Health and Financial Wellness

Research Agenda

The Intersection of Health and Wealth

Economic status is widely understood to be a determinant of health and behavioral health outcomes, with lower income groups experiencing poorer health and higher rates of premature mortality than individuals of higher economic status. Literature suggests that the relationship between financial status and health is influenced by factors like financial literacy, financial behaviors, and uninsured status, among other factors. Less is known about the relationship between health service utilization and the inability to pay for medical services due to financial hardship, high deductibles, and medical debt.

This study fills a gap in existing research by exploring the relationship between health-related debt, utilization of medical care and health outcomes. Findings from the study will inform interventions that target reducing medical debt and address how medical debt and cost of care impact healthcare utilization and health outcomes.

Assessing the Tax Filing Behaviors of ACA Marketplace Eligible Households

Eligibility for premium tax credits and subsidies through the Affordable Care Act Marketplace insurance program is contingent upon an applicant’s annual income. The primary way that Marketplace participants report their income to establish and/or maintain eligibility is through tax filing. Thus, insurance and health correlates with tax filing behaviors.

Applicants who apply for Marketplace coverage without having filed their federal taxes for the previous year are at risk for not receiving health insurance subsidies, which, in turn, can lead to unnecessary financial strain and health risks. This risk is particularly likely to impact applicants whose annual income is between 100% and 400% of the federal poverty level.

The existing research literature examine tax filing and insurance coverage separately. This study fills a gap in existing literature by examining tax filing and insurance together to address the gap in knowledge pertaining to factors and barriers associated with non-filing status among Marketplace enrollees. In addition, it addresses the lack of evidence regarding effective interventions, programs and tools that increase tax filing and facilitate access to subsidies.  

The study will leverage both existing and new data sources to understand the scope of the problem and potential solutions, as well as pilot an intervention or set of interventions to test effective tools to address the problem.