II 

110TH CONGRESS 

1ST SESSION S. 897 

To amend the Internal Revenue Code of 1986 to provide more help to 

Alzheimer’s disease caregivers. 

IN THE SENATE OF THE UNITED STATES 

MARCH 15, 2007 

Ms. MIKULSKI (for herself, Mr. GRASSLEY, Mr. BOND, Mrs. CLINTON, and 

Ms. COLLINS) introduced the following bill; which was read twice and referred to the Committee on Finance 

A BILL 

To amend the Internal Revenue Code of 1986 to provide 

more help to Alzheimer’s disease caregivers. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Alzheimer’s Family 

5 Assistance Act of 2007’’. 

6 SEC. 2. CREDIT FOR TAXPAYERS WITH LONG-TERM CARE 

7 NEEDS. 

8 (a) IN GENERAL.—Subpart A of part IV of sub9 chapter A of chapter 1 of the Internal Revenue Code of 

10 1986 (relating to nonrefundable personal credits) is 


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1 amended by inserting after section 25D the following new 

2 section: 

3 ‘‘SEC. 25E. CREDIT FOR TAXPAYERS WITH LONG-TERM 

4 CARE NEEDS. 

5 ‘‘(a) ALLOWANCE OF CREDIT.— 

6 ‘‘(1) IN GENERAL.—There shall be allowed as a 

7 credit against the tax imposed by this chapter for 

8 the taxable year an amount equal to the applicable 

9 credit amount multiplied by the number of applica10 ble individuals with respect to whom the taxpayer is 

11 an eligible caregiver for the taxable year. 

12 ‘‘(2) APPLICABLE CREDIT AMOUNT.—For pur13 poses of paragraph (1), the applicable credit amount 

14 shall be determined in accordance with the following 

15 table: 

‘‘For taxable years beginning 

in calendar year— 

The applicable credit amount 

is— 

2007 ............................................................................................. $1,000

2008 ............................................................................................. 1,500

2009 ............................................................................................. 2,000

2010 ............................................................................................. 2,500

2011 or thereafter ....................................................................... 3,000. 

16 ‘‘(b) LIMITATION BASED ON ADJUSTED GROSS IN17 COME.— 

18 ‘‘(1) IN GENERAL.—The amount of the credit 

19 allowable under subsection (a) shall be reduced (but 

20 not below zero) by $100 for each $1,000 (or fraction 

21 thereof) by which the taxpayer’s modified adjusted 

22 gross income exceeds the threshold amount. For 


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1 purposes of the preceding sentence, the term ‘modi2 fied adjusted gross income’ means adjusted gross in3 come increased by any amount excluded from gross 

4 income under section 911, 931, or 933. 

5 ‘‘(2) THRESHOLD AMOUNT.—For purposes of 

6 paragraph (1), the term ‘threshold amount’ means— 

7 ‘‘(A) $150,000 in the case of a joint re8 turn, and 

9 ‘‘(B) $75,000 in any other case. 

10 ‘‘(3) INDEXING.—In the case of any taxable 

11 year beginning in a calendar year after 2007, each 

12 dollar amount contained in paragraph (2) shall be 

13 increased by an amount equal to the product of— 

14 ‘‘(A) such dollar amount, and 

15 ‘‘(B) the medical care cost adjustment de16 termined under section 213(d)(10)(B)(ii) for 

17 the calendar year in which the taxable year be18 gins, determined by substituting ‘2006’ for 

19 ‘1996’ in subclause (II) thereof. 

20 If any increase determined under the preceding sen21 tence is not a multiple of $50, such increase shall 

22 be rounded to the next lowest multiple of $50. 

23 ‘‘(c) DEFINITIONS.—For purposes of this section— 

24 ‘‘(1) APPLICABLE INDIVIDUAL.— 


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1 ‘‘(A) IN GENERAL.—The term ‘applicable 

2 individual’ means, with respect to any taxable 

3 year, any individual who has been certified, be4 fore the due date for filing the return of tax for 

5 the taxable year (without extensions), by a phy6 sician (as defined in section 1861(r)(1) of the 

7 Social Security Act) as being an individual with 

8 long-term care needs described in subparagraph 

9 (B) for a period— 

10 ‘‘(i) which is at least 180 consecutive 

11 days, and 

12 ‘‘(ii) a portion of which occurs within 

13 the taxable year. 

