America is drowning in medical debt. It is a reality for nearly one in 12 adults, with at least $220 billion owed nationwide. This burden cuts across income, gender, geography and profession. Medical debt doesn’t care about your politics; it quietly undermines families and the broader economy. Creating targeted tax incentives — both credits and deductions — for consumers should be on the table.

Whether you cheer or groan, a Republican tax bill, approved by Congress, and signed by President Trump is likely to happen. Whatever emerges from the legislative sausage-making, the status quo is about to shift. And beauty to some is ugliness to others.

The Republicans tout market-friendly reforms, such as expanding Health Savings Accounts and updating Individual Coverage Health Reimbursement Accounts. These tools use tax incentives to nudge Americans toward smarter health care spending. These are good for middle class, mostly healthy consumers, but not for low-income Americans.

There will likely be steep Medicaid cuts and trims to Affordable Care Act subsidies. That means millions at or near the poverty line could lose coverage, driving up medical debt and forcing many into bare bones plans with high out-of-pocket costs and limited provider networks. The think tank Third Way estimates that proposed Medicaid cuts alone could push

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