Leaders at the American Society of Nephrology have expressed concerns that the Tax Cuts and Jobs Bill Act, passed by the House of Representatives on Nov. 16 and the Senate on Dec. 2, has provisions that could hurt patient care and impact the pipeline of future scientists.

In a Nov. 22 letter to select members of Congress, Eleanor Lederer, president of the ASN, said several elements of the tax legislation would negatively impact millions of patients, particularly the elimination of the individual insurance mandate.

“Millions of Americans could lose access to health care services as a result of repealing the individual mandate, including those who rely on lifesaving access to dialysis or medications to keep their transplanted kidney healthy,” she wrote in the letter. “Any provisions that are likely to compromise access to care by destabilizing the healthcare market should be eliminated.”

The tax legislation would also have a “decimating” impact on developing future scientists, Lederer wrote. The plan would increase taxable income for medical students by requiring them to report tuition-fee waivers, moving the students into a higher tax bracket.

The tax legislation passed by the Senate does not contain the student provisions, ASN reported.

“The already strained kidney science and care workforce, particularly PhD scientists, would be decimated by eliminating the deduction for graduate education and by PAYGO (pay-as-you-go) cuts to the student aid administration program, jeopardizing any hope of future discoveries to cure kidney diseases,” Lederer wrote. “Every effort should be taken to encourage, not discourage, the next generation of scientists from pursuing their studies.”

Pay-as-you-go is a federal budget rule that requires tax cuts as well as increases in entitlement and other mandatory spending be covered by tax increases or cuts in mandatory spending.