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Public Statements

Statements on Introduced Bills and Joint Resolutions

Floor Speech

Location: Washington, DC


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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