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This document explores how a refundable tax credit to offset the cost of health insurance premiums would affect health system performance along nine dimensions. A refundable tax credit would produce a slight gain in health as measured by life expectancy; 2.3 to 10 million people would become newly insured under this policy change. It is uncertain how the policy would affect waste or patient experience. Refundable tax credits would have no discernable effect on total health care spending, overall consumer financial risk, reliability of care, or health system capacity. Implementing refundable tax credits would be relatively easy.

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