[Congressional Record Volume 155, Number 111 (Wednesday, July 22, 2009)]
[Senate]
[Pages S7887-S7888]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Ms. CANTWELL (for herself and Mrs. Murray):
  S. 1497. A bill to amend the Internal Revenue Code of 1986 to allow 
tax-exempt bond financing for fixed-wing emergency medical aircraft; to 
the Committee on Finance.
  Ms. CANTWELL. Mr. President, I rise to introduce legislation that 
will remove an unintended obstacle in the tax-exempt bond rules so that 
states can use these bonds to finance the purchase of fixed-wing air 
ambulances in the same way they can now use them to finance the 
purchase of medical helicopters.
  The difference between a medical helicopter and a fixed wing air 
ambulance

[[Page S7888]]

may seem minor to some, but if you live in a remote area the difference 
can be as big as life or death.
  Air medical services, AMS, are an essential component of the health 
care system. When appropriately used, air critical care transport saves 
lives and reduces the cost of health care by minimizing the time the 
critically injured and ill spend out of a hospital, by bringing more 
medical capabilities to the patient than are normally provided by 
ground emergency medical services, and by quickly getting the patient 
to the right specialty care. Dedicated medical helicopters and fixed 
wing aircraft are mobile flying emergency intensive care units deployed 
at a moment's notice to patients whose lives depend on rapid care and 
transport.
  In remote rural areas, the use of helicopters often is impractical 
and unsafe because of the long distances that patients must be 
transported, sometimes during poor weather conditions. In these 
situations, the better alternative is a fixed-wing aircraft.
  Both helicopters and fixed wing aircraft cost millions of dollars to 
purchase or lease, operate, house and maintain. But under the way that 
the tax-exempt bond rules currently work, states are prohibited from 
using these bonds to finance air ambulance services in rural areas, 
even though they can use these bonds for helicopters. This result was 
not what Congress intended, and our bill would make that clear.
  Under current law, tax-exempt bonds can not be issued for the 
purchase of any ``airplane, skybox or other privacy luxury box, health 
club facility, facility primarily used for gambling, or store the 
principal business of which is the sale of alcoholic beverages for 
consumption off premises.'' The restrictions were enacted in order to 
prevent tax-exmpt bonds to be used for frivolous or extravagant 
purposes. Unfortunately, the law has been interpreted to exclude the 
purchase of new fixed-wing planes to provide air ambulance services, 
but the purchase of helicopters--which are not airplanes--is permitted.
  This result is not what was intended by the restrictions and our bill 
would simply make it clear that the general restriction against the use 
of tax-exempt bonds for purchasing an airplane does not apply in the 
case of planes that are equipped for and exclusively dedicated to 
emergency medical services.
  There is supporting precedent in distinguishing planes for air 
ambulance services different than other airplanes. The air 
transportation excise tax provides an exemption for air transportation 
that is used to provide ``emergency medical services . . . by a fixed-
wing aircraft equipped for and exclusively dedicated on that flight to 
acute care emergency medical services.''
  This issue hits close to home for me and my colleagues who are 
joining me on this legislation, but we are certainly not alone with 
respect to the need to ensure that folks in our rural and remote areas 
have access to needed medical services.
  Inland Northwest Health Services, INHS, is a non-profit organization 
that provides critical health care support services in the Inland 
Northwest, including air ambulance services through Northwest MedStar. 
INHS is based in Spokane, Washington, and provides health care services 
in Eastern Washington, Eastern Oregon, Northern Idaho, and Western 
Montana. Unfortunately, this unintended restriction in the tax code is 
preventing INHS from asking the appropriate state authorities to issue 
tax-exempt bonds to finance the purchase of new fixed-wing planes for 
air ambulance service.
  The legislation that I am introducing with Senator Murray is a 
common-sense fix to this problem, and I hope we can address it quickly.
  Mr. President, I ask unanimous consent that the text of the bill be 
printed in the Record.
  There being no objection, the text of the bill was ordered to be 
printed in the Record, as follows:

                                S. 1497

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. TAX-EXEMPT BOND FINANCING FOR FIXED-WING EMERGENCY 
                   MEDICAL AIRCRAFT.

       (a) In General.--Subsection (e) of section 147 of the 
     Internal Revenue Code of 1986 (relating to no portion of 
     bonds may be issued for skyboxes, airplanes, gambling 
     establishments, etc.) is amended by adding at the end the 
     following new sentence: ``The preceding sentence shall not 
     apply to any fixed-wing aircraft equipped for, and 
     exclusively dedicated to providing, acute care emergency 
     medical services (within the meaning of 4261(g)(2)).''
       (b) Effective Date.--The amendment made by this section 
     shall apply to obligations issued after the date of the 
     enactment of this Act.
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