I 
108TH CONGRESS 
1ST SESSION 
H. R. 53
To improve health care choice by providing for the tax deductibility of medical 
expenses by individuals. 
IN THE HOUSE OF REPRESENTATIVES 
JANUARY 7, 2003
Mr. COX introduced the following bill; which was referred to the Committee 
on Ways and Means 
A BILL 
To improve health care choice by providing for the tax 
deductibility of medical expenses by individuals.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Health Care Freedom 
of Choice Act’’.
SEC. 2. FINDINGS. 
The Congress finds the following: 
(1) Current law confers a tax benefit for health 
insurance provided as an employee fringe benefit, 
but no similar tax benefit for health insurance pur-
chased by individuals. Similarly, current law confers 
a tax benefit on third-party payment of medical ex-
penses, but no similar tax benefit for an individual’s 
direct payment of medical expenses. This has effec-
tively promoted employer-provided third party pay-
ment systems and effectively discouraged direct doc-
tor-patient relationships. 
(2) The current tax treatment of medical ex-
penses has significantly curtailed competition for 
both health insurance and health care services gen-
erally. This has effectively increased the cost of 
health care and health insurance, which in turn has 
exposed people to greater health risks and made it 
more likely that individuals will go without needed 
care. 
(3) The current tax treatment of medical ex-
penses has restricted the freedom of individuals to 
exercise direct control over their health care dollars. 
The exclusion from gross income for employer-pro-
vided health care plans with no corresponding tax 
benefit for health insurance and health care obtained 
by individuals constitutes a strong preferment for 
health care provided through employers’ group plans 
as compared to health care that individuals purchase 
for themselves.
(4) Providing a tax benefit for employer-pro-
vided plans, but not for individually-purchased 
health care, discriminates against individuals who 
work for companies that do not provide health bene-
fits, individuals who are self-employed, individuals 
who are temporarily employed, and the disabled. 
(5) In many cases, employers are not able to 
offer their employees a variety of health insurance 
plans. The Tax Code’s provision of benefits for only 
for employer-provided health insurance has discrimi-
nated against individuals who work for these em-
ployers. 
(6) The Tax Code’s preferment of employer-
provided group plans has triggered a marketplace 
response reflected in the significant increases in 
large group health care delivery, and the creation of 
a few health care conglomerates in lieu of thousands 
of competitive providers of medical services. This has 
increasingly placed medical decisions in the hands of 
health care bureaucracies, and significantly eroded 
the doctor-patient relationship. Medical decisions 
should be returned to doctors and their patients. 
This will result in higher quality treatment and more 
patient protection.
(7) Consumers should have the freedom to pur-
chase the health insurance of their choice, to choose 
their own doctors, and to make their own decisions 
about their health care. 
(8) By putting the medical choices made by in-
dividuals on an equal footing with the medical 
choices made for them by their employers and third 
parties, the Tax Code can encourage greater choice 
and competition, thereby reducing the cost of nec-
essary insurance for all Americans. This will enable 
millions more Americans to obtain needed health 
coverage, to make their own choices about which 
doctors to see, and to have access to the quality care 
they deserve and expect. 
SEC. 3. TAX DEDUCTIBILITY OF MEDICAL EXPENSES FOR 
INDIVIDUALS. 
(a) IN GENERAL.—Section 213(a) of the Internal 
Revenue Code of 1986 (relating to the treatment of med-
ical and dental expenses) is amended to read as follows: 
‘‘(a) ALLOWANCE OF DEDUCTION.—There shall be 
allowed as a deduction the expenses paid during the tax-
able year, not compensated for by insurance or otherwise, 
for medical care of the taxpayer, the taxpayer’s spouse, 
or a dependent (as defined in section 152).’’.
(b) EFFECTIVE DATE.—The amendment made by 
subsection (a) shall apply to taxable years beginning after 
the calendar year which includes the date of the enactment 
of this Act.
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