Senator Bob Corker

The House passed a sweeping tax reform bill Dec. 20 that the Senate had tweaked and approved hours earlier in the middle of the night.

The conversion of a few Senate holdouts in the days previous erased suspense and put the tax overhaul over the top. The Senate ultimately passed the bill 51-48, entirely along party lines.

Vital conversions were Sens. Bob Corker (R-TN) and Marco Rubio (R-FL), who were won over in the week ahead of the historic vote.

The reconciled bill, which President Trump was expect to sign as of press time, included provisions for medical expense deductions and private acuity bonds, both of which were added during reconciliation talks. The ability to deduct medical expenses is vital for skilled nursing and assisted living residents, as well as families who pay out of pocket for long-term care services, long-term care association leaders agreed.

Nearly nine million people used the medical expense deduction to save $86.9 billion in 2015, according to estimates from AARP. Private activity bonds are an important source of financing for many providers looking to expand or enhance services. Their initial omission caused providers and senior care advocates to protest loudly for reconsideration.