Bill Overview
Title: Indian Health Service Health Professions Tax Fairness Act of 2022
Description: This bill excludes from gross income, for income tax purposes, payments under the Indian Health Service Loan Repayment Program and certain amounts received under the Indian Health Professions Scholarships Program.
Sponsors: Rep. Moore, Gwen [D-WI-4]
Target Audience
Population: Individuals participating in Indian Health Service Loan Repayment or Scholarship Programs
Estimated Size: 10000
- The bill targets individuals who are part of the Indian Health Service Loan Repayment Program, which typically includes health professionals working in Indian health facilities.
- The Indian Health Professions Scholarships Program is aimed at students enrolled in health profession education programs who commit to a service obligation in an Indian health facility.
- The Indian Health Service programs are specifically designed to improve healthcare services for the American Indian and Alaska Native populations.
- Such students and health professionals who are part of these programs are most likely the direct beneficiaries.
Reasoning
- The target population includes health professionals and students participating in the Indian Health Service Loan Repayment and Scholarships Programs, mainly serving American Indian and Alaska Native communities.
- Participants are likely to have varying levels of exposure to financial burdens due to student loans, impacting their decision to pursue healthcare education and practice in underserved areas.
- The policy aims to alleviate financial pressure by making certain payments tax-exempt, which could significantly influence their well-being and long-term financial security.
- Given the budget constraints and target of 10,000 individuals, each participant could see moderate financial benefits if the policy is implemented efficiently.
Simulated Interviews
Primary Care Physician (Arizona)
Age: 30 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 10.0 years
Commonness: 5/20
Statement of Opinion:
- The tax exclusion will bring significant relief and allow more focus on patient care rather than financial stress.
- However, the policy's impact on my overall financial health might still be limited due to other expenses.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 8 | 6 |
| Year 5 | 8 | 6 |
| Year 10 | 9 | 7 |
| Year 20 | 8 | 7 |
Dentist (New Mexico)
Age: 28 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 20.0 years
Commonness: 4/20
Statement of Opinion:
- This policy eases my financial burden substantially, making it easier to stay committed to working in underserved areas.
- It also motivates more consistent service without having the overhead stress of loan payments.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 8 | 5 |
| Year 10 | 9 | 6 |
| Year 20 | 8 | 6 |
Nurse Practitioner (California)
Age: 35 | Gender: female
Wellbeing Before Policy: 7
Duration of Impact: 5.0 years
Commonness: 6/20
Statement of Opinion:
- Though the tax exclusion is beneficial, high living costs in urban areas diminish its effect.
- Still, it encourages ongoing service to the community and enhances job satisfaction.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 7 | 7 |
| Year 3 | 7 | 7 |
| Year 5 | 8 | 7 |
| Year 10 | 7 | 6 |
| Year 20 | 7 | 6 |
Pharmacist (Montana)
Age: 40 | Gender: male
Wellbeing Before Policy: 8
Duration of Impact: 0.0 years
Commonness: 10/20
Statement of Opinion:
- While this policy may not directly impact me, it improves team morale as colleagues benefit.
- It reflects positively on the program's commitment to supporting healthcare providers.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 8 |
| Year 2 | 8 | 8 |
| Year 3 | 8 | 8 |
| Year 5 | 8 | 8 |
| Year 10 | 8 | 8 |
| Year 20 | 8 | 8 |
General Surgeon (Alaska)
Age: 45 | Gender: female
Wellbeing Before Policy: 9
Duration of Impact: 0.0 years
Commonness: 15/20
Statement of Opinion:
- I don't receive direct benefits, but I support the policy as it helps recruit and retain talented professionals.
- It’s an investment in the future healthcare of the community.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 9 | 9 |
| Year 2 | 9 | 9 |
| Year 3 | 9 | 9 |
| Year 5 | 9 | 9 |
| Year 10 | 9 | 9 |
| Year 20 | 8 | 8 |
Medical Student (South Dakota)
Age: 26 | Gender: male
Wellbeing Before Policy: 4
Duration of Impact: 15.0 years
Commonness: 3/20
Statement of Opinion:
- The policy lessens future financial burdens and supports my educational journey.
- It's motivating, knowing that serving my community will have fewer financial setbacks.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 6 | 4 |
| Year 3 | 6 | 5 |
| Year 5 | 7 | 5 |
| Year 10 | 8 | 6 |
| Year 20 | 8 | 6 |
Physician Assistant (Oklahoma)
Age: 50 | Gender: female
Wellbeing Before Policy: 7
Duration of Impact: 3.0 years
Commonness: 7/20
Statement of Opinion:
- While my direct benefits are limited, the tax relief for current and emerging practitioners is crucial for the next generation.
- It's a positive adjustment that secures our continuity in quality care provision.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 7 | 7 |
| Year 3 | 7 | 7 |
| Year 5 | 7 | 7 |
| Year 10 | 7 | 7 |
| Year 20 | 7 | 7 |
Physical Therapist (North Dakota)
Age: 32 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 8.0 years
Commonness: 4/20
Statement of Opinion:
- The exclusion is a big relief and ensures I remain dedicated to serving at the clinic.
- Tax savings reduce my financial stress and improve mental well-being significantly.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 8 | 5 |
| Year 10 | 7 | 5 |
| Year 20 | 7 | 5 |
Public Health Graduate Student (Idaho)
Age: 24 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 12.0 years
Commonness: 5/20
Statement of Opinion:
- This tax exclusion offers significant support as I transition into my career.
- It makes working in this sector more attractive amidst other competitively paying options.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 8 | 6 |
| Year 3 | 8 | 6 |
| Year 5 | 8 | 6 |
| Year 10 | 8 | 6 |
| Year 20 | 7 | 6 |
Retired Physician (Washington)
Age: 60 | Gender: male
Wellbeing Before Policy: 8
Duration of Impact: 0.0 years
Commonness: 12/20
Statement of Opinion:
- I'm not directly affected, but the policy helps maintain morale and retention in the community.
- Continued support for new entrants ensures excellence and growth in our field.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 8 |
| Year 2 | 8 | 8 |
| Year 3 | 8 | 8 |
| Year 5 | 8 | 8 |
| Year 10 | 8 | 8 |
| Year 20 | 8 | 8 |
Cost Estimates
Year 1: $30000000 (Low: $25000000, High: $35000000)
Year 2: $30800000 (Low: $25750000, High: $35900000)
Year 3: $31620000 (Low: $26522500, High: $36880000)
Year 5: $32460000 (Low: $27272500, High: $37770000)
Year 10: $35000000 (Low: $29500000, High: $40500000)
Year 100: $50000000 (Low: $42000000, High: $58000000)
Key Considerations
- The policy primarily affects tax revenue, rather than other expenditures.
- The number of individuals affected, approximately 10,000, is relatively small in federal budget terms.
- IRS and administrative processes for reporting and complying with these changes should be considered but are not expected to be costly.