IDEAS home Printed from https://ideas.repec.org/h/nbr/nberch/0164.html
   My bibliography  Save this book chapter

Tax Policy for Health Insurance

In: Tax Policy and the Economy, Volume 19

Author

Listed:
  • Jonathan Gruber

Abstract

Despite a $140 billion existing tax break for employer-provided health insurance, tax policy remains the tool of choice for many policy-makers in addressing the problem of the uninsured. In this paper, I use a microsimulation model to estimate the impact of various tax interventions to cover the uninsured, relative to an expansion of public insurance designed to accomplish the same goals. I contrast the efficiency of these policies along several dimensions, most notably the dollars of public spending per dollar of insurance value provided. I find that every tax policy is much less efficient than public insurance expansions: while public insurance costs the government only between $1.17 and $1.33 per dollar of insurance value provided, tax policies cost the government between $2.36 and $12.98 per dollar of insurance value provided. I also find that targeting is crucial for efficient tax policy; policies tightly targeted to the lowest income earners have a much higher efficiency than those available higher in the income distribution. Within tax policies, tax credits aimed at employers are the most efficient, and tax credits aimed at employees are the least efficient, because the single greatest determinant of insurance coverage is being offered insurance by your employer, and because most employees who are offered already take up that insurance. Tax credits targeted at non-group coverage are fairly similar to employer tax credits at low levels, but much less efficient at higher levels.
(This abstract was borrowed from another version of this item.)

Suggested Citation

  • Jonathan Gruber, 2005. "Tax Policy for Health Insurance," NBER Chapters,in: Tax Policy and the Economy, Volume 19, pages 39-64 National Bureau of Economic Research, Inc.
  • Handle: RePEc:nbr:nberch:0164
    as

    Download full text from publisher

    File URL: http://www.nber.org/chapters/c0164.pdf
    Download Restriction: no

    Other versions of this item:

    References listed on IDEAS

    as
    1. Jonathan Gruber, 2000. "Tax Subsidies for Health Insurance: Evaluating the Costs and Benefits," NBER Working Papers 7553, National Bureau of Economic Research, Inc.
    2. Gruber, Jonathan & Lettau, Michael, 2004. "How elastic is the firm's demand for health insurance?," Journal of Public Economics, Elsevier, vol. 88(7-8), pages 1273-1293, July.
    3. Jonathan Gruber, 2002. "Taxes and Health Insurance," NBER Chapters,in: Tax Policy and the Economy, Volume 16, pages 37-66 National Bureau of Economic Research, Inc.
    4. Marquis, M. Susan & Long, Stephen H., 1995. "Worker demand for health insurance in the non-group market," Journal of Health Economics, Elsevier, vol. 14(1), pages 47-63, May.
    5. Dahlia K. Remler & Joshua Graff Zivin & Sherry A. Glied, 2004. "Modeling health insurance expansions: Effects of alternate approaches," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 23(2), pages 291-313.
    6. Jonathan Gruber, 1998. "Health Insurance and the Labor Market," NBER Working Papers 6762, National Bureau of Economic Research, Inc.
    7. Gruber, Jonathan & McKnight, Robin, 2003. "Why did employee health insurance contributions rise?," Journal of Health Economics, Elsevier, vol. 22(6), pages 1085-1104, November.
    8. Royalty, Anne Beeson, 2000. "Tax preferences for fringe benefits and workers' eligibility for employer health insurance," Journal of Public Economics, Elsevier, vol. 75(2), pages 209-227, February.
    9. Jonathan Gruber & Michael Lettau, 2000. "How Elastic is the Firm's Demand for Health Insurance?," NBER Working Papers 8021, National Bureau of Economic Research, Inc.
    10. Gruber, Jonathan & Washington, Ebonya, 2005. "Subsidies to employee health insurance premiums and the health insurance market," Journal of Health Economics, Elsevier, vol. 24(2), pages 253-276, March.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Karsten Jeske & Sagiri Kitao, 2005. "Health insurance and tax policy," FRB Atlanta Working Paper 2005-14, Federal Reserve Bank of Atlanta.
    2. Jonathan Gruber, 2008. "Covering the Uninsured in the U.S," NBER Working Papers 13758, National Bureau of Economic Research, Inc.
    3. Jonathan Gruber, 2008. "Incremental Universalism for the United States: The States Move First?," Journal of Economic Perspectives, American Economic Association, vol. 22(4), pages 51-68, Fall.
    4. Tracy L. Regan & Gulcin Gumus, 2006. "Tax Incentives as a Solution to the Uninsured: Evidence from the Self-Employed," Working Papers 0709, University of Miami, Department of Economics, revised Oct 2007.
    5. Schulkind, Lisa & Shapiro, Teny Maghakian, 2014. "What a difference a day makes: Quantifying the effects of birth timing manipulation on infant health," Journal of Health Economics, Elsevier, vol. 33(C), pages 139-158.
    6. repec:eee:jhecon:v:53:y:2017:i:c:p:72-86 is not listed on IDEAS
    7. Ellen Meara & Meredith Rosenthal & Anna Sinaiko & Katherine Baicker, 2008. "State and Federal Approaches to Health Reform: What Works for the Working Poor?," NBER Working Papers 14125, National Bureau of Economic Research, Inc.
    8. Jeske, Karsten & Kitao, Sagiri, 2009. "U.S. tax policy and health insurance demand: Can a regressive policy improve welfare?," Journal of Monetary Economics, Elsevier, vol. 56(2), pages 210-221, March.
    9. Benedek, Dóra & Kiss, Áron, 2011. "Mikroszimulációs elemzés a személyi jövedelemadó módosításainak hatásvizsgálatában
      [Micro-simulation analysis in examination of the effects of personal income-tax changes]
      ," Közgazdasági Szemle (Economic Review - monthly of the Hungarian Academy of Sciences), Közgazdasági Szemle Alapítvány (Economic Review Foundation), vol. 0(2), pages 97-110.
    10. Meara Ellen & Rosenthal Meredith B & Sinaiko Anna D. & Baicker Katherine, 2008. "State and Federal Approaches to Health Reform: What Works for the Working Poor?," Forum for Health Economics & Policy, De Gruyter, vol. 10(1), pages 1-28, July.

    More about this item

    JEL classification:

    • H2 - Public Economics - - Taxation, Subsidies, and Revenue
    • I1 - Health, Education, and Welfare - - Health

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:nbr:nberch:0164. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (). General contact details of provider: http://edirc.repec.org/data/nberrus.html .

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service hosted by the Research Division of the Federal Reserve Bank of St. Louis . RePEc uses bibliographic data supplied by the respective publishers.