IMS Outlines Concerns with Tax Reform

Date of Publication December 1, 2017

This week, IMS President Joyce Vista-Wayne, MD, DFAPA, wrote to Senator Charles Grassley and Senator Joni Ernst to outline IMS’ concerns with the health policy implications of the current federal tax reform proposal working its way through the U.S. Senate. The legislation, known as the Tax Cuts and Jobs Act, passed the Senate Budget Committee on Tuesday and is expected to be taken up by the full Senate soon.

IMS articulated two primary concerns:

1. Eliminating the Individual Insurance Mandate
IMS has consistently held the position that federal reform efforts must be approached in a holistic fashion, with a consideration of the totality of the implications for the reforms being proposed. Eliminating the individual mandate — absent additional reforms to also address the market forces that have led to the near collapse of Iowa’s individual insurance market — will only result in even greater instability for the individual insurance market.

IMS urged Senators Grassley and Ernst to push Senate leadership not to move forward simply with a repeal of the individual mandate, as is currently proposed in the tax reform legislation.

2. Cutting Funding for Medicare and Medicaid
The Medicaid and Medicare programs provide health coverage for more than a third of our state’s population and are a critical component of Iowa's healthcare system. A recent analysis by the nonpartisan Congressional Budget Office (CBO) found that increasing the federal deficit in the range of the tax reform proposals currently under consideration would trigger a sequestration order resulting in a $25 billion reduction in Medicare spending in federal fiscal year 2018, alone.

Recently, the U.S. Senate also passed its version of the federal budget, which includes $473 billion in Medicare funding cuts and $1 trillion in Medicaid funding cuts called for over the next decade. IMS stressed this week the importance of sufficiently funding these crucial health coverage programs. IMS reiterated its call from last summer’s health reform debates that the senators avoid repeating the mistakes of the past by rushing passage of this significant tax reform measure simply to meet leadership-imposed calendar deadlines.

We reinforced our commitment to helping ensure Iowa physicians have sufficient resources to continue providing high-quality care for their patients and asked Senator Grassley and Senator Ernst to help make this possible.

The full IMS letter is available here. We continue to be in close communication with Iowa’s Congressional Delegation regarding the ongoing federal tax reform debate. For more information on these efforts, please contact Dennis Tibben with the IMS Center for Physician Advocacy.

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