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Private Activity Bonds and Medical Expense Deduction Provisions in U.S. Congressional Tax Proposals

Dana Halvorson

On November 2, 2017, the Republican leadership of the U.S. House of Representatives introduced the Tax Cuts and Jobs Act. This bill proposes to eliminate the use of private activity and advance refunding bonds beginning on Jan. 1, 2018. 

The elimination of private activity debt instruments would significantly and adversely impact the ability for the majority of our not-for-profit members to fund new construction, infrastructure improvements, acquisitions and other capital expenditures for their operations, including skilled nursing, assisted living centers and many affordable housing projects. For-profit providers would also be impacted.

The Tax Cuts and Jobs Act also includes repealing the medical expense deduction. AHCA/NCAL has recently joined an AARP-led coalition to preserve the medical expense deduction. AHCA/NCAL opposesboth the elimination of private activity bonds and the repealing of the medical expense deduction.

On November 9, the Senate Republicans released their own tax reform plan. This plan would preserve private activity bonds, but advance refundings would still be terminated after this year. 

The Senate proposal also preserves the existing medical expense deduction and enhances the standard deduction for the blind and elderly. As work in both chambers continues on the tax reform proposals, AHCA/NCAL will keep its members posted of any relevant updates.       

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