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Harris wants to forgive medical debt for millions of Americans

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Vice President Kamala Harris addresses the Democratic National Convention at the United Center in Chicago on Aug. 19, 2024.

Tom Williams | CQ-Roll Call, Inc. | Getty Images

Vice President Kamala Harris wants to forgive medical debt for millions of Americans.

The economic plan Harris rolled out last week notes that the Democratic presidential nominee and her running mate, Minnesota Gov. Tim Walz, would work with states to relieve people of their medical debt and “to help them avoid accumulating such debt in the future, because no one should go bankrupt just because they had the misfortune of becoming sick or hurt.”

Some 15 million Americans have medical bills on their credit reports, according to Consumer Financial Protection Bureau research published in April. People in the U.S. owe at least $220 billion in medical debt, a February KFF analysis found.

“Medical debt affects an enormous number of people, so it’s an issue that resonates with voters,” said Larry Levitt, executive vice president for health policy at KFF.

How medical debt became normal in the U.S.

Indeed, 51% of adults say it is extremely or very important for the federal government to forgive medical debt, compared with 39% who said the same about student loan debt, according to a May poll conducted by the University of Chicago Harris School of Public Policy and The Associated Press-NORC Center for Public Affairs Research. The groups surveyed 1,309 adults.

“Vice President Harris may see student loan forgiveness and medical debt forgiveness as both addressing inequities that prevent people from achieving the American dream,” said higher education expert Mark Kantrowitz.

The Harris campaign did not respond to a request for comment.

Former President Donald Trump hasn’t come out with a medical debt cancellation proposal, but as president he pushed for more price transparency for patients and to curb surprise medical bills.

The Trump administration also tried but failed to repeal the Affordable Care Act. Overturning even portions of that law would lead to more Americans becoming uninsured and higher premium costs for policyholders, according to an estimate by the Congressional Budget office.

Harris differentiates herself with focus on medical debt

By coming out with a medical debt forgiveness plan, Harris may be looking to differentiate herself from President Joe Biden and his student debt efforts, said Braxton Brewington, press secretary for the Debt Collective, an organization that advocates for debt cancellation.

Biden has forgiven more student debt than any other president.

“She has the freedom to move into another space,” Brewington said, adding that Harris would likely continue Biden’s work on student debt, as well.

“I’m sure she’ll do both,” he said.

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The American health-care system has long been on Harris’ radar.

As a presidential candidate in 2020, Harris pushed for a version of Medicare For All, a plan she no longer backs as she shifts to the center of her party. But Harris continued to show a concern with health-care costs as vice president, leading a White House effort in June to clear medical bills from Americans’ credit reports.

This focus may come, in part, from her own experience.

In a 2019 interview with late activist Ady Barkan, Harris described the day her mother informed her she had cancer.

“My mother, she said to my sister and me, ‘I want to meet you guys for lunch,’ and she showed up at the restaurant wearing makeup — my mother never wore makeup, and her hair was blow dried,” Harris said, tearing up. “She took our hands, and she’d said she’d been diagnosed with colon cancer.

“That was one of the worst days of my life, truly.”

That families experiencing this “would also have to worry about how to pay the bills,” Harris told Barkan was “just inhumane.”

Harris’s mother, who was a cancer researcher, died in 2009 at 70.

How medical debt could be canceled

Harris’ economic plan didn’t include specific details on how the medical debt jubilee would happen, but experts say an investment by the government would go far.

“Amazingly, medical debt can be bought from collection agencies for a penny on the dollar, a reflection of the fact that so few people can afford to pay their overdue medical bills,” KFF’s Levitt said.

Allison Sesso, president and chief executive officer of Undue Medical Debt, a nonprofit that partners with local governments to cancel people’s medical debts, said the group can usually wipe out around $1,000 of the debt for every $10. It often buys the debt directly from hospitals, Sesso said.

