One spouse has large medical expenses, miscellaneous itemized deductions, or casualty losses.

一个配偶有很多的医疗费用，各种项目的抵扣或者伤亡损失。

youdao

Worse, miscellaneous deductions subject to the 2% floor can't be claimed at all in the alternative minimum tax.

FORBES: The Way The Tax Code Crumbles

But such losses are not subject to the same floor (2% of adjusted gross income) that limits other miscellaneous deductions.

FORBES: Busted

Under the AMT, a taxpayer must do a second calculation that doesn't allow itemized miscellaneous deductions such as lawyers' fees.

FORBES: Double taxation