WASHINGTON - Rep. Charles Rangel is trying to build support among House Ways and Means Committee members to eliminate the $150 million cap on the outstanding debt of nonhospital health care institutions.

The New York Democrat is circulating a letter among committtee members that urges the panel's acting chairman, Sam Gibbons, D-Fla., to include the measure in the committee's health care health care reform bill.

The proposal to remove the cap for nonhospital health care organizations is the one bond measure that appears to have a chance of being included in the committee's health care reform bill, sources said this week.

The Public Securities Association and the National Council of Health Facilities Fiance Authorities have been pushing two other bond proposals.

One would permit a health care institution that had exhausted its allowable number of advance refundings to do another noe if needed to merge, consolidate, or otherwise restructure. The other would ease limits on bank deductibility to allow deductibility to flow through to small health care institutions that participate in larger borrowings.

But neither proposal appears likely at this point to be included in the Ways and Meand Committee bill, the sources said.

The committee has been trying to write a bill, but is not expected to take up tax provisions until next week.

Rangel, meanwhile, is trying to get signatures from as many committee members as possible in support of the cap proposal.

Under the current tax law, nonhospital 501(c)(3) organizations cannot have more than $150 million of taxexempt bonds outstanding at any time.

Rangel's letter to committee members said that the $150 million cap will prevent nonhospital health care institutions from restructuring even though they may need to do so to survive health care reform.

"The $150 million cap impedes hospital mergers and discourages the formation of th desired integrated delivery systems providing for a continuum of care in a variety of settings, including community health clinics," the letter said.

The letter acknowledged that "it will be necessary to address this problem in a revenue neutral manner" but told Gibbons "we stand ready to work with you to find acceptable revenue offsets."

Revenue estiamtes show that eliminating the cap for nonhospital health care institutions would result in a loss of about $85 million of federal revenues over a five-year period, sources said. The revenue loss is not huge but will have to be offset by revenue gains from elsewhere in the bill, they said.

Rangel's letter comes as Senate Finance Committee Chairman Daniel Moynihan, D-N.Y., has proposed that the Finance Committee include a provision in its health care bill to remove the cap for all nonhospital facilities. But the committee is still struggling with major health care reform issues and appears to be moving more slowly than the Ways and Means Committee on a bill.

Congress has voted to entirely eliminate teh $150 million cap in the past. House and Senate members voted to do away with the cap in the tax bill that was sent to President Bush in 1992. But Bush vetoed the bill.

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