14 Such term shall not include any individual oth15 erwise meeting the requirements of the preceding sentence unless within the 391 16 ⁄2 month 

17 period ending on such due date (or such other 

18 period as the Secretary prescribes) a physician 

19 (as so defined) has certified that such indi20 vidual meets such requirements. 

21 ‘‘(B) INDIVIDUALS WITH LONG-TERM CARE

22 NEEDS.—An individual is described in this sub23 paragraph if the individual meets any of the fol24 lowing requirements: 


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1 ‘‘(i) The individual is at least 18 years 

2 of age and— 

3 ‘‘(I) is unable to perform (with4 out substantial assistance from an5 other individual) at least 3 activities 

6 of daily living (as defined in section 

7 7702B(c)(2)(B)) due to a loss of 

8 functional capacity, or 

9 ‘‘(II) requires substantial super10 vision to protect such individual from 

11 threats to health and safety due to se12 vere cognitive impairment and is un13 able to perform at least 1 activity of 

14 daily living (as so defined) or to the 

15 extent provided in regulations pre16 scribed by the Secretary (in consulta17 tion with the Secretary of Health and 

18 Human Services), is unable to engage 

19 in age appropriate activities. 

20 ‘‘(ii) The individual is at least 6 but 

21 not 18 years of age and— 

22 ‘‘(I) is unable to perform (with23 out substantial assistance from an24 other individual) at least 3 activities 

25 of daily living (as defined in section 


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1 7702B(c)(2)(B)) due to a loss of 

2 functional capacity, 

3 ‘‘(II) requires substantial super4 vision to protect such individual from 

5 threats to health and safety due to se6 vere cognitive impairment and is un7 able to perform at least 1 activity of 

8 daily living (as so defined) or to the 

9 extent provided in regulations pre10 scribed by the Secretary (in consulta11 tion with the Secretary of Health and 

12 Human Services), is unable to engage 

13 in age appropriate activities, 

14 ‘‘(III) has a level of disability 

15 similar to the level of disability de16 scribed in subclause (I) (as deter17 mined under regulations promulgated 

18 by the Secretary), or 

19 ‘‘(IV) has a complex medical con20 dition (as defined by the Secretary) 

21 that requires medical management 

22 and coordination of care. 

23 ‘‘(iii) The individual is at least 2 but 

24 not 6 years of age and— 


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1 ‘‘(I) is unable due to a loss of 

2 functional capacity to perform (with3 out substantial assistance from an4 other individual) at least 2 of the fol5 lowing activities: eating, transferring, 

6 or mobility, 

7 ‘‘(II) has a level of disability 

8 similar to the level of disability de9 scribed in subclause (I) (as deter10 mined under regulations promulgated 

11 by the Secretary), or 

12 ‘‘(III) has a complex medical con13 dition (as defined by the Secretary) 

14 that requires medical management 

15 and coordination of care. 

16 ‘‘(iv) The individual is under 2 years 

17 of age and— 

18 ‘‘(I) requires specific durable 

19 medical equipment by reason of a se20 vere health condition or requires a 

21 skilled practitioner trained to address 

22 the individual’s condition to be avail23 able if the individual’s parents or 

24 guardians are absent, 


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1 ‘‘(II) has a level of disability 

2 similar to the level of disability de3 scribed in subclause (I) (as deter4 mined under regulations promulgated 

5 by the Secretary), or 

6 ‘‘(III) has a complex medical con7 dition (as defined by the Secretary) 

8 that requires medical management 

9 and coordination of care. 

10 ‘‘(v) The individual has 5 or more 

11 chronic conditions (as defined in subpara12 graph (C)) and is unable to perform (with13 out substantial assistance from another in14 dividual) at least 1 activity of daily living 

15 (as so defined) due to a loss of functional 

16 capacity. 

