A guest opinion by Stephanie Saltzgaver on an approach to dealing with Idaho's ongoing nursing shortage.
Idaho is experiencing one of the worst nursing shortages in the country, jeopardizing the health and safety of residents, especially in rural communities. One of the easiest ways to alleviate the issue is for communities to hire licensed health care workers from out of state to deliver exceptional care and serve patients. While there is a financial cost to hire and certify these workers, Congress has an incredible opportunity in the upcoming tax legislation to ease the regulatory burden and help solve Idaho's health care crisis.
Ardor Health currently has hundreds of nursing jobs that are unfilled in the western U.S., including nearly three dozen in Idaho. We have contracts in place with local health care providers such as hospitals and rehabilitation facilities to recruit workers, confirm they hold the proper certifications, find them housing, and ensure they are ready to care for patients. One tool to finance these start-up costs are business loans, which allow us to recruit and onboard the best health care workers for Idaho.
Currently interest rates are at historic highs, making borrowing expensive and challenging. Not only that, but the federal tax code also penalizes businesses like ours for taking out loans. Before 2018, interest on business loans was 100% deductible, making it easy to borrow to expand operations, hire staff, or otherwise reinvest in a company. However, recent changes to federal tax law, known in Washington as the 163(j)-interest deduction limit, caps the interest deduction to just 30%, and businesses must now use a strict calculation that does not account for the depreciation of assets.
The problem with change is simple. Rather than spending money to hire and train nurses to address Idaho's nursing shortage, companies like mine must pay the government additional tax dollars for taking out loans. It makes no sense to penalize companies for investing in their future and hiring more employees.
Meanwhile, the impacts of this tax policy are personal for Idahoans. Every dollar that we spend on taxes and interest is one less dollar that we spend on recruitment. That means communities like Pocatello, McCall, and Lewiston are waiting for health care workers when we could be hiring and training new nurses to fill open roles.
One recent estimate found that Idaho is short more than 1,800 registered nurses. Such a significant and immediate need cannot be solved through in-state nursing programs alone, as it can take years to stand up programs and recruit instructors. And while many communities have sought to alleviate the issue with foreign workers, securing the necessary immigration and visa approvals is even more burdensome. The most effective way to quickly address this crisis is through travel nurse programs.
Lowering the cost of borrowing through federal tax policy will pay dividends into the future. Many of our recruits have completed more than a dozen different assignments since we were formed in 2001. That means that new nurses we hire may go on to serve multiple Idaho communities for years to come. That is a measurable impact that will close the shortfall and ensure that more Idahoans are getting the care they need.
We can fix Idaho's health care crisis – we just need Congress to act. As Congress considers a tax bill to grow our economy and provide tax relief, I'm asking U.S. Senators Mike Crapo and Jim Risch, as well as U.S. Representatives Mike Simpson and Russ Fulcher to raise the 163(j)-interest deduction to 50% and allow businesses to apply it against the EBITDA standard. Doing so will better enable us to address the nursing shortage and help ensure that Idaho's communities get the care they need.
Stephanie Saltzgaver is the President of Ardor Health Solutions.