[Congressional Record Volume 164, Number 180 (Wednesday, November 14, 2018)]
[Senate]
[Page S6966]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Ms. COLLINS (for herself and Ms. Cantwell):
  S. 3621. A bill to amend the Internal Revenue Code of 1986 to provide 
for a permanent extension of the lower threshold for the medical 
expense deduction; to the Committee on Finance.
  Ms. COLLINS. Mr. President, for Americans struggling with high health 
care expenses, the tax deduction for certain medical expenses continues 
to be of significant assistance for many taxpayers. But unless it is 
extended, the income threshold for this vital deduction will increase 
at the end of this year.
  That is why I rise to introduce with my colleague, Senator Cantwell, 
a bill that would provide for a permanent extension of the medical 
expense deduction for unreimbursed health care costs that exceed 7.5 
percent of a taxpayer's income.
  For those who suffer from pre-existing medical conditions, have 
chronic medical conditions, experience unexpected illnesses or 
injuries, or find that long-term care services are a necessity but are 
not covered by insurance, health care expenses can quickly become an 
unbearable burden. Too many Americans are forced to choose between 
purchasing medical services and making other equally necessary 
expenditures.
  The Affordable Care Act (ACA) increased the income threshold for 
taxpayers to deduct their medical expenses from 7.5 percent to 10 
percent. For individuals under 65, the increase went into effect in 
2013. Those over 65 would have been exposed to this higher threshold 
for the first time in 2017.
  When the ACA increase was phased in, individuals under 65 struggling 
with serious health conditions saw their financial health worsen. For 
example, a 2016 study estimates that parents, including many with 
limited means, already provide nearly $36 billion annually in 
uncompensated medical care at home to children who have special health 
care needs, such as muscular dystrophy and cystic fibrosis. A 2016 
survey of cancer survivors showed that one-third go into debt and of 
those more than half incurred more than $10,000 in expenses.
  Medical debt is a serious challenge facing millions of families in 
our country, and as we endeavor to moderate rising health costs, we 
should also make every effort to ensure that we lower their tax burden 
as well.
  Some erroneously believe that this deduction only benefits the 
wealthy, when in fact, lower and middle-income Americans felt the 
impact of the increase. According to AARP, nearly 70 percent of 
taxpayers taking the deduction in 2014 reported income of $75,000 or 
less, and nearly half reported incomes of $50,000 or less. In my home 
state of Maine, according to AARP, 35,764 Maine residents claimed this 
deduction in 2014, while 18,788 of these individuals reported an income 
of $50,000 or less.
  This is why during tax reform last year, I introduced an amendment 
that rolled back the income threshold to 7.5 percent for all taxpayers 
to deduct their medical expenses for 2017 and 2018. My amendment 
expanded upon the efforts of Senators Rob Portman and Sherrod Brown, 
who had worked to prevent this increase from going into effect for 
individuals over 65.
  The AARP and 44 other consumer groups strongly endorsed the effort, 
stating: ``. . . it provides important tax relief which helps offset 
the costs of acute and chronic medical conditions for older Americans, 
children, pregnant women, disabled individuals, and other adults as 
well as the costs associated with long term care and assisted living.''
  While I am proud my amendment was included in the Tax Cuts and Jobs 
Act, it is set to expire at the end of the calendar year. I urge my 
colleagues to join Senator Cantwell and me in supporting this 
legislation as we take one more step toward addressing the impact of 
health care costs.
  Thank you, Mr. President.

                          ____________________