17 ‘‘(C) CHRONIC CONDITION.—For purposes 

18 of this paragraph, the term ‘chronic condition’ 

19 means a condition that lasts for at least 6 con20 secutive months and requires ongoing medical 

21 care. 

22 ‘‘(2) ELIGIBLE CAREGIVER.— 

23 ‘‘(A) IN GENERAL.—A taxpayer shall be 

24 treated as an eligible caregiver for any taxable 

25 year with respect to the following individuals: 


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1 ‘‘(i) The taxpayer. 

2 ‘‘(ii) The taxpayer’s spouse. 

3 ‘‘(iii) An individual who is a quali4 fying child (as defined in section 152(c)) 

5 or a qualifying relative (as defined in sec6 tion 152(d)) with respect to whom the tax7 payer is allowed a deduction under section 

8 151(c) for the taxable year. 

9 ‘‘(iv) An individual who would be a 

10 qualifying relative described in clause (iii) 

11 for the taxable year if section 152(d)(1)(B) 

12 were applied by substituting for the exemp13 tion amount an amount equal to the sum 

14 of the exemption amount, the standard de15 duction under section 63(c)(2)(C), and any 

16 additional standard deduction under sec17 tion 63(c)(3) which would be applicable to 

18 the individual if clause (iii) applied. 

19 ‘‘(v) An individual who would be a 

20 qualifying relative described in clause (iii) 

21 for the taxable year if— 

22 ‘‘(I) the requirements of clause 

23 (iv) are met with respect to the indi24 vidual, and 


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1 ‘‘(II) the requirements of sub2 paragraph (B) are met with respect to 

3 the individual in lieu of the support 

4 test of section 152(d)(1)(C). 

5 ‘‘(B) RESIDENCY TEST.—The require6 ments of this subparagraph are met if an indi7 vidual has as his principal place of abode the 

8 home of the taxpayer and— 

9 ‘‘(i) in the case of an individual who 

10 is an ancestor or descendant of the tax11 payer or the taxpayer’s spouse, is a mem12 ber of the taxpayer’s household for over 

13 half the taxable year, or 

14 ‘‘(ii) in the case of any other indi15 vidual, is a member of the taxpayer’s 

16 household for the entire taxable year. 

17 ‘‘(C) SPECIAL RULES WHERE MORE THAN

18 1 ELIGIBLE CAREGIVER.— 

19 ‘‘(i) IN GENERAL.—If more than 1 in20 dividual is an eligible caregiver with re21 spect to the same applicable individual for 

22 taxable years ending with or within the 

23 same calendar year, a taxpayer shall be 

24 treated as the eligible caregiver if each 

25 such individual (other than the taxpayer) 


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1 files a written declaration (in such form 

2 and manner as the Secretary may pre3 scribe) that such individual will not claim 

4 such applicable individual for the credit 

5 under this section. 

6 ‘‘(ii) NO AGREEMENT.—If each indi7 vidual required under clause (i) to file a 

8 written declaration under clause (i) does 

9 not do so, the individual with the highest 

10 modified adjusted gross income (as defined 

11 in section 32(c)(5)) shall be treated as the 

12 eligible caregiver. 

13 ‘‘(iii) MARRIED INDIVIDUALS FILING

14 SEPARATELY.—In the case of married indi15 viduals filing separately, the determination 

16 under this subparagraph as to whether the 

17 husband or wife is the eligible caregiver 

18 shall be made under the rules of clause (ii) 

19 (whether or not one of them has filed a 

20 written declaration under clause (i)). 

21 ‘‘(d) IDENTIFICATION REQUIREMENT.—No credit 

22 shall be allowed under this section to a taxpayer with re23 spect to any applicable individual unless the taxpayer in24 cludes the name and taxpayer identification number of 

25 such individual, and the identification number of the phyVerDate Aug 31 2005 21:03 Mar 19, 2007 Jkt 059200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\S897.IS S897

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1 sician certifying such individual, on the return of tax for 

2 the taxable year. 

