminate the tax-exemption for private-activity bonds for not-for-profit hospitals, protecting hospitals’ and health systems’ access to this vital source of low-cost capital,” AHA President and CEO Rick Pollack said Saturday. “…In addition, we are glad that the bill did not eliminate medical expense deductions for people with high medical costs and instead lowers the threshold for medical expense deductions from 10% to 7.5% for two years. We are also disappointed that the tax legislation passed with a provision that would [effectively] eliminate the individual mandate, which would result in the loss of health insurance coverage for millions of Americans.”

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