Americans are using their tax refunds to pay for health care

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Taxes are due April 17, and while many Americans dread the coming deadline, filing could be a saving grace for others. That's because many people use their refunds to pay for key medical expenses they had otherwise been putting off.

The JPMorgan Chase Institute analyzed the out-of-pocket spending habits of 1.2 million Americans who received a refund in 2016 and found a "dramatic link between health care spending and tax refunds."

Those who filed earliest and received their refund in February put 64 percent of their spending response toward paying for deferred care. A smaller but still startling 55 percent of those who filed in the following months did the same.

In both groups, almost all of the remaining spending went to paying bills with service-providers, with a small fraction going toward drugs or other medical supplies that could be stockpiled, according to the data.

In the week after receiving a refund, the overall level of health care spending was 60 percent higher than in a typical week over the 100 days before. Out-of-pocket spending on debit cards increased 83 percent with no offsetting change to credit-card spending, "suggesting the cash infusion provided by the tax refund was a major factor driving changes in health-care spending behavior," the report notes.

And 62 percent of spending was paid in-person at health-care providers, which "means cash-flow dynamics influenced not just when consumers paid for health care but also when they received it."

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Overall, people who were owed large refunds filed early in the tax season, the findings show. Among those early filers, women, low-income and young people especially may have done so because "they have a greater need for the cash," according to the report.

In the United States, women, on average, are paid 20 percent less than men, while those aged 18-to-24, some data show, have less than $1,000 in their savings accounts to cover costs including a medical emergency.

As such, women, young people and those without savings are "more likely to defer care" until receiving a refund, JPMorgan Chase notes. In fact, 65 percent of spending by women, and nearly 70 percent of spending by low-income filers or of those with little-to-no savings, went toward health care.

This issue is especially pressing in the U.S., the only "very highly developed country" without universal health care. The nation spent almost 18 percent of its gross domestic product on health care in 2016, yet results were "not so good," analysts say. Meanwhile, the average spending of 11 comparable countries was only 11.5 percent. Per capita, the U.S. spent $9,403, nearly double what the others spent.

In peer countries like Canada, some citizens are taxed at higher rates throughout the year, the Organization for Economic Cooperation and Development notes, but they get a lot more from their government in terms of social services, including health care.

[Sixty-five] percent of spending by women went toward deferred medical care.

Diana Farrell, JPMorgan Chase Institute president and chief executive officer, concludes, "it's increasingly clear that families are using their tax refunds as a zero-interest savings vehicle" and adds that "if consumers have a health need at some other time of the year, they might have to delay treatment until cash arrives during tax time."

In response, she suggests policymakers consider periodic refund payments that reduce the deferral of care or work on ways to increase flexibility in the timing of when refunds are made available. That way, filers "can access savings for health care whenever they need it."

Not everyone gets a refund, though, which is part of the problem with putting off spending on health care until tax time.

A study that analyzed tax data from 2012 to 2016 found 17 percent of taxpayers faced a federal tax bill. In 2017, according to financial website GOBankingRates, that number was closer to 30 percent. Researchers predict that scenario will repeat itself this year.

If you find yourself with a tax bill instead of a refund, it's important to take it seriously, particularly if you were counting on the funds for an important expense, like health care. Here's what you can do.

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