3 ‘‘(e) TAXABLE YEAR MUST BE FULL TAXABLE

4 YEAR.—Except in the case of a taxable year closed by rea5 son of the death of the taxpayer, no credit shall be allow6 able under this section in the case of a taxable year cov7 ering a period of less than 12 months.’’. 

8 (b) CONFORMING AMENDMENTS.— 

9 (1) Section 6213(g)(2) of the Internal Revenue 

10 Code of 1986 is amended by striking ‘‘and’’ at the 

11 end of subparagraph (L)(ii), by striking the period 

12 at the end of subparagraph (M) and inserting ‘‘, 

13 and’’, and by inserting after subparagraph (M) the 

14 following new subparagraph: 

15 ‘‘(N) an omission of a correct TIN or phy16 sician identification required under section 

17 25E(d) (relating to credit for taxpayers with 

18 long-term care needs) to be included on a re19 turn.’’. 

20 (2) The table of sections for subpart A of part 

21 IV of subchapter A of chapter 1 of such Code is 

22 amended by inserting after the item relating to sec23 tion 25D the following new item: 

‘‘Sec. 25E. Credit for taxpayers with long-term care needs.’’. 


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1 (c) EFFECTIVE DATE.—The amendments made by 

2 this section shall apply to taxable years beginning after 

3 December 31, 2006. 

4 SEC. 3. TREATMENT OF PREMIUMS ON QUALIFIED LONG5 TERM CARE INSURANCE CONTRACTS. 

6 (a) IN GENERAL.—Part VII of subchapter B of chap7 ter 1 of the Internal Revenue Code of 1986 (relating to 

8 additional itemized deductions) is amended by redesig9 nating section 224 as section 225 and by inserting after 

10 section 223 the following new section: 

11 ‘‘SEC. 224. PREMIUMS ON QUALIFIED LONG-TERM CARE IN12 SURANCE CONTRACTS. 

13 ‘‘(a) IN GENERAL.—In the case of an individual, 

14 there shall be allowed as a deduction an amount equal to 

15 the applicable percentage of the amount of eligible long16 term care premiums (as defined in section 213(d)(10)) 

17 paid during the taxable year for coverage for the taxpayer 

18 and the taxpayer’s spouse and dependents under a quali19 fied long-term care insurance contract (as defined in sec20 tion 7702B(b)). 

21 ‘‘(b) APPLICABLE PERCENTAGE.—For purposes of 

22 subsection (a)— 

23 ‘‘(1) IN GENERAL.—Except as otherwise pro24 vided in this subsection, the applicable percentage 

25 shall be determined in accordance with the following 


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1 table based on the number of years of continuous 

2 coverage (as of the close of the taxable year) of the 

3 individual under any qualified long-term care insur4 ance contracts (as defined in section 7702B(b)): 

‘‘If the number of years of The applicable 

continuous coverage is— percentage is—

Less than 1 .................................................................. 60

At least 1 but less than 2 ............................................. 70

At least 2 but less than 3 ............................................. 80

At least 3 but less than 4 ............................................. 90

At least 4 ...................................................................... 100.

5 ‘‘(2) SPECIAL RULES FOR INDIVIDUALS WHO

6 HAVE ATTAINED AGE 55.—In the case of an indi7 vidual who has attained age 55 as of the close of the 

8 taxable year, the following table shall be substituted 

9 for the table in paragraph (1): 

‘‘If the number of years of The applicable 

continuous coverage is— percentage is—

Less than 1 .................................................................. 70

At least 1 but less than 2 ............................................. 85

At least 2 ...................................................................... 100.

10 ‘‘(3) ONLY COVERAGE AFTER 2004 TAKEN INTO

11 ACCOUNT.—Only coverage for periods after Decem12 ber 31, 2006, shall be taken into account under this 

13 subsection. 

14 ‘‘(4) CONTINUOUS COVERAGE.—An individual 

15 shall not fail to be treated as having continuous cov16 erage if the aggregate breaks in coverage during any 

17 1-year period are less than 60 days. 