States, counties and cities across the U.S. are already using funds from the American Rescue Plan passed during the Covid pandemic to purchase and eliminate around $7 billion in medical debt for roughly 3 million Americans by the end of 2026. As many as 1 million residents in Arizona could benefit, for example, and 400,000 people in New Jersey, according to the White House.

Medical debt affects an enormous number of people, so it’s an issue that resonates with voters.

Larry Levitt

executive vice president for health policy at the Kaiser Family Foundation

Recent research has raised some doubts about the benefits of forgiving medical debt. The relief has no impact on people’s mental health, credit access or financial distress, according to a National Bureau of Economic Research study published in April.

Experts say this may be due in part to the fact that, beginning last year, the major credit reporting companies cleared most medical collections under $500 from people’s records. Those past-due bills are now less likely to affect people’s credit. Harris is now trying to get even more, if not all, medical debts off people’s credit reports.

However, Sesso said Undue Medical Debt hears from people all the time about how canceling their medical debt improved their lives. In extreme cases, unpaid medical bills can lead to wage garnishments and seized assets, she said.

Frequently, people who still owe a hospital or doctor a bill will avoid necessary treatments, she said.

“People don’t go back to the doctor because they feel they’ll be asked for the bill,” Sesso said. “And then the problem gets worse, and the interventions much more expensive.”

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House GOP tax bill passes ‘SALT’ deduction cap of $40,000

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House Ways and Means Committee Chairman Jason Smith (R-MO) holds a news conference before a markup hearing in the Longworth House Building on Capitol Hill on May 13, 2025 in Washington, DC.

Chip Somodevilla | Getty Images News | Getty Images

House lawmakers on Thursday morning passed changes for the federal deduction for state and local taxes, known as SALT, as part of President Donald Trump‘s tax package.

Enacted via the Tax Cuts and Jobs Act, or TCJA, of 2017, there’s currently a $10,000 limit on the SALT deduction, and raising that cap has been a priority for certain House lawmakers in high-tax states like New York, New Jersey and California. Filers must itemize deductions to claim the tax break for SALT.

If the House provision is enacted, the SALT cap would rise to $40,000, up from $30,000 in the previous plan, and phases out over $500,000, according to revised language released by the House Rules Committee. The provision would go into effect in 2025.

The SALT cap and income phaseout would increase annually by 1% from 2026 through 2033, according to the text.

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The revised text would also reduce itemized deductions for certain taxpayers in the 37% income tax bracket, which could reduce the benefit of the higher SALT cap.

For 2025, the top rate of 37% applies to individuals with taxable income above $626,350, and married couples filing jointly earning $751,600 or more.

However, the House proposal for changes to the SALT deduction could still face pushback in the Senate.

How the SALT deduction works

When filing taxes, you pick the greater of the standard deduction or your itemized deductions, including SALT capped at $10,000, medical expenses above 7.5% of your adjusted gross income, charitable gifts and others.

Starting in 2018, the Tax Cuts and Jobs Act doubled the standard deduction, and it adjusts for inflation yearly. For 2025, the standard deduction is $15,000 for single filers and $30,000 for married couples filing jointly. These could increase under the House-proposed tax bill.

Under the current thresholds, the vast majority of filers — roughly 90%, according to the latest IRS data — use the standard deduction and don’t benefit from itemized tax breaks.

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Who benefits from the higher SALT cap

“Any changes to lift the cap would primarily benefit higher earners,” Garrett Watson, director of policy analysis at the Tax Foundation, wrote in an analysis on Tuesday.

With an income phaseout over $400,000, the top 20% of taxpayers “would be the only group to meaningfully benefit,” Watson wrote.

But members of the so-called “SALT Caucus” argue the SALT deduction limit is a middle-class issue in their districts.

Rep. Josh Gottheimer, D-NJ., co-chair of the SALT Caucus, told CNBC’s “The Exchange” on Tuesday that a full repeal of the $10,000 SALT deduction limit would be a “huge tax cut and benefit for middle-class families around the country.”    

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SNAP benefits, food stamps face cuts under GOP tax bill

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People shop at a grocery store in Brooklyn on May 13, 2025 in New York City.

