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Proposed tax credits aim to entice doctors to rural communities

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The Missouri House of Representatives Committee on Rural Community Development heard a bill late last week that would incentivize doctors to open practices in underserved rural areas by offering tax credits.

“Any of you who are from rural areas of Missouri know that we just don’t have very many doctors,” said Rep. Herman Morse, R-Dexter, the bill’s sponsor.

While 34% of the state’s population lives in rural areas, only 21% of available health care providers serve rural residents, according to a 2020 report from the Missouri Department of Health and Senior Services Office of Rural Health and Primary Care.

If House Bill 2133 passes, primary care physicians that practice and reside in counties with fewer than 35,000 residents would be eligible for a $15,000 tax credit starting in 2023.

Committee members expressed support for the spirit of the bill but highlighted potential loopholes and pitfalls in the bill as written.

“I don’t want to keep a doctor from being able to work in multiple areas, because sometimes maybe in a very rural area there’s not enough business there to maintain a practice,” said Rep. Barry Hovis, R-Whitewater.

Rep. Greg Sharpe, R-Ewing, raised concerns that the bill’s current wording presents a lot of gray area for providers along the edges of the state.

“You’re going to have a lot of out-of-state providers looking at this,” Sharpe said. “I mean, it’s not a huge amount of money, but it may be something to look at.”

Advocates from the Missouri Association of Osteopathic Physicians and Surgeons, the Missouri Academy of Family Physicians and the Missouri State Medical Association testified in support of the bill.

Shantel Dooling of the Missouri State Medical Association pointed out that the tax credit program outlined in the bill would expire in six years.

“If we’re seeing it’s not pulling more physicians or health care workers to rural areas, there is a sunset to where this would not just be an ongoing thing and have to come back to legislation to stop,” Dooling said.

There were no witnesses who testified in opposition to the bill.

A companion bill, HB 1630, already has passed the committee. That bill would create a grant program for physicians who commit to serving a rural community for five years. The grants would be awarded through the Department of Health and Senior Services.


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As the parent of a U. of Missouri-trained M.D., I'm thinking the incentive perhaps should be greater. Students graduating medical school not only have huge debt, but they have, in many case, foregone years of earnings. In the case of our son, his postgraduate medical education included a one-year Master's degree, one year of research, four years of medical school, four years of residency, and four years of fellowship. Through all those years of training, his debt, like that of all medical students, grew steadily,

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