18 ‘‘(c) COORDINATION WITH OTHER DEDUCTIONS.— 

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1 term care insurance contract to which subsection (a) ap2 plies shall not be taken into account in computing the 

3 amount allowable to the taxpayer as a deduction under 

4 section 162(l) or 213(a).’’. 

5 (b) CONFORMING AMENDMENTS.— 

6 (1) Section 62(a) of the Internal Revenue Code 

7 of 1986 is amended by inserting after paragraph 

8 (20) the following new paragraph: 

9 ‘‘(21) PREMIUMS ON QUALIFIED LONG-TERM

10 CARE INSURANCE CONTRACTS.—The deduction al11 lowed by section 224.’’. 

12 (2) The table of sections for part VII of sub13 chapter B of chapter 1 of such Code is amended by 

14 striking the last item and inserting the following 

15 new items: 

‘‘Sec. 224. Premiums on qualified long-term care insurance contracts. 

‘‘Sec. 225. Cross reference.’’. 

16 (c) EFFECTIVE DATE.—The amendments made by 

17 this section shall apply to taxable years beginning after 

18 December 31, 2006. 

19 SEC. 4. ADDITIONAL CONSUMER PROTECTIONS FOR LONG20 TERM CARE INSURANCE. 

21 (a) ADDITIONAL PROTECTIONS APPLICABLE TO

22 LONG-TERM CARE INSURANCE.—Subparagraphs (A) and 

23 (B) of section 7702B(g)(2) of the Internal Revenue Code 


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1 of 1986 (relating to requirements of model regulation and 

2 Act) are amended to read as follows: 

3 ‘‘(A) IN GENERAL.—The requirements of 

4 this paragraph are met with respect to any con5 tract if such contract meets— 

6 ‘‘(i) MODEL REGULATION.—The fol7 lowing requirements of the model regula8 tion: 

9 ‘‘(I) Section 6A (relating to guar10 anteed renewal or noncancellability), 

11 and the requirements of section 6B of 

12 the model Act relating to such section 

13 6A. 

14 ‘‘(II) Section 6B (relating to pro15 hibitions on limitations and exclu16 sions). 

17 ‘‘(III) Section 6C (relating to ex18 tension of benefits). 

19 ‘‘(IV) Section 6D (relating to 

20 continuation or conversion of cov21 erage). 

22 ‘‘(V) Section 6E (relating to dis23 continuance and replacement of poli24 cies). 


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1 ‘‘(VI) Section 7 (relating to unin2 tentional lapse). 

3 ‘‘(VII) Section 8 (relating to dis4 closure), other than section 8F there5 of. 

6 ‘‘(VIII) Section 11 (relating to 

7 prohibitions against post-claims un8 derwriting). 

9 ‘‘(IX) Section 12 (relating to 

10 minimum standards). 

11 ‘‘(X) Section 13 (relating to re12 quirement to offer inflation protec13 tion), except that any requirement for 

14 a signature on a rejection of inflation 

15 protection shall permit the signature 

16 to be on an application or on a sepa17 rate form. 

18 ‘‘(XI) Section 25 (relating to pro19 hibition against preexisting conditions 

20 and probationary periods in replace21 ment policies or certificates). 

22 ‘‘(XII) The provisions of section 

23 26 relating to contingent nonforfeiture 

24 benefits, if the policyholder declines 


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1 the offer of a nonforfeiture provision 

2 described in paragraph (4). 

3 ‘‘(ii) MODEL ACT.—The following re4 quirements of the model Act: 

5 ‘‘(I) Section 6C (relating to pre6 existing conditions). 

7 ‘‘(II) Section 6D (relating to 

8 prior hospitalization). 

9 ‘‘(III) The provisions of section 8 

10 relating to contingent nonforfeiture 

11 benefits, if the policyholder declines 

12 the offer of a nonforfeiture provision 

13 described in paragraph (4). 