Spencer Platt | Getty Images

As Republicans push forward with the “big, beautiful” tax bill, federal food assistance may see big cuts.

The Supplemental Nutrition Assistance Program, or SNAP, may be cut about 30% under the terms of the bill, which would be the “biggest cut in the program’s history,” according to Ty Jones Cox, vice president for food assistance policy at the Center on Budget and Policy Priorities.

SNAP, formerly known as food stamps, currently provides food assistance to more than 40 million individuals including children, seniors and adults with disabilities.

Yet cuts to the program proposed by the House — which would shrink the program’s funding by about $300 billion through 2034 — would put those benefits at risk.

“The House Republican plan would take away food assistance for millions who struggle to afford the high cost of groceries, including families with children and other vulnerable people with low incomes,” Cox said during a Tuesday webinar hosted by the CBPP, a progressive think tank.

The SNAP reform efforts come amid a broader effort to reduce waste and fraud in government programs. SNAP, like other government benefits, can be susceptible to improper or fraudulent payments.

The “one big, beautiful bill restores integrity to the Supplemental Nutrition Assistance Program,” House Agriculture Committee Chairman Glenn “GT” Thompson, R-Pa., said in a May 14 statement, through “long-overdue accountability incentives to control costs and end executive and state overreach.”

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Many Americans cite high food costs as a top economic concern, according to an April Pew Research Center survey. If new tariff policies are put into effect, that could prompt food prices to go higher.

Moreover, the proposed SNAP cuts come as some experts say the U.S. is facing higher recession risks. In previous downturns, every additional dollar spent on SNAP generates about $1.54 in returns to the economy, according to Elaine Waxman, senior fellow at the Urban Institute’s tax and income support division.

“People spend SNAP dollars right away, and they spend them locally,” Waxman said.

The proposed SNAP cuts would largely happen by expanding work requirements to qualify for benefits and by cutting federal funding for food benefits and administration and leaving it up to states to make up the difference.

Federal cuts would leave states with tough choices

The largest cut to SNAP would come from federal funding cuts to basic SNAP benefits ranging from 5% to 25% starting in 2028, according to CBPP.

It would then be up to states to find ways to make up for that benefit shortfall, which could include making it more difficult to enroll in the program or finding other localized cuts to the program, according to CBPP.

“The change in the bill that is most dramatic is asking states to share part of the benefit cost,” Waxman said. “That’s new; since SNAP was originated, the federal government has always paid the full cost of the benefits.”

Notably, it would also mark the first time in the history of SNAP that the federal government would no longer ensure children in every state have access to food benefits, according to CBPP.

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In addition, the proposal also seeks to make it so states pay a larger portion of the program’s administrative costs.

How states may react to the changes may vary. In worst-case scenarios, some states could even opt out of the program altogether, according to CBPP.

However, Waxman said most states will likely try to protect benefits because they’re “so critical,” even though they are not legally obligated to offer the program.

“The vast majority, if not all, will try to do something,” Waxman said.

In addition to the benefits SNAP provides to individuals and families, it also provides an “integral” part of economies, Waxman said. In lower-income rural areas, for example, rural grocery stores that rely on SNAP customers would see food spending go down.

“It has all these ripples that will hurt a lot of people other than just the people who are on the program,” Waxman said.

Work requirements may cost families $254 per month

House Minority Leader Hakeem Jeffries, D-N.Y., at the House Democrats’ news conference on Medicaid and SNAP cuts proposed by the Republicans’ reconciliation process.

Bill Clark | Cq-roll Call, Inc. | Getty Images

Work requirements for SNAP already make it so certain individuals must work at least 80 hours per month to qualify for the program’s benefits. That includes individuals ages 18 to 54 who are able to work and who have no dependents. Current policy also limits SNAP benefits for certain individuals to three months within a 36-month period unless work requirements are met.

