As Congress moves to assemble the final version of its tax plan, projects like Spooner, Wisconsin's 20-bed hospital hang in the balance.

The rural community, about 110 miles (177 kilometers) northeast of Minneapolis, sold tax-exempt bonds to build the $26 million facility it opened last May. The hospital's chief executive officer said that if its access to such low cost financing had been cut off it would have paid over $6 million more in interest.

That may soon be an expense that other hospitals across the country will have to shoulder. The House's tax legislation revokes non-profit hospitals' ability to raise money in the municipal market, where investors are willing to accept lower interest rates because the income is exempt from federal taxes. That's threatening to saddle health-care providers with higher borrowing costs at a time when their finances are already under pressure.