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AAP Statement on Congressional Efforts to Advance Tax Legislation

11/16/2017 by: Fernando Stein, MD, FAAP, President, American Academy of Pediatrics

"As Congress prepares to depart for Thanksgiving break, they have taken no action to extend funding for the Children's Health Insurance Program (CHIP), which covers nearly 9 million children from low-income families, or the Maternal, Infant, and Early Childhood Home Visiting program, which serves at-risk pregnant women and parents with young children, both of which expired nearly two months ago. Instead, elected officials are advancing tax legislation that undermines historic gains in health insurance coverage, misses an important opportunity to help lift families and children out of poverty, and serves as a vehicle for anti-immigrant policy.

"Research demonstrates that when parents have health insurance, children are more likely to get the care they need. Repealing the Affordable Care Act's requirement to purchase health insurance means that 13 million fewer people, including parents and children, will have coverage. In addition, no longer allowing families to deduct out-of-pocket medical expenses that exceed 10 percent of their income means that families with children who suffer from chronic and often costly medical conditions will have to bear more financial burden to ensure their children can stay healthy. Any proposal that makes it harder for families to access affordable, high-quality health care coverage harms children's health.

"The Child Tax Credit, which gives eligible families a tax credit per child to help offset the cost of raising children, has been instrumental in lifting children out of poverty. While the bills under consideration by Congress may increase the credit, they do so in a way that leaves out many low-income families. Especially troubling is that tax reform is being used to advance anti-immigrant policies, including proposed changes to the Child Tax Credit that would limit its eligibility to only those children with social security numbers. This change to current law disproportionately harms immigrant families and the young adults who came to the United States as children, known as DREAMers.

"Rising levels of educational debt for medical trainees is a major barrier to addressing shortages and maldistributions of primary care pediatricians and pediatric subspecialists across the country. Being able to deduct student loan debt when filing taxes can help pediatric trainees make career decisions based on their interests and the needs of children, rather than financial necessity. Congress should maintain this important provision in tax legislation.

"The tax legislation currently advancing through Congress does not help make families living in poverty more financially secure, and in fact, puts more barriers in place preventing vulnerable families from achieving sound financial footing. Rather than pursue legislation that leaves millions more uninsured, pediatricians urge Congress to prioritize the immediate passage of a long-term, bipartisan CHIP funding extension so that families will no longer face an uncertain future when it comes to their children's health care coverage."


The American Academy of Pediatrics is an organization of 66,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults. For more information, visit and follow us on Twitter @AmerAcadPeds.