To amend the Internal Revenue Code of 1986 to allow individuals a deduction for qualified long-term care insurance premiums, a credit for individuals who care for those with long-term care needs, and for other purposes.

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Comprehensive Long-Term Care Support 
Act of 2004''.

SEC. 2. FINDINGS.

    The Congress hereby finds:
            (1) As our Nation's seniors live longer lives, the United 
        States faces a major challenge in long-term health care needs.
            (2) The United States does not have a comprehensive system 
        to support long-term care needs.
            (3) Since the late 1980s the proportion of households in 
        the United States involved in unpaid caregiving activities 
        jumped to over 25 percent.
            (4) Eighty-three percent of people over age 85 have a 
        functional limitation or chronic health care condition 
        requiring care.
            (5) Medicare spending on home health care has decreased 
        significantly during the last 10 years and long-term care is 
        expected to place a huge burden on State Medicaid programs, 
        which are the primary source of funding for nursing homes.

SEC. 3. DEDUCTION FOR QUALIFIED LONG-TERM CARE INSURANCE PREMIUMS.

    (a) In General.--Part VII of subchapter B of chapter 1 of the 
Internal Revenue Code of 1986 (relating to additional itemized 
deductions) is amended by redesignating section 224 as section 225 and 
by inserting after section 223 the following new section:

``SEC. 224. PREMIUMS ON QUALIFIED LONG-TERM CARE INSURANCE CONTRACTS.

    ``(a) In General.--In the case of an individual, there shall be 
allowed as a deduction an amount equal to the applicable percentage of 
the amount of eligible long-term care premiums (as defined in section 
213(d)(10)) paid during the taxable year for coverage for the taxpayer 
or any member of the family of the taxpayer under a qualified long-term 
care insurance contract (as defined in section 7702B(b)).
    ``(b) Applicable Percentage.--For purposes of subsection (a), the 
applicable percentage shall be determined in accordance with the 
following table:

``For taxable years beginning in    The applicable percentage is--
        calendar year--
        2005......................................                  50 
        2006......................................                  75 
        2007 or thereafter........................                 100.
    ``(c) Member of the Family.--For purposes of this section, the term 
`member of the family' means, with respect to any individual--
            ``(1) the spouse of the individual,
            ``(2) an ancestor or lineal descendant of the individual or 
        the individual's spouse,
            ``(3) a brother or sister of the individual or any 
        individual described in paragraph (1) or (2), and
            ``(4) the spouse of any individual described in paragraph 
        (2) or (3).
    ``(d) Coordination With Other Deductions.--Any amount paid by a 
taxpayer for any qualified long-term care insurance contract to which 
subsection (a) applies shall not be taken into account in computing the 
amount allowable to the taxpayer as a deduction under section 162(l) or 
213(a).''.
    (b) Long-Term Care Insurance Permitted To Be Offered Under 
Cafeteria Plans and Flexible Spending Arrangements.--
            (1) Cafeteria plans.--Section 125(f) of the Internal 
        Revenue Code of 1986 (defining qualified benefits) is amended 
        by inserting before the period at the end ``; except that such 
        term shall include the payment of premiums for any qualified 
        long-term care insurance contract (as defined in section 7702B) 
        to the extent the amount of such payment does not exceed the 
        eligible long-term care premiums (as defined in section 
        213(d)(10)) for such contract''.
            (2) Flexible spending arrangements.--Section 106 of such 
        Code (relating to contributions by an employer to accident and 
        health plans) is amended by striking subsection (c).
    (c) Conforming Amendments.--
            (1) Section 62(a) of the Internal Revenue Code of 1986 is 
        amended by inserting after paragraph (19) the following new 
        item:
            ``(20) Premiums on qualified long-term care insurance 
        contracts.--The deduction allowed by section 224.''.
            (2) The table of sections for part VII of subchapter B of 
        chapter 1 of such Code is amended by striking the last item and 
        inserting the following new items:

                              ``Sec. 224. Premiums on qualified long-
                                        term care insurance contracts.
                              ``Sec. 225. Cross reference.''.
    (d) Effective Dates.--
            (1) In general.--Except as provided in paragraph (2), the 
        amendments made by this section shall apply to taxable years 
        beginning after December 31, 2004.
            (2) Cafeteria plans and flexible spending arrangements.--
        The amendments made by subsection (b) shall apply to taxable 
        years beginning after December 31, 2006.

SEC. 4. CREDIT FOR TAXPAYERS WITH LONG-TERM CARE NEEDS.

    (a) In General.--Subpart A of part IV of subchapter 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. CREDIT FOR TAXPAYERS WITH LONG-TERM CARE NEEDS.

