This year Congress will consider proposals to significantly restrict the access of not-for-profit healthcare organizations to affordable capital and other federal benefits of their tax-exempt status. The federal benefits of tax-exempt status are (1) exemption from federal tax on net income, (2) eligibility for tax-deductible charitable contributions, and (3) access to tax-exempt financing. Of these, the last is probably most important because hospitals' capital needs are substantial and almost always met through the issuance of tax-exempt bonds. In recent years, budget pressures have prompted many state and local governments to challenge the tax-exempt status of not-for-profit organizations. At the federal level, tax-exempt bonds have been under sustained attack for the past 10 years, and tax-exempt organizations have been under scrutiny for the past 4 years. In 1989 several bills were introduced in Congress that would limit some of the benefits of tax exemption. This year the signs are particularly ominous: Budget pressures are severe, no one seems willing to call for "new taxes," and tax-exempt organizations are considered fair game. To preserve their tax-exempt status, not-for-profits must act now to convince congressional decision makers that they deserve their tax exemptions and need them to continue to provide community service.
今年，国会将审议多项提案，这些提案旨在大幅限制非营利性医疗保健组织获得可负担资本的机会以及享受因其免税地位而带来的其他联邦福利。免税地位带来的联邦福利包括：（1）净收入免征联邦税；（2）有资格接受可减税的慈善捐款；（3）获得免税融资。其中，最后一项可能最为重要，因为医院的资本需求巨大，几乎总是通过发行免税债券来满足。近年来，预算压力促使许多州和地方政府对非营利组织的免税地位提出质疑。在联邦层面，免税债券在过去10年里一直受到持续攻击，免税组织在过去4年里也一直受到审查。1989年，国会提出了几项法案，这些法案将限制一些免税福利。今年的形势尤其严峻：预算压力巨大，似乎没有人愿意呼吁“开征新税”，而且免税组织被视为合适的攻击目标。为了维持其免税地位，非营利组织必须立即采取行动，说服国会决策者相信它们理应获得免税待遇，并且需要这种待遇来继续提供社区服务。
