I 
108TH CONGRESS 
2D SESSION 
H. R. 4025
To amend the Internal Revenue Code of 1986 to allow individuals a credit 
against income tax for medical expenses for dependents. 
IN THE HOUSE OF REPRESENTATIVES 
MARCH 24, 2004
Mr. PAUL introduced the following bill; which was referred to the Committee 
on Ways and Means 
A BILL 
To amend the Internal Revenue Code of 1986 to allow indi-
viduals a credit against income tax for medical expenses 
for dependents.
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 ‘‘Child Health Care Af-
fordability Act’’. 
SEC. 2. CREDIT FOR MEDICAL EXPENSES FOR DEPEND-
ENTS. 
(a) IN GENERAL.—Subpart A of part IV of sub-
chapter A of chapter 1 of the Internal Revenue Code of 
1986 (relating to nonrefundable personal credits) is
amended by inserting after section 25B the following new 
section: 
‘‘SEC. 25C. MEDICAL EXPENSES FOR DEPENDENTS. 
‘‘(a) ALLOWANCE OF CREDIT.—In the case of an in-
dividual, there shall be allowed as a credit against the tax 
imposed by this chapter for the taxable year an amount 
equal to the expenses paid during the taxable year, not 
compensated for by insurance or otherwise, for medical 
care for any dependent of the taxpayer. 
‘‘(b) LIMITATIONS.—
‘‘(1) IN GENERAL.—Except as provided in para-
graph (2), the credit allowed by this section shall not 
exceed $500 per dependent for any taxable year. 
‘‘(2) INCREASED CREDIT FOR TERMINAL DIS-
EASES, ETC.—In the case of expenses for medical 
care of a dependent who has a terminal disease, can-
cer (whether or not in remission), a disability, or 
any other health condition requiring hospitalization 
or other forms of specialized care, the credit allowed 
by this section shall not exceed $3,000 for each such 
dependent for any taxable year. 
‘‘(c) PORTION OF CREDIT REFUNDABLE.—
‘‘(1) IN GENERAL.—The aggregate credits al-
lowed to a taxpayer under subpart C shall be in-
creased by the lesser of—
‘‘(A) the credit which would be allowed 
under this section without regard to this sub-
section and the limitation under section 26(a), 
or 
‘‘(B) the amount by which the aggregate 
amount of credits allowed by this subpart (de-
termined without regard to this subsection) 
would increase if the limitation imposed by sec-
tion 26(a) were increased by the the taxpayer’s 
social security taxes for the taxable year. 
‘‘(2) COORDINATION
WITH
NONREFUNDABLE 
CREDIT.—The amount of the credit allowed under 
this subsection shall not be treated as a credit al-
lowed under this subpart and shall reduce the 
amount of credit otherwise allowable under sub-
section (a) without regard to section 26(a). 
‘‘(d) DEFINITIONS.—For purposes of this section—
‘‘(1) MEDICAL CARE.—The term ‘medical care’ 
has the meaning given such term by section 213. 
‘‘(2) DEPENDENT.—The term ‘dependent’ has 
the meaning given such term by section 152. 
‘‘(3) DISABILITY.—The term ‘disability’ means 
a condition that requires qualified long-term care 
services (as defined in section 7702B(c)).
‘‘(4) SOCIAL SECURITY TAXES.—The term ‘so-
cial security taxes’ has the meaning given such term 
by section 24(d)(2). 
‘‘(e) EXCLUSION OF AMOUNTS ALLOWED FOR CARE 
OF CERTAIN DEPENDENTS.—Any expense allowed as a 
credit under section 21 shall not be treated as an expense 
paid for medical care under this section. 
‘‘(f) ADJUSTMENTS FOR INFLATION.—
‘‘(1) IN GENERAL.—In the case of any taxable 
year beginning in a calendar year after 2003, the 
$500 amount contained in subsection (b)(1), and the 
$3,000 amount contained in subsection (b)(2), shall 
each be increased by an amount equal to—
‘‘(A) such dollar amount, multiplied by 
‘‘(B) the cost-of-living adjustment deter-
mined under section 1(f)(3) for the calendar 
year in which the taxable year begins by sub-
stituting ‘calendar year 2002’ for ‘calendar year 
1992’ in subparagraph (B) thereof. 
‘‘(2) ROUNDING.—If any increase determined 
under paragraph (1) is not a multiple of $10, such 
increase shall be rounded to the next highest mul-
tiple of $10. 
‘‘(g) REGULATIONS.—The Secretary shall prescribe 
regulations to carry out this section, including regulations
providing for claiming the credit under this section on 
Form 1040EZ.’’. 
(b) DENIAL OF DOUBLE BENEFIT FOR MEDICAL EX-
PENSES DEDUCTION.—Subsection (e) of section 213 of 
such Code is amended by inserting ‘‘or 25C’’ after ‘‘sec-
tion 21’’. 
(c) CONFORMING AMENDMENTS.—
(1) The table of sections for such subpart A is 
amended by inserting after the item relating to sec-
tion 25B the following new item:
‘‘Sec. 25C. Medical expenses for dependents.’’.
(2) Paragraph (2) of section 1324(b) of title 
31, United States Code, is amended by striking 
‘‘section 35’’ and inserting ‘‘section 25C or 35’’. 
(d) EFFECTIVE DATE.—The amendments made by 
this section shall apply to amounts paid after the date of 
the enactment of this Act in taxable years ending after 
such date.
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