Economic Analysis of Proposals to Limit the Municipal Bond Market: 501(c)(3) Issuance

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Economic Analysis of Proposals to Limit the Municipal Bond Market: 501(c)(3) Issuance Conducted for the National Association of Health and Educational Facilities Finance Authorities IHS Economics October 4, 2013

Executive Summary Proposals to limit or eliminate 501(c)(3) tax exempt financing would be felt across the US economy A 28% cap on interest exemption would, based on average spending in the past decade, reduce US gross domestic product by $8.3-billion per year. It would cost the nation 104,652 jobs and $5.5-billion in labor income annually A complete elimination would reduce gross domestic product by $23.6-billion and lose 299,003 jobs generating $15.6-billion in labor income Higher interest expenses limits nonprofits ability to fund important capital projects for hospitals and schools that create long-term economic value for communities across the nation 2

501(c)(3) tax exempt financing Additional interest costs from pending tax exempt bond reform proposals would limit nonprofits ability to fund new projects resulting in significant direct and indirect job losses which would be felt across the US economy. Nonprofit organizations relied on 501(c)(3) tax exempt financing to raise $554-billion for capital projects from 2003-2012 Proposals to reduce or eliminate the interest tax exemption would cost nonprofits billions more in interest expenses: A 28-percent benefit cap on tax exempt interest would have increased total interest expenses by $58.2-billion from 2003-2012 A complete elimination would have cost nonprofits an additional $166.3-billion 3

Types of projects funded General acute care hospitals Critical access hospitals Children s hospitals General medical and surgical facilities Single specialty hospitals Higher education and private school facilities Libraries, museums, cultural and performing arts centers Senior and assisted living and nursing homes Behavioral health care centers 4

Examples of hospitals and healthcare Children s, Single Specialty, General Acute Care Hospitals: Detect, prevent, control, and cure disease Employ workers at every skill level Over 17 million employed in healthcare services industry in US Provides stability and growth in economic downturns Industry historically immune to business cycle fluctuations Demographic changes and technological advances drives investment demand Positive socio-economic externalities New hospitals lure other businesses and provide for healthier communities Hospital equipment loans-provide needed capital equipment Provide needed capital equipment for electronic medical systems to comply with HIPAA 5

Project examples: health care Rehabilitation Institute of Chicago: $450 million tax exempt bond financing constructing a 242 bed rehabilitation Hospital in Chicago, Illinois creating 330 new jobs and 1460 construction jobs Memorial Sloan Kettering Cancer Center: $89.5 million in bonds to pay a portion of the costs of constructing, improving and equipping a new outpatient care facility in Harrison New York Palmetto Health in Columbia,South Carolina: $215 million financing for the construction and equipping of a new hospital, creating 270 new jobs and retaining 7562 existing jobs Lifespan Hospital Network in Providence, Rhode Island: $50 million funding to acquire state-of-the-art integrated electronic medical record systems to improve patient care in four hospital network Western Montana Mental Health Center : $1.7 million construction of 16 bed adult patient addiction treatment facility, resulting in 19 permanent new jobs and 250 construction jobs 6

Education, cultural and art museums Higher and private education: Supports and attracts a more productive workforce, center for research and innovation, helps spur new business ventures Directly employs and supports millions of US jobs Libraries, museums, and performing arts: Rich source of information, promotes culture and community Serves as a major draw for tourism and recreation Examples of projects funded: Providence College: $38 million funding for construction of an academic building, new 200 bed dormitory and renovation to other campus facilities in Providence Rhode Island Wolcott School in Chicago, Illinois: $3 million tax-exempt financing for acquiring and equipping a new high school for students with learning challenges and disabilities (20 new jobs, 20 construction jobs) 7

Using IMPLAN to model 501(c)(3) impacts National inter-industry purchasing relationships derives the full effects on regional economic activity resulting from direct project expenditures on goods and services. Multiplier effect: a decrease of $1-million in final demand spending leads to a loss of 18 total jobs throughout the economy Two types of economic impacts generated through the supply chain linkages: Indirect effects are generated when a business directly involved in the change in spending purchases inputs from its suppliers located in the region. This spending supports suppliers as well as the business supporting those firms etc. Induced effects are produced by the change in local spending of disposable income by all the workers involved in the event being studied, including both the direct workers supported by the initial changes in final demand (e.g., the construction workers) and by workers in the supplying industries (e.g., firms that sell concrete to the contractor). 8

Potential annual economic impacts 28% Cap Full Repeal Interest cost increase, mil. $ 5,819 16,627 Direct Total Direct Total Employment, number of jobs 41,134 104,651 117,526 299,003 Labor income, mil. $ 2,154 5,483 6,153 15,664 Gross domestic product, mil. $ 2,650 8,256 7,570 23,590 Ouput, mil. $ 5,819 16,060 16,627 45,885 State/local taxes, mil. $ 603 1,723 Federal taxes, mil. $ 1,146 3,275

Employment Impacts By Industry (Jobs) 28% INDUSTRY Cap Full Repeal TOTAL 104,651 299,003 Construction 41,758 119,309 Professional & Business Services 12,131 34,661 Trade, Transportation, & Utilities 11,919 34,055 Manufacturing 8,395 23,986 Education & Health Services 8,144 23,268 Financial Services 7,895 22,558 Leisure & Hospitality Services 6,475 18,500 Other Services 4,308 12,309 Information Services 1,229 3,512 Agriculture, Forestry, Fishing 1,173 3,353 Government 729 2,084 Natural Resources & Mining 493 1,409

28% Exemption Cap Industry Total Direct Indirect Induced Construction 41,758 41,134 279 345 Professional & Business Services 12,131-7,696 4,435 Trade, Transportation, & Utilities 11,919-3,119 8,800 Manufacturing 8,395-6,547 1,848 Education & Health Services 8,144-12 8,132 Financial Services 7,895-2,170 5,725 Leisure & Hospitality Services 6,475-1,219 5,255 Other Services 4,308-1,002 3,306 Information Services 1,229-484 745 Agriculture, Forestry, Fishing 1,173-327 846 Government 729-195 534 Natural Resources & Mining 493-299 194 11

Full Repeal Industry Total Direct Indirect Induced Construction 119,309 117,526 798 985 Professional & Business Services 34,661-21,989 12,673 Trade, Transportation, & Utilities 34,055-8,912 25,143 Manufacturing 23,986-18,705 5,281 Education & Health Services 23,268-34 23,234 Financial Services 22,558-6,199 16,358 Leisure & Hospitality Services 18,500-3,484 15,016 Other Services 12,309-2,863 9,446 Information Services 3,512-1,384 2,129 Agriculture, Forestry, Fishing 3,353-935 2,418 Government 2,084-557 1,527 Natural Resources & Mining 1,409-854 555 12

Conclusion Proposals to limit or eliminate 501(c)(3) tax exempt financing would be felt across the US economy A 28% cap on interest exemption would, based on average spending in the past decade, reduce US gross domestic product by $8.3-billion per year. It would cost the nation 104,652 jobs and $5.5-billion in labor income annually A complete elimination would reduce gross domestic product by $23.6-billion and lose 299,003 jobs generating $15.6-billion in labor income Higher interest expenses limits nonprofits ability to fund important capital projects for hospitals and schools that create long-term economic value for communities across the nation 13