BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  AB 2514
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          Date of Hearing:  May 13, 2014


                     ASSEMBLY COMMITTEE ON REVENUE AND TAXATION
                                Raul Bocanegra, Chair

                      AB 2514 (Pan) - As Amended:  April 1, 2014


          Majority vote.  Tax levy.  Fiscal committee.  
           
          SUBJECT  :  Personal Income Tax Law:  credit:  rural health care  
          professionals

           SUMMARY  :  Allows a personal income tax (PIT) credit to encourage  
          health care professionals to locate in medically underserved  
          areas of California.  Specifically,  this bill  :  

          1)Contains the following legislative findings:

             a)   In order for all geographic areas of California to have  
               the opportunity for economic development, it is vital that  
               excellent health care be available throughout the state;

             b)   Payment of student loans is an incentive used by rural  
               communities and health care institutions to attract health  
               care professionals to practice; and, 

             c)   It is the Legislature's intent to provide a tax credit  
               for the purpose of payment of student loans as an incentive  
               to encourage health care professionals to locate is  
               medically underserved areas of California.

          2)Allows a credit, for taxable years beginning on or after  
            January 1, 2014, and before January 1, 2019, to a "qualified  
            taxpayer" based on the "qualified taxpayer's" "student loans".  
             

          3)Specifies that the credit amount shall be the lesser of the  
            following:

             a)   One-third of the balance due on the "qualified  
               taxpayer's" "student loans" as of January 1 of the taxable  
               year in which the credit is allowed; or, 









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             b)   The total balance due on the "qualified taxpayer's"  
               "student loans" as of January 1 of the taxable year in  
               which the credit is allowed, minus the total amount of  
               credit allowed in previous taxable years.  

          4)Allows the credit for five consecutive taxable years.  

          5)Defines a "qualified taxpayer" as an individual who meets all  
            of the following conditions:

             a)   Is a dentist, physician, physician assistant, or  
               advanced practice nurse who is licensed or certified to  
               practice within California;

             b)   Resides and practices full-time, as defined, in a "rural  
               health care professional shortage area" and has committed  
               to residing and practicing in that area for at least three  
               years and up to five years pursuant to an agreement with  
               the State Department of Health Care Services; and, 

             c)   Is a borrower on student loans under a recognized loan  
               program used for higher education opportunities resulting  
               in a degree that enables him or her to be licensed or  
               certified as a health care professional in California.

          6)Defines a "student loan" as a student obligation note or other  
            debt evidencing a loan to any individual for higher education  
            purposes or for the purpose of consolidating or refinancing a  
            loan for higher education purposes, which is either:

             a)   A guaranteed student loan;

             b)   An educational loan; or, 

             c)   A loan eligible for consolidation or refinancing under  
               the Higher Education Act of 1965, as amended (20 U.S.C.  
               Sec. 1070 et seq.).

          7)Defines a "rural health care professional shortage area" as  
            any area of the state that:

             a)   Is not a metropolitan statistical area as described in  
               the publication "State and Metropolitan Area Data Book,"  
               2010, published by the United States Census Bureau; and, 









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             b)   Is located 30 or more miles from the nearest hospital  
               containing 30 or more licensed beds.

          8)Allows the credit only for those taxable years in which:

             a)   The qualified taxpayer is not delinquent on his or her  
               student loan payments;

             b)   The qualified taxpayer resides and practices in a rural  
               health care professional shortage area under an agreement  
               with the State Department of Health Care Services; and,

             c)   The qualified taxpayer's student loan has an outstanding  
               balance for at least a part of the taxable year.

          9)Specifies that if the qualified taxpayer does not reside and  
            practice within a rural health care professional shortage area  
            during the period in which he or she was committed to reside  
            and practice in that area or pays his or her student loan in  
            full by means of any other loan repayment program, any  
            remaining unapplied credit shall be cancelled and any  
            previously applied credit for the taxable year in which the  
            move occurred, in which the practice ended, or in which the  
            loan was paid in full shall be recaptured, and the qualified  
            taxpayer shall be liable for any increase in tax attributable  
            to the recapture.  

          10)Requires the State Department of Health Care Services and the  
            Franchise Tax Board (FTB) to promulgate rules and regulations  
            as necessary to implement this credit.  

          11)Sunsets the credit provisions on December 1, 2019. 

          12)Takes immediate effect as a tax levy.    

