Out-of-pocket costs for health care expenditures contribute to a growing share of households’ consumption relative to income. Even among households with health insurance coverage, delaying of care due to out-of-pocket costs is commonly reported in surveys. This is because health plan deductibles introduce steep spot prices for cost-sharing early in coverage periods, which may drive people who are not financially prepared to defer care until they have the financial resources. Using restricted Medical Expenditure Panel Survey (MEPS) longitudinal data on monthly medical health care visits from 2010 to 2016, this study examines the relationship between monthly income changes due to Federal and State tax credit refunds and health care utilization among lower income adults. Estimates from a difference-in-differences framework show that increases in income tax refunds have no influence on the proportion of health care consumption in the months when these funds are typically received. Results were similar by health insurance cost sharing and for adults with lower amounts of liquid savings. Most people appear to incorporate tax refunds into their income expectations and appear to smooth health care consumption. This suggests health coverage may benefit from examining the heterogeneous effects of cost-sharing across the workforce.

Accepted Oral Presentation