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Eliminating the Medical Expense Deduction Would Seriously Harm People Who Are Chronically Ill

Another important announcement from NAELA.  This would have devastated us in caring for my mother-in-law! -------------------------------------------------------------------------------------------------------------------- Older man kissing sick wife

The House Republicans tax proposal introduced today ends the medical expense deduction. This change will cause major harm to individuals and families trying to pay for the catastrophic costs of long-term services and supports (LTSS).

Read the bill text. Here's how you can help:Call your representative - Look up the direct office number in the House of Representatives Directory. • Post this or your own thoughts on social media. • Warn others in your local community organizations. Read NAELA's "Overview of the Medical Expense Deduction for the Chronically Ill" and NAELA's "The Medical Expense Deduction for the Chronically Ill, Key Points." LTSS provides assistance with Activities of Daily Living -- eating, transferring, bathing, dressing, and continence. In many instances, individuals who need LTSS must be placed in a nursing facility to receive 24-hour care. Conditions that may require LTSS include Alzheimer's disease, Multiple Sclerosis, or spinal cord injury. The tax code allows individuals to deduct qualified long-term care expenses if they are chronically ill, meaning those unable to perform two or more Activities of Daily Living without assistance, or who need constant supervision because of a severe cognitive impairment, such as Alzheimer's disease.These expenses are usually catastrophic, requiring many Americans to spend all of their income and to liquidate resources to pay for care. For instance, paying for nursing home care can quickly impoverish middle- and working-class Americans, costing a median of $97,000 a year for a private room. According to NAELA President Hy Darling, CELA, CAP, "The problem is as much a practical issue as it is a policy one. Fundamentally, many individuals paying for these costs will not be able to pay for their care and federal income tax at the same time. Raising the standard deduction and lowering tax rates will not address the issue." Why wouldn't increasing the standard deduction and lowering tax rates help? "Because many chronically ill Americans must pay all of their income towards care, and without the Medical Expense Deduction they could still have a tax liability that they cannot afford to pay," explains Darling. Put simply, eliminating the Medical Expense Deduction puts chronically ill Americans between a rock and a hard place. If these individuals cannot pay for the cost of LTSS, this could lead to eviction from their care facility. Yet paying for their care and not the increased tax creates an uncollectible tax liability. And, it likely would lead to an increased reliance on government programs. Many middle- and working-class individuals must "spend down" their resources to qualify for Medicaid. Without a tax subsidy, there is an increased incentive for people in need of care to participate in an already stressed federal/state program rather than assuming personal responsibility for their care or the care of their loved ones. 

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