           EXISTING LAW  :

          1)Allows various tax credits under the PIT Law. These credits  
            are generally designed to encourage socially beneficial  
            behavior or to provide relief to taxpayers who incur specified  
            expenses.

          2)Allows individuals to deduct the interest paid on qualified  
            student loans, as specified.   









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           FISCAL EFFECT  :   The FTB estimates that this bill would reduce  
          General Fund revenues by $5 million in fiscal year (FY) 2014-15,  
          by $3.5 million in FY 2015-16, and by $3.8 million in FY  
          2016-17.  

           COMMENTS  :   

          1)The author has provided the following statement in support of  
            this bill:

               The federal government has recognized a large number of  
               California communities as Health Professional Shortage  
               Areas (HPSA).  These [HPSAs] have a deficiency of health  
               care professionals (medical in particular) able to serve  
               residents of their communities.  In order for all regions  
               of California to have an opportunity for economic progress,  
               it is vital that comprehensive physician-led health care  
               services be made available.  

               AB 2514 would allow a tax credit to health care  
               professionals who practice in a health care professional  
               shortage area in a specified amount of the qualified  
               taxpayer's student loans.  The legislation seeks to create  
               a tax credit for the purpose of repayment of student loans  
               as a financial incentive to encourage health care  
               professionals to practice in medically under-served regions  
               of the State.

          2)Proponents of this bill note the following:

               With the expansion of health care coverage under the  
               Affordable Care Act and California's existing physician  
               shortage, we must allocate the appropriate resources to  
               ensure that all Californians have access to world-class  
               health care.  AB 2514 is an important step toward  
               increasing access to care for underserved communities.  

               AB 2514 would improve access to health care for patients in  
               underserved communities by providing tax credits for the  
               purpose of student loan repayment for health care  
               professionals who practice within medically underserved  
               regions of California.  This program will help meet the  
               serious need for physicians to serve the growing number of  
               newly insured and Medi-Cal patients.  









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          3)Opponents of this bill note the following:

               CTRA supports the aim of reducing student loans in exchange  
               for duty practicing medicine in rural areas, but we are  
               concerned that this bill provides a potentially very large  
               tax credit for many medical professionals who will earn  
               substantial [amounts] of money over their lifetime and take  
               out large loans for medical school accordingly, in exchange  
               for relatively short duty in rural areas.  

               Instead, CTRA suggests amending the bill to provide for  
               some substantial limitations on the amount of debt that may  
               be eliminated, commensurate with the differential of income  
               from working in a rural area.  CTRA also believes there  
               would be a more direct way of eliminating some student  
               debt, since some of this activity will take place in any  
               case at [a] cost to the state.  

          4)The FTB notes the following implementation concerns in its  
            staff analysis of this bill:

             a)   Because this bill fails to specify otherwise, the FTB  
               would be subject to the rulemaking procedures required  
               under the Administrative Procedures Act.  Because this bill  
               is specifically operative for taxable years beginning on or  
               after January 1, 2014, following these rulemaking  
               procedures may delay the bill's immediate implementation.

             b)   This bill requires that, in order to claim the credit, a  
               qualified taxpayer must not be delinquent on his or her  
               student loan payments.  It is unclear to FTB staff how the  
               FTB would know whether a taxpayer is delinquent or not.   
               Thus, the FTB recommends appropriate amendments to "clarify  
               that documentation be provided to the FTB when the  
               qualified taxpayer claims the credit."  

             c)   This bill fails to specify the details that must be  
               included in the agreement to practice and reside in a rural  
               health care shortage area or when and how often the  
               agreement must be updated.  Thus, the FTB recommends  
               amending this bill to provide additional clarity on these  
               issues.  

             d)   This bill's recapture provisions are inconsistent with  
               those contained in the PIT Law.  As such, the FTB has  








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               suggested appropriate amendments for internal consistency.   


