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Limited Take-Up of Health Coverage Tax Credits: A Challenge to Future Tax Credit Design

The Trade Act of 2002 created federal tax credits to subsidize health coverage for certain early retirees and workers displaced by international trade. Though small, this program offers the opportunity to learn how to design future tax credits for larger groups of uninsured. During September 2004, the most recent month for which there are data about all forms of Trade Act credits, roughly 22 percent of eligible individuals received credits. The authors find that health insurance tax credits are more likely to reach their target populations if such credits: 1) limit premium costs for the low-income uninsured and do not require full premium payments while applications are pending; 2) provide access to coverage that beneficiaries value, including care for preexisting conditions; 3) are combined with outreach that uses easily understandable, multilingual materials and proactive enrollment efforts; and 4) feature a simple application process involving one form filed with one agency.

Note: This issue brief summarizes the authors' more detailed research report, Limited Take-Up of Health Coverage Tax Credits and the Design of Future Tax Credits for the Uninsured. The longer report includes full sources, more in-depth analysis, and Appendices that explain key details of program operation.

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Limited Take-Up of Health Coverage Tax Credits: A Challenge to Future Tax Credit Design, Stan Dorn, J.D., Janet Varon, J.D., and Fouad Pervez, M.P.H., The Commonwealth Fund, October 2005