[Congressional Record Volume 160, Number 95 (Wednesday, June 18, 2014)]
[Senate]
[Page S3813]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. SCOTT:
  S. 2492. A bill to amend the Internal Revenue Code of 1986 to 
increase access for the uninsured to high quality physician care; to 
the Committee on Finance.
  Mr. SCOTT. Mr. President, one of the greatest issues impacting the 
American health care system is the lack of access to high quality care 
for the uninsured. According to a 2012 CBO study, 26-27 million people 
will not have health insurance in 2016, with other studies suggesting 
that number may be closer to 30 million. Recent data from the Health 
Resource and Services Administration, HRSA, shows that close to 20 
percent of Americans live in areas with an insufficient number of 
primary care physicians. According to the Association of American 
Medical Colleges, AAMC, it is expected that there will be a shortage of 
45,000 primary care physicians in the US by 2020, further limiting 
access to care.
  An immediate way to improve access to high quality health care for 
the uninsured is to engage the physician community to provide greater 
levels of charity care. Currently, there is little incentive for 
physicians to provide charity care outside of their normal scope of 
practice, and the percentage of physicians providing charity care has 
been in a state of steady decline. Due to reimbursement changes over 
the years, physicians are currently forced to maintain a certain amount 
of private, Medicare, and Medicaid insured patients in order to ensure 
their practices can remain profitable. This often leaves no opportunity 
to care for patients who lack insurance and who are often the most 
vulnerable and sick.
  The Charity Care Expansion Act would create a much needed incentive 
for doctors to deliver uncompensated care, thereby improving and 
expanding access to care for the uninsured.
  The bill amends the Internal Revenue Code of 1986 and allows for 
physicians to have a tax deduction for the taxable year at an amount 
equal to the amount the physician would have otherwise been paid.
  For example, if Medicare would have reimbursed at $100 for a service, 
the physician would be able to deduct for $100. None of the deduction 
amounts would be arbitrary.
  To qualify for the tax deduction, the bill would require physicians 
to have a pre-existing relationship with a health care clinic or 
another organization providing health care which is targeted to serve 
low income individuals. Through this coordination, the patient would be 
placed into the healthcare system with follow ups and health care 
professionals to see, instead of getting lost in the system after 
treatment. This would also prevent the use of the tax deduction as a 
tool to write off bad debt.
  The limitations on the deduction are 10 percent of gross income of 
the taxpayer for the taxable year derived from the taxpayer's provision 
of physicians' services. For retired physicians, no more than a $10,000 
deduction would be allowed.
  While I am still waiting for a cost estimate on the bill, I repeal 
the Preventive Health and Health Services Block Grant, PHHSBG, which 
was included in the President's budget as a recommended cut, to provide 
an offset.

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