The proposed legislation would expand that those work requirements, according to the Urban Institute, by:

  • extending the requirements to households with children, unless they have a child under age seven;
  • expanding the work requirements and time limits to individuals ages 55 through 64;
  • limiting states’ flexibility to request waivers of the work requirement policies in high unemployment areas; and
  • reducing discretionary exemptions from the time limits that states may provide.

Expanded work requirements would affect 2.7 million families and 5.4 million individuals, according to a new report from the Urban Institute.

That includes 1.5 million families who would lose benefits entirely and 1.2 million families who would receive lower benefits. It also includes 1.8 million people, including 48,000 children, who would lose benefits entirely; and 3.6 million people, including 1.5 million children, who would receive lower benefits, according to the Urban Institute.

Families that lose some or all their benefits would lose $254 per month on average, according to the research. Meanwhile, families with children would lose $229 per month on average, the Urban Institute found.

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What the Senate ‘no tax on tips’ bill could mean for workers

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U.S. President Donald Trump speaks at an event about the economy at the Circa Resort and Casino in Las Vegas, Nevada, U.S., January 25, 2025. 

Leah Millis | Reuters

The Senate on Tuesday unanimously passed the No Tax on Tips Act in a surprise vote, which could boost momentum for an idea floated by President Donald Trump during his 2024 campaign. 

If enacted, the legislation would create a federal income tax deduction of up to $25,000 per year, with some limitations. The tax break applies to workers who typically receive cash tips reported to their employer for payroll tax withholdings, according to a summary of the bill. 

To qualify for the deduction, there’s a $160,000 earnings limit for 2025. That limit would be indexed for inflation yearly.

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Currently, workers who receive cash tips of $20 or more monthly must report those earnings to employers, according to the IRS. Cash tips can include funds received directly from customers, tip-sharing from other employees or tips paid via credit card.

Lawmaker support for a tax break on tip income

During the 2024 presidential campaign, Trump and Vice President Kamala Harris both called for no tax on tips during appearances in Nevada.

The bill advanced by the House Ways and Means Committee last week also includes a no tax on tips provision. If enacted, workers could deduct all “qualified tips” from 2025 through 2028. Tips must be reported to qualify for the deduction. However, this could still change before the full House floor vote.

“Whether it passes free-standing or as part of the bigger bill, one way or another, no tax on tips is going to become law and give real relief to hard-working Americans,” Sen. Ted Cruz, R-Texas., said from the Senate floor on Tuesday. 

Cruz introduced the bipartisan bill in January with Sens. Jacky Rosen and Catherine Cortez Masto from Nevada.

Who benefits from no tax on tips

In 2023, there were roughly 4 million U.S. workers in tipped occupations, representing 2.5% of all employment, according to estimates from The Budget Lab at Yale University.

“This is a very narrow subset of the workforce,” said Alex Muresianu, senior policy analyst at the Tax Foundation. 

Tipped occupations include jobs in restaurants and hotels, as well as courier services like taxis, rideshares and food delivery services, he said.

What’s more, a good chunk of tipped workers are part-time employees, and they wouldn’t see a significant benefit from a tip exemption, he said. Many such workers already don’t pay federal income tax because their earnings fall under the standard deduction.

“For the lowest income tipped workers, it provides no marginal benefit” Muresianu said. “It would benefit moderate to middle income workers substantially.”

Policy ‘clearly violates some principle of fairness’

A no tax on tips policy could create several issues, Muresianu said.

For example, there could be the introduction of tips in new occupations, or a shift in compensation in already tipped occupations toward a greater reliance on tips. It’s also possible that income could be misclassified as tips to take advantage of the tax benefit, he said.

“It’s tough to model or project because tipping is a social behavior, not strictly an economic transaction,” Muresianu said.

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From a general economic standpoint, it doesn’t make sense to treat one type of income earned in specific industries differently than another type of income, he said. Take, for example, a waitress and a retail cashier: Both earn $35,000, but the waitress makes $10,000 in tips, which would be tax exempt.

“Why does the cashier pay full income tax on her income but the waitress gets a very substantial tax exemption?” he said. “That clearly violates some principle of fairness.”

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