    ``(a) Allowance of Credit.--
            ``(1) In general.--There shall be allowed as a credit 
        against the tax imposed by this chapter for the taxable year an 
        amount equal to the applicable credit amount multiplied by the 
        number of applicable individuals with respect to whom the 
        taxpayer is an eligible caregiver for the taxable year.
            ``(2) Applicable credit amount.--For purposes of paragraph 
        (1), the applicable credit amount shall be determined in 
        accordance with the following table:

``For taxable years beginning in    The applicable credit amount is--
        calendar year--
    2005..........................................              $1,000 
    2006..........................................               1,500 
    2007..........................................               2,000 
    2008..........................................               2,500 
    2009 or thereafter............................               3,000.
    ``(b) Limitation Based on Adjusted Gross Income.--
            ``(1) In general.--The amount of the credit allowable under 
        subsection (a) shall be reduced (but not below zero) by $100 
        for each $1,000 (or fraction thereof) by which the taxpayer's 
        modified adjusted gross income exceeds the threshold amount. 
        For purposes of the preceding sentence, the term `modified 
        adjusted gross income' means adjusted gross income increased by 
        any amount excluded from gross income under section 911, 931, 
        or 933.
            ``(2) Threshold amount.--For purposes of paragraph (1), the 
        term `threshold amount' means--
                    ``(A) $150,000 in the case of a joint return, and
                    ``(B) $75,000 in any other case.
            ``(3) Indexing.--In the case of any taxable year beginning 
        in a calendar year after 2005, each dollar amount contained in 
        paragraph (2) shall be increased by an amount equal to the 
        product of--
                    ``(A) such dollar amount, and
                    ``(B) the medical care cost adjustment determined 
                under section 213(d)(10)(B)(ii) for the calendar year 
                in which the taxable year begins, determined by 
                substituting `August 2004' for `August 1996' in 
                subclause (II) thereof.
        If any increase determined under the preceding sentence is not 
        a multiple of $50, such increase shall be rounded to the next 
        lowest multiple of $50.
    ``(c) Definitions.--For purposes of this section--
            ``(1) Applicable individual.--
                    ``(A) In general.--The term `applicable individual' 
                means, with respect to any taxable year, any individual 
                who has been certified, before the due date for filing 
                the return of tax for the taxable year (without 
                extensions), by a physician (as defined in section 
                1861(r)(1) of the Social Security Act) as being an 
                individual with long-term care needs described in 
                subparagraph (B) for a period--
                            ``(i) which is at least 180 consecutive 
                        days, and
                            ``(ii) a portion of which occurs within the 
                        taxable year.
                Such term shall not include any individual otherwise 
                meeting the requirements of the preceding sentence 
                unless within the 39\1/2\ month period ending on such 
                due date (or such other period as the Secretary 
                prescribes) a physician (as so defined) has certified 
                that such individual meets such requirements.
                    ``(B) Individuals with long-term care needs.--An 
                individual is described in this subparagraph if the 
                individual meets any of the following requirements:
                            ``(i) The individual is at least 6 years of 
                        age and--
                                    ``(I) is unable to perform (without 
                                substantial assistance from another 
                                individual) at least 3 activities of 
                                daily living (as defined in section 
                                7702B(c)(2)(B)) due to a loss of 
                                functional capacity, or
                                    ``(II) requires substantial 
                                supervision to protect such individual 
                                from threats to health and safety due 
                                to severe cognitive impairment and is 
                                unable to preform, without reminding or 
                                cuing assistance, at least 1 activity 
                                of daily living (as so defined) or to 
                                the extent provided in regulations 
                                prescribed by the Secretary (in 
                                consultation with the Secretary of 
                                Health and Human Services), is unable 
                                to engage in age appropriate 
                                activities.
                            ``(ii) The individual is at least 2 but not 
                        6 years of age and is unable due to a loss of 
                        functional capacity to perform (without 
                        substantial assistance from another individual) 
                        at least 2 of the following activities: eating, 
                        transferring, or mobility.
                            ``(iii) The individual is under 2 years of 
                        age and requires specific durable medical 
                        equipment by reason of a severe health 
                        condition or requires a skilled practitioner 
                        trained to address the individual's condition 
                        to be available if the individual's parents or 
                        guardians are absent.
            ``(2) Eligible caregiver.--
                    ``(A) In general.--A taxpayer shall be treated as 
                an eligible caregiver for any taxable year with respect 
                to the following individuals:
                            ``(i) The taxpayer.
                            ``(ii) The taxpayer's spouse.
                            ``(iii) An individual with respect to whom 
                        the taxpayer is allowed a deduction under 
                        section 151 for the taxable year.
                            ``(iv) An individual who would be described 
                        in clause (iii) for the taxable year if section 
                        151(c)(1)(A) were applied by substituting for 
                        the exemption amount an amount equal to the sum 
                        of the exemption amount, the standard deduction 
                        under section 63(c)(2)(C), and any additional 
                        standard deduction under section 63(c)(3) which 
                        would be applicable to the individual if clause 
                        (iii) applied.
                            ``(v) An individual who would be described 
                        in clause (iii) for the taxable year if--
                                    ``(I) the requirements of clause 
                                (iv) are met with respect to the 
                                individual, and
                                    ``(II) the requirements of 
                                subparagraph (B) are met with respect 
                                to the individual in lieu of the 
                                support test of section 152(a).
                    ``(B) Residency test.--The requirements of this 
                subparagraph are met if an individual has as his 
                principal place of abode the home of the taxpayer and--
                            ``(i) in the case of an individual who is 
                        an ancestor or descendant of the taxpayer or 
                        the taxpayer's spouse, is a member of the 
                        taxpayer's household for over half the taxable 
                        year, or
                            ``(ii) in the case of any other individual, 
                        is a member of the taxpayer's household for the 
                        entire taxable year.
                    ``(C) Special rules where more than 1 eligible 
                caregiver.--
                            ``(i) In general.--If more than 1 
                        individual is an eligible caregiver with 
                        respect to the same applicable individual for 
                        taxable years ending with or within the same 
                        calendar year, a taxpayer shall be treated as 
                        the eligible caregiver if each such individual 
                        (other than the taxpayer) files a written 
                        declaration (in such form and manner as the 
                        Secretary may prescribe) that such individual 
                        will not claim such applicable individual for 
                        the credit under this section.
                            ``(ii) No agreement.--If each individual 
                        required under clause (i) to file a written 
                        declaration under clause (i) does not do so, 
                        the individual with the highest modified 
                        adjusted gross income (as defined in section 
                        32(c)(5)) shall be treated as the eligible 
                        caregiver.
                            ``(iii) Married individuals filing 
                        separately.--In the case of married individuals 
                        filing separately, the determination under this 
                        subparagraph as to whether the husband or wife 
                        is the eligible caregiver shall be made under 
                        the rules of clause (ii) (whether or not one of 
                        them has filed a written declaration under 
                        clause (i)).
    ``(d) Identification Requirement.--No credit shall be allowed under 
this section to a taxpayer with respect to any applicable individual 
unless the taxpayer includes the name and taxpayer identification 
number of such individual, and the identification number of the 
physician certifying such individual, on the return of tax for the 
taxable year.
    ``(e) Taxable Year Must Be Full Taxable Year.--Except in the case 
of a taxable year closed by reason of the death of the taxpayer, no 
credit shall be allowable under this section in the case of a taxable 
year covering a period of less than 12 months.''.
    (b) Conforming Amendments.--
            (1) Section 6213(g)(2) of the Internal Revenue Code of 1986 
        is amended by striking ``and'' at the end of subparagraph (K), 
        by striking the period at the end of subparagraph (M) and 
        inserting ``, and'', and by inserting after subparagraph (M) 
        the following new subparagraph:
                    ``(N) an omission of a correct TIN or physician 
                identification required under section 25C(d) (relating 
                to credit for taxpayers with long-term care needs) to 
                be included on a return.''.
            (2) The table of sections for subpart A of part IV of 
        subchapter A of chapter 1 of such Code is amended by inserting 
        after the item relating to section 25B the following new item:

