Effects of refundable state earned income tax credits on access to medical and dental services of low-income mothers.

BACKGROUND: Low-income women face constraints to timely access to medical and dental services. There is little evidence on whether refundable state earned income tax credit (EITC) programs affect access to care. We examine the effects of refundable state EITC levels on accessing medical and dental care among low-income mothers and potential interactions with state Medicaid eligibility levels.

METHODS: We use data from 1996-2019 Behavioral Risk Factor Surveillance System (BRFSS). We focus on single mothers aged 18-44 with high school or less education and two or more children as the group that receives the most EITC payments, but also consider other subgroups. We consider the timing of EITC disbursement relative to interview month and outcome measurement. The regression analysis adjusts for state time-invariant differences, national time trends, and several individual-level and state time-varying covariates.

RESULTS: There is little evidence that higher refundable state EITC affects access to medical and dental services among low-income mothers including among the group mostly likely to benefit from this policy. A small improvement in dental visits and decrease in forgone medical visits are observed in some models. However, these results are sensitive to the timing of EITC measure and included interview months. Moreover, some effects are observed among subgroups less exposed to EITC. There is also no evidence that EITC effects differ by state Medicaid eligibility.

CONCLUSION: The overall small payments from refundable state EITC do not appear to impact medical and dental care access of low-income mothers. Further research to understand potential individual-level heterogeneity by EITC amounts and timing relative to health care needs is important.