Dear Senator, Dear Representative: Take Action Now!

Restore and Make Permanent the 7.5% Adjusted Gross Income Floor

For the Medical Expense Deduction

Congress must act now to restore and make permanent the medical expense deduction income threshold at 7.5%. This threshold reverted to 10% on December 31, 2018—which means that more than 4 million Americans who rely on the medical expense deduction will be blindsided by a substantially lower deduction when they file their 2019 tax returns early next year unless this problem is fixed immediately.

Spousal caregivers (Well Spouses) are on the front line of this important issue. As we know all too well, the cost of long-term care—whether at home or in a nursing home—can be financially catastrophic.  Home health aides, durable medical equipment, ramp vans, medical supplies, medical transportation, medical insurance premiums, co-pays and deductibles for drugs, doctor visits, physical, occupational and speech therapy not fully covered by insurance, and on and on and on—eat up a huge portion of many Well Spouse family budgets. Often, our medical expenses amount to 40%, 50%, 60% or even more of our household income.

Not only do medical expenses consume a huge share of Well Spouse income, but our incomes are severely constrained. Our Ill Spouses often are unable to work, and our own earnings potential is adversely affected by our caregiving responsibilities.

For many Well Spouses, the medical expense deduction is virtually the only financial assistance we have to help us cope with the enormous economic burden of caring for our Ill Spouses. Medicare and most private health insurance specifically exclude coverage for long-term care. Long-term care insurance is expensive, riddled with exclusions and other limitations, and typically cannot be purchased for persons who have “pre-existing conditions.” This leaves Medicaid, a means-tested program for which many of us have not yet become poor enough to qualify.

That’s why we need S. 110 and H.R. 2073, which would make the 7.5% threshold permanent. Pending adoption of a permanent fix, it is crucial that at least a temporary extension be enacted before December 31.