Last week, my colleague, Steven Sacharow, Esquire, an outstanding and personable attorney who limits his practice to family law, adoptions, and “corporate divorces,” and I, co-presented a seminar addressing how the new federal tax laws will impact divorcing, elderly and/or disabled clients in in New Jersey and Pennsylvania. Here is a link to the Facebook Live presentation, and following are my top seven tips for saving hard earned dollars for the elderly and disabled under the new tax regime.

1. Medicare is not a Long-Term Care Plan. Some folks expect Medicare to pay the cost of any care they may need. Medicare may provide for some short-term care, for a limited period of time, subject to a co-pay after the first twenty days per spell of illness, but will not provide for any long-term care absent a three day qualifying hospital stay. Do not let your loved one be placed on “observation status” in the hospital.
2. Plan ahead for Long-Term Care. The sweeping cuts in the TCJA will increase pressure to trim federally funded social welfare programs. The House GOP budget plan proposed to trim over $5 billion dollars from the Medicare program over a ten year period, and an additional sum of more than $1.5 trillion dollars from Medicaid and other health insurance programs. Plans included proposals to change Medicare to a capped dollar benefit or a voucher system, which could be used to purchase health insurance. Block grants were proposed to shift Medicaid costs to the states (and ultimately the taxpayers). Lacking legal effect, these proposals may be harbingers of the future. Advance planning is more important than ever, and even crisis planning can help some individuals. Strategies to pay for long-term care may include long-term care insurance, planning with Medicaid compliant annuities and IRA annuities, and trusts.  For detailed strategies to save with long-term care insurance, see my handout, available here.
3. Consider an ABLE account. ABLE accounts are special, tax-favored disability savings accounts available to qualified disabled individuals with a serious disability incurred prior to age 26.  In 2018, up to the sum of $15,000 per disabled beneficiary may be contributed to an ABLE account for the disabled beneficiary. (In 2018, an additional sum of up to $12,060 may be contributed by the disabled beneficiary from his or her own funds, in limited circumstances, as is further discussed in section 5, below). The funds on deposit in an ABLE account are disregarded in determining eligibility for federal public welfare benefits, such as Medicaid, Supplemental Security Income (SSI), Supplemental Nutritional Assistance (SNAP), Section 8 housing and other programs.  (The disregard is subject to a $100,000 cap for recipients of SSI).  Funds distributed from an ABLE account may be used to pay for qualified disability expenses, which can include shelter and housing expenses, educational, transportation, assisted technology, health and other expenses incurred with respect to the qualifying individual’s disability. Beginning this year, up to $15,000 of funds on deposit in a 529 educational savings account may be rolled over annually, tax-free into an ABLE account for the beneficiary of the 529 educational account, or a sibling or step sibling of the 529 account beneficiary, provided that the ABLE account beneficiary is a qualified disabled individual. For more information, see my blog post on ABLE accounts.
4. Only one ABLE account and one $15,000 contribution per calendar year per qualified disabled beneficiary. This general rule, subject to some exceptions, can be a concern in families of divorce, due to communication issues. Accountants, attorneys and financial planners can help their clients by reminding them of the rule in their annual year end planning letter, on their websites or in their intake materials.
5. Leverage the ABLE contribution. The TCJA now allows some qualified disabled individuals to contribute up to the sum of $12,060 from their taxable income to an ABLE account, in addition to the $15,000 annual contribution, which is tied to the annual exclusionary amount of IRC 2503. The saver’s credit may also be available to some ABLE account beneficiaries.
6. Don’t forget about deductions! The TCJA left intact the credit for the elderly and disabled under IRC 22, and the ability to deduct the excess of the taxpayer’s reasonable and necessary medical expenses in excess of 7.5% of adjusted gross income. Deductible medical expenses may include health insurance premiums, some long-term care insurance premiums, some cosmetic procedures needed to ameliorate a deformity arising from a congenital birth defect or to correct a trauma or disfiguring disease. For example, breast reconstruction after a mastectomy may be deductible. Rev. Rul. 2003-57. The medical component of long-term care can sometimes be deductible, as can room and board costs, where medically necessary for dementia care. See Estate of Baral v. C.I.R., 137 T.C. 1 (July 5, 2011). The TCJA also left intact the deduction for qualified adoption expenses.
7. ROTH IRA conversions may be new “Hotel California.” Given the historically low income tax rates, taxpayers in lower income tax brackets may want to consider converting a traditional IRA or a qualified plan account to a ROTH IRA, so long as the conversion does not bump the taxpayer into a higher bracket. However, the TCJA transformed the partial ROTH conversion into the new “Hotel California.” (i.e., “You can check in any time you want, but you can never leave.”)  Taxpayers can still return an excess ROTH contribution before December 31 of the taxable year in question, but can no longer partially re-characterize a ROTH IRA conversion after the conclusion of the taxable year.