14 ‘‘(B) DEFINITIONS.—For purposes of this 

15 paragraph— 

16 ‘‘(i) MODEL PROVISIONS.—The terms 

17 ‘model regulation’ and ‘model Act’ mean 

18 the long-term care insurance model regula19 tion, and the long-term care insurance 

20 model Act, respectively, promulgated by 

21 the National Association of Insurance 

22 Commissioners (as adopted as of Sep23 tember 2000). 

24 ‘‘(ii) COORDINATION.—Any provision 

25 of the model regulation or model Act listed 


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1 under clause (i) or (ii) of subparagraph 

2 (A) shall be treated as including any other 

3 provision of such regulation or Act nec4 essary to implement the provision. 

5 ‘‘(iii) DETERMINATION.—For pur6 poses of this section and section 4980C, 

7 the determination of whether any require8 ment of a model regulation or the model 

9 Act has been met shall be made by the 

10 Secretary.’’. 

11 (b) EXCISE TAX.—Paragraph (1) of section 

12 4980C(c) of the Internal Revenue Code of 1986 (relating 

13 to requirements of model provisions) is amended to read 

14 as follows: 

15 ‘‘(1) REQUIREMENTS OF MODEL PROVISIONS.— 

16 ‘‘(A) MODEL REGULATION.—The following 

17 requirements of the model regulation must be 

18 met: 

19 ‘‘(i) Section 9 (relating to required 

20 disclosure of rating practices to consumer). 

21 ‘‘(ii) Section 14 (relating to applica22 tion forms and replacement coverage). 

23 ‘‘(iii) Section 15 (relating to reporting 

24 requirements), except that the issuer shall 

25 also report at least annually the number of 


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1 claims denied during the reporting period 

2 for each class of business (expressed as a 

3 percentage of claims denied), other than 

4 claims denied for failure to meet the wait5 ing period or because of any applicable 

6 preexisting condition. 

7 ‘‘(iv) Section 22 (relating to filing re8 quirements for marketing). 

9 ‘‘(v) Section 23 (relating to standards 

10 for marketing), including inaccurate com11 pletion of medical histories, other than 

12 paragraphs (1), (6), and (9) of section 

13 23C, except that— 

14 ‘‘(I) in addition to such require15 ments, no person shall, in selling or 

16 offering to sell a qualified long-term 

17 care insurance contract, misrepresent 

18 a material fact; and 

19 ‘‘(II) no such requirements shall 

20 include a requirement to inquire or 

21 identify whether a prospective appli22 cant or enrollee for long-term care in23 surance has accident and sickness in24 surance. 


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1 ‘‘(vi) Section 24 (relating to suit2 ability). 

3 ‘‘(vii) Section 29 (relating to standard 

4 format outline of coverage). 

5 ‘‘(viii) Section 30 (relating to require6 ment to deliver shopper’s guide). 

7 The requirements referred to in clause (vi) shall 

8 not include those portions of the personal work9 sheet described in Appendix B relating to con10 sumer protection requirements not imposed by 

11 section 4980C or 7702B. 

12 ‘‘(B) MODEL ACT.—The following require13 ments of the model Act must be met: 

14 ‘‘(i) Section 6F (relating to right to 

15 return), except that such section shall also 

16 apply to denials of applications and any re17 fund shall be made within 30 days of the 

18 return or denial. 

19 ‘‘(ii) Section 6G (relating to outline of 

20 coverage). 

21 ‘‘(iii) Section 6H (relating to require22 ments for certificates under group plans). 

23 ‘‘(iv) Section 6I (relating to policy 

24 summary). 


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1 ‘‘(v) Section 6J (relating to monthly 

2 reports on accelerated death benefits). 

3 ‘‘(vi) Section 7 (relating to incontest4 ability period). 

5 ‘‘(C) DEFINITIONS.—For purposes of this 

6 paragraph, the terms ‘model regulation’ and 

7 ‘model Act’ have the meanings given such terms 

8 by section 7702B(g)(2)(B).’’. 

9 (c) EFFECTIVE DATE.—The amendments made by 

10 this section shall apply to policies issued more than 1 year 

11 after the date of the enactment of this Act. 

Æ 


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