          5)Committee Staff Comments

              a)   What is a "tax expenditure"  ?  Existing law provides  
               various credits, deductions, exclusions, and exemptions for  
               particular taxpayer groups.  In the late 1960s, U.S.  
               Treasury officials began arguing that these features of the  
               tax law should be referred to as "expenditures," since they  
               are generally enacted to accomplish some governmental  
               purpose and there is a determinable cost associated with  
               each (in the form of foregone revenues).  This bill, in  
               turn, would enact a new tax expenditure program in the form  
               of a PIT credit designed to encourage health care  
               professionals to locate in medically underserved areas of  
               California.  

              b)   How is a tax expenditure different from a direct  
               expenditure  ?  As the Department of Finance notes in its  
               annual Tax Expenditure Report, there are several key  
               differences between tax expenditures and direct  
               expenditures.  First, tax expenditures are reviewed less  
               frequently than direct expenditures once they are put in  
               place.  This can offer taxpayers greater economic  
               certainty, but it can also result in tax expenditures  
               remaining a part of the tax code without demonstrating any  
               public benefit.  Second, there is generally no control over  
               the amount of revenue losses associated with any given tax  
               expenditure.  Finally, it should also be noted that, once  
               enacted, it takes a two-thirds vote to rescind an existing  
               tax expenditure absent a sunset date.  This effectively  
               results in a "one-way ratchet" whereby tax expenditures can  
               be conferred by majority vote, but cannot be rescinded,  
               irrespective of their efficacy, without a supermajority  
               vote. 

              c)   Implementation and policy concerns  :  A number of  
               implementation and policy concerns have been identified  
               with this bill's current language.  Committee staff is  
               available to work with the author's office on these and any  
               other concerns that may be identified.  These include: 

                i)     Double dipping  ?  Because some taxpayers can  
                 currently deduct student loan interest, this bill would  








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                 allow certain taxpayers to claim multiple tax benefits  
                 for the same item of expense.  The Committee may wish to  
                 consider appropriate amendments requiring that the credit  
                 be taken in lieu of any available deduction.

                ii)    When do we get started  ?  This bill requires a  
                 qualified taxpayer to reside and practice full-time in a  
                 rural health care professional shortage area.   
                 "Full-time," in turn, is defined as at least 20 hours per  
                 week on average for 180 days in the first taxable year in  
                 which a credit is allowed.  If this bill were enacted in  
                 late September or early October of this year, there would  
                 not be 180 working days left in the 2014 calendar year.   
                 Thus, this credit would only apply, if at all, to those  
                 health care professionals already living and working in a  
                 shortage area.  Tax credits are typically enacted,  
                 however, to incentivize rather than to reward behavior.   
                 Thus, the Committee may wish to consider amending this  
                 bill to apply to taxable years beginning on or after  
                 January 1, 2015.

                iii)   What loans are covered  ?  Currently, this bill  
                 requires a qualified taxpayer to have student loans used  
                 for "higher education opportunities" resulting in a  
                 degree enabling him or her to practice as a health care  
                 professional in this state.  Thus, it is unclear to  
                 Committee staff whether this bill would apply to loans  
                 incurred solely for professional (e.g., medical)  
                 education, or whether it would also apply to  
                 undergraduate loans that arguably also "resulted" in a  
                 degree enabling health care practice.  Thus, the  
                 Committee may wish to consider appropriate amendments  
                 clarifying the scope of the student loans covered by the  
                 credit.  

                iv)    Establishing the right incentive  :  This bill's goal  
                 of attracting health care professionals to medically  
                 underserved areas is highly laudable.  This bill seeks to  
                 accomplish this goal by providing a generous credit to  
                 those health care professionals who commit to work and  
                 reside in such areas.  By basing the credit on the  
                 taxpayer's outstanding student loan balance, however,  
                 this bill might inadvertently discourage the accelerated  
                 payment of student loans.  For example, if a doctor had  
                 outstanding student loans of $100,000 on January 1, 2015,  








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                 the doctor would be eligible for a credit of $33,333 for  
                 that year.  However, there would be little incentive to  
                 apply this anticipated tax savings to the outstanding  
                 loan amount.  By doing so, the doctor would be decreasing  
                 his or her loan balance by a significant amount, creating  
                 a smaller balance upon which to calculate the credit in  
                 future years.  Thus, the Committee may wish to consider  
                 some alternative incentive structure.         


           REGISTERED SUPPORT / OPPOSITION  :   

           Support 
           
          Union of American Physicians and Dentists (co-sponsor)  
          American Federation of State, County and Municipal Employees,  
          AFL-CIO
          Association of California Healthcare Districts
          California Arthritis Foundation Council
          California Chapter of the American College of Emergency  
          Physicians
          California Rheumatology Alliance 
          Rural County Representatives of California
          11 individuals

           Opposition 
           
          California Tax Reform Association
           
          Analysis Prepared by  :  M. David Ruff / REV. & TAX. / (916)  
          319-2098