Expanding coverage via tax credits: trade-offs and outcomes

Health Aff (Millwood). 2001 Jan-Feb;20(1):9-26. doi: 10.1377/hlthaff.20.1.9.


In this paper we discuss various options for using refundable tax credits to reduce the number of uninsured persons. The effect of tax credits on the number of uninsured depends on the form of the credit scheme adopted. Moreover, since large subsidies for private insurance directed to low-income persons have never been implemented, there is considerable uncertainty about the effect of various tax credit proposals. We find that small credits will do little to reduce the number of uninsured but that credits covering about half of the premium for a benchmark policy might have a significant effect, especially if they take a fixed-dollar form and can be used for policies with few restrictions. Finally, we discuss the normative issues surrounding the "costs" of these credits schemes, and the policy issues raised by the uncertainty of the effects.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Accounting
  • Fees and Charges
  • Health Care Reform / legislation & jurisprudence
  • Health Care Reform / organization & administration*
  • Humans
  • Income Tax / legislation & jurisprudence*
  • Medically Uninsured / legislation & jurisprudence*
  • Organizational Innovation
  • Tax Exemption / legislation & jurisprudence*
  • United States
  • Universal Health Insurance / economics*
  • Universal Health Insurance / legislation & jurisprudence