Aim Your Enthusiasm: Targeting Increased Middle Class Health Insurance Tax Credits

2021 ◽  
Author(s):  
Mark Pauly
Keyword(s):  
Health Insurance ◽  
Middle Class ◽  
Tax Credits ◽  
Insurance Tax

scholarly journals Public Subsidies for Employees' Contributions to Employer-Sponsored Insurance

2001 ◽  
Vol 38 (2) ◽  
pp. 121-132 ◽  
Author(s):  
Mark Merlis
Keyword(s):  
Health Insurance ◽  
Low Income ◽  
Cost Effective ◽  
Tax Credits ◽  
Public Subsidies ◽  
Low Income Families ◽  
Employee Premium Contributions ◽  
Premium Contributions ◽  
Insurance Tax ◽  
Fair Balance

Proposals to provide or subsidize health insurance for low-income families must take account of the fact that many workers have access to employer-sponsored insurance (ESI), but decline it because of required employee premium contributions. This article considers a tax credit for the employee share of ESI in the context of a broader program of income-based health insurance tax credits. Helping uninsured workers pay for available ESI could be more cost-effective than subsidizing their coverage in the nongroup market. The credit would also be available to workers who were already covered, both for equity reasons and to reduce the incentives for employers to drop coverage or for workers to shift to subsidized individual plans. One key issue is how to prevent employers from reducing their current health plan contributions to take advantage of the new funding. Other design questions considered by the article include whether workers should be able to choose between ESI and nongroup coverage, whether minimum benefit standards should apply for employer plans, and how to achieve a fair balance in subsidies for group and nongroup coverage.

Markets for Individual Health Insurance: Can We Make Them Work with Incentives to Purchase Insurance?

2001 ◽  
Vol 38 (2) ◽  
pp. 133-145 ◽  
Author(s):  
Katherine Swartz
Keyword(s):  
Health Insurance ◽  
High Risk ◽  
Low Income ◽  
Low Risk ◽  
Tax Credits ◽  
Careful Examination ◽  
Insurance Markets ◽  
Individual Health ◽  
The Individual ◽  
Insurance Tax

Simple income-based incentives to purchase health insurance (tax credits or deductions, or subsidies) are unlikely to succeed in significantly reducing the number of uninsured because income is not a good predictor of the extent to which individuals use medical service. Proposals to provide incentives to low-income people so they will purchase individual health insurance need to address the inherent tension between the interests of low-risk and high-risk people who rely on individual coverage. If carriers are forced to cover all applicants and to community rate premiums, low-risk people will drop coverage or not apply for it because premiums will exceed their expected need for insurance. Concern for people who currently have access to individual coverage calls for careful examination of options to permit incentive programs to succeed with the individual insurance markets. In particular, attention should focus on using alternatives to simple income-based subsidies to spread the burden of high-risk people's costs broadly, rather than impose the costs on low-risk people who purchase individual coverage. This paper describes three such alternatives. One uses risk adjustments and two rely on reinsurance so that carriers are compensated for the higher costs of covering high-risk people who use incentives to buy insurance. One alternative also permits risk selection by insurance carriers.

Keeping Health Insurance Tax Credits on the Table

JAMA ◽  
2004 ◽  
Vol 291 (18) ◽  
pp. 2255 ◽  
Author(s):  
Mark V. Pauly
Keyword(s):  
Health Insurance ◽  
Tax Credits ◽  
Insurance Tax

Private Purchasing Pools to Harness Individual Tax Credits for Consumers

2001 ◽  
Vol 38 (2) ◽  
pp. 159-176 ◽  
Author(s):  
Richard E. Curtis ◽  
Edward Neuschler ◽  
Rafe Forland
Keyword(s):  
Health Insurance ◽  
Significant Contribution ◽  
Tax Credits ◽  
Health Plans ◽  
Tax Credit ◽  
Administrative Costs ◽  
Large Employer ◽  
Health Rating ◽  
Insurance Tax ◽  
Small Employers

While health insurance tax credits could help people who otherwise could not afford to purchase coverage, many might still find individual coverage too expensive and its marketplace dynamics bewildering. As an alternative, this paper outlines an approach using private purchasing pools for tax-credit recipients. The objective is to offer these individuals and families a choice among competing health plans, and provide many of the same advantages enjoyed by workers in large employer groups, such as relatively low administrative costs, no health rating, and an effective “sponsor.” Some express optimism that private pools will emerge naturally and thrive as an option for individual tax-credit recipients. However, adverse selection and other individual health insurance market forces make this a dubious prospect. The approach presented here gives purchasing pools the same tool employer groups use to maintain stability and cohesion—a significant contribution that cannot be used elsewhere. The ability to offer health plans exclusive access to a sizable new, previously uninsured clientele—tax-credit recipients—would enable purchasing pools to attract health plan participation and thus overcome one major reason several state-directed pools for small employers have failed. To avoid other pitfalls, the paper also suggests private pool structures, as well as federal and state roles that seek to balance objectives for market innovation and choice with those for coverage-source stability and efficiency.

A Health Insurance Tax Credit for Uninsured Workers

2001 ◽  
Vol 38 (2) ◽  
pp. 106-120 ◽  
Author(s):  
Lawrence Zelenak
Keyword(s):  
Health Insurance ◽  
Low Income ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Tax Credits ◽  
Tax Credit ◽  
Poverty Level ◽  
The Cost ◽  
Insurance Tax ◽  
Age And Sex

This paper describes a new system of tax credits to help low-income workers pay for health insurance. The system would be designed to subsidize health insurance coverage for workers who are currently uninsured, or who pay high premiums for nongroup insurance. Anyone age 19 or older who is not covered by Medicaid, Medicare, or employer-sponsored health insurance would be eligible for a health insurance tax credit (HITC), administered through the Internal Revenue Service. The base amount of the proposed credit would be $2,000 per year for each covered individual, but this amount would be adjusted for the individual's age and sex, according to the effect of age and sex on the cost of insurance coverage. The base amount of the credit would be reduced by $150 for every $1,000 by which a person's income exceeded 200% of the federal poverty level, thus limiting HITC eligibility to lower-income workers. To encourage participation in the credit program, most of the credit would be available through an advance payment system, with final reconciliation after year's end.

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