8 Must-Know OBBB Tax Changes for Physicians The One Big Beautiful Bill (OBBB) Act, signed into law by President Trump on July 4th, 2025, is poised to reshape the U.S. tax landscape, bringing notable changes for individuals and businesses. While some provisions — such as changes to Medicare and Medicaid — may affect the practice side of medicine, this summary highlights the key elements of the bill from a personal financial perspective that the advisors at FDI feel every physician should keep in mind as the law takes effect.
Current Law (2025) Federal Income Tax Brackets The current top marginal rate is 37%, but the brackets were scheduled to revert to pre-Tax Cuts and Jobs Act (TCJA) levels in 2026 (top rate 39.6%). Additional Standard Deduction (Age 65+) Taxpayers over age 65 receive an additional standard deduction based on status: Individual: $2,000 Married Filing Jointly: $3,200
State and Local Tax (SALT) Deduction Cap There is currently a $10,000 annual cap on SALT deductions for itemized filers.
Signed Bill (7/4/25)
Potential Impact
OBBB makes the existing TCJA tax bracket structure (including 37% top rate) permanent.
Physicians with higher income avoid the increased 39.6% bracket.
OBBB keeps the existing deduction and adds an additional $6,000 deduction for taxpayers aged 65+ that is reduced by 6% of your AGI* over:
May not apply to higher-income households as the additional deduction amount phases out at:
Individual: $75,000 Married Filing Jointly: $150,000
Individuals: $175,000 Married Filing Jointly: $350,000
The deduction cap has raised and new phase-out limits apply, but the deduction can’t be reduced below the original $10,000 amount by phase-out.
With the SALT deduction cap increased, physicians in high-tax states who previously took the standard deduction may find it more advantageous to itemize going forward.
2025: $40,000 cap, reduced by 30% of MAGI** > $500,000 2026: $40,400 cap, reduced by 30% of MAGI** > $505,000 2027-2029: Both amounts increase by 1% annually
Expansion of 529 Account Capabilities In addition to tuition and related expenses for secondary and graduate schooling, 529 withdrawals can be used on K-12 tuition, up to $10,000 per child annually. However, 529 funds cannot be used for other K–12 expenses such as books or supplies.
Effective 7/4/2025: The OBBB expands 529 plan usage to include qualified non-tuition expenses for both K–12 and college, such as books, tutoring, online learning, or post-secondary credentialing.
This will significantly increase the flexibility and advantages of utilizing 529 accounts.
Effective in 2026: The annual limit for K-12 tuition withdrawals is increased to $20,000 per child. * AGI - Adjusted Gross Income ** MAGI - Modified Adjusted Gross Income
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