Here's a number that should bother you: $773,000. That's what a surgeon in New York can owe in state estate tax on an $8 million estate, even while sitting $7 million under the new federal exemption.

In this episode, Jared unpacks what the "permanent exemption" headline leaves out. The One Big Beautiful Bill Act set the federal estate and gift tax exemption at $15 million per person with no scheduled sunset, real and welcome news for most surgeons. But federal exemption and total exposure aren't the same thing. Jared walks through New York's estate tax cliff, where crossing the state exemption by more than 5% doesn't just reduce the exemption, it erases it, and the state taxes the entire estate from dollar one. He maps the twelve states plus Washington, D.C. that still run their own estate tax, and explains why a surgeon who owns a second property in one of them can have exposure they've never considered.

Then he covers the trap some surgeons already walked into: irrevocable trusts built to dodge the old exemption sunset that may now be costing more in lost step-up basis than the estate tax they were built to avoid.