                              ``Sec. 25C. Credit for taxpayers with 
                                        long-term care needs.''.
    (c) Effective Date.--The amendments made by this section shall 
apply to taxable years beginning after December 31, 2004.

SEC. 5. INCREASED FUNDING FOR NATIONAL FAMILY CAREGIVER SUPPORT 
              PROGRAM.

    (a) In General.--Section 303(e)(1) of the Older Americans Act of 
1965 (42 U.S.C. 3023(e)(1)) is amended by striking ``$125,000,000 for 
fiscal year 2001'' and inserting ``$250,000,000 for fiscal year 2005''.
    (b) Native Americans.--Section 643(2) of the Older Americans Act of 
1965 (42 U.S.C. 3057n(2)) is amended by striking ``$5,000,000 for 
fiscal year 2001'' and inserting ``$10,000,000 for fiscal year 2005''.

Summary: Comprehensive Long-Term Care Support Act of 2004 - Amends the Internal Revenue Code to allow a deduction from gross income (available for taxpayers who do not itemize deductions) for the cost of long-term care premiums for the taxpayer and certain family members, including the taxpayer's spouse, ancestors, or lineal descendants. Phases in the deduction by allowing the deduction of 50 percent of the cost of premiums in 2005, 75 percent in 2006, and 100 percent in 2007 or thereafter. Allows long-term care insurance as a benefit under tax-qualified cafeteria plans and flexible spending arrangements.

Allows a tax credit for caregivers of individuals with long-term health care needs. Phases in a $3,000 credit amount for 2009 or thereafter, beginning with $1,000 in 2005, $1,500 in 2006, $2,000 in 2007, and $2,500 in 2008. Reduces the amount of the credit for taxpayers with adjusted gross incomes over $75,000 ($150,000 for joint returns), adjusted for inflation after 2005.

Increases funding for the the National Family Caregiver Support Program and the Native American Caregiver Support Program.