Take-up of the 2021 child tax credit expansion among disadvantaged households in California: Continuing barriers to health equity

Abstract

Background: In 2021 Congress expanded the Child Tax Credit (CTC), one of the largest US economic supports for working families with proven benefits for health. Information on CTC take-up among eligible families is lacking. Understanding barriers to anti-poverty programs is an urgent policy issue, as low take-up is an established barrier to health equity.

Methods: Among a longitudinal cohort of primarily Latino and Black California families with low income (N = 380), we used data from individuals' 2019 and 2021 tax returns to compare CTC take-up (i.e., receipt among eligible individuals) pre- and post-program expansion. We also compared CTC take-up with take-up of the Earned Income Tax Credit (EITC), a similar US anti-poverty tax policy. We also compared take-up rates by income, age, language, and education.

Results: CTC take-up was higher in 2021 (79 %) compared with 2019 (44 %). EITC take-up was relatively unchanged. CTC and EITC take-up was lower among marginalized groups across both periods.

Conclusion: CTC take-up increased in 2021 among this sample of low-income households, yet disparities persisted. Optimizing potential benefits of-and removing barriers to-the CTC and EITC could further reduce poverty and improve health equity. This study provides policymakers with timely evidence to inform program design to address persistent health and social inequities.

Keywords: Child tax credit (CTC); Earned Income Tax Credit (EITC); Health policy, Health equity, Health disparities, Social determinants of health.