Republicans release tax reform legislation

Kevin Brady (R-TX), Chairman of the House Ways and Means Committee, introduced H.R. 1, the Tax Cuts and Jobs Act, late last week. The committee began the “markup” process for the nearly 429-page bill on Monday.  Few, if any, amendments are anticipated from Republicans, however democrats are expected to offer a number of proposed changes.

The legislation, which would rewrite the tax code for the first time in more than 30 years, and includes some focus areas of interest and concern for health care as follows:


  • There are no provisions related to tax exempt status for healthcare providers; and
  • It does not include language that would repeal or modify the individual mandate taxes.


  • It would eliminate the tax exemption status for 501(c)(3) private activity bonds and advance refunding bonds. Currently, hospitals utilize $46 billion a year in tax exempt financing and without this designated benefit, interest rates would rise and significantly increase costs. The AHA is joining a coalition of municipal organizations that count on this essential program, in requesting this provision be removed from the proposed legislation; and
  • It would increase taxes related to executive compensation which could negatively impact retention and recruitment of senior leadership positions.

To view a summary of H.R.1 or to read the full text version, click here.