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

## TL;DR

This study finds that refundable state EITC programs have little impact on medical and dental care access for low-income mothers.

## Contribution

The study provides new evidence on the effects of refundable state EITC on healthcare access for non-pregnant low-income mothers.

## Key findings

- Higher refundable state EITC levels show little evidence of improving medical or dental care access for low-income mothers.
- Small improvements in dental visits and reduced forgone medical visits are observed but are sensitive to timing and model specifications.
- No significant differences in EITC effects are found based on state Medicaid eligibility levels.

## Abstract

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.

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.

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.

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.

•Low-income women of childbearing age face constraints in accessing medical and dental care.•We examine effects of refundable EITC on access to care among low-income mothers irrespective of pregnancy.•There is little evidence that the small refundable state EITC affects access including the subgroup receive most benefits.•There is also no evidence that the EITC effects on access vary with the state Medicaid eligibility level.•These findings add evidence on EITC effects on access which largely focuses on federal or state EITC among pregnant women.

Low-income women of childbearing age face constraints in accessing medical and dental care.

We examine effects of refundable EITC on access to care among low-income mothers irrespective of pregnancy.

There is little evidence that the small refundable state EITC affects access including the subgroup receive most benefits.

There is also no evidence that the EITC effects on access vary with the state Medicaid eligibility level.

These findings add evidence on EITC effects on access which largely focuses on federal or state EITC among pregnant women.