今天，12bet官方研究所发布了自20世纪80年代以来第一份根据收入和其他人口特征分析美国退税情况的报告. 这项研究, Who Files Early and Who Defers 医疗保健: Insights from 1.2 Million Tax Refunds, 还包括首次分析退税对不同收入和其他人口群体的医疗支出的影响. 研究发现，在所有收入群体中，退税数额较大的美国人都提前报税, 那些提前报税的人也把更多的年度退税花在了他们推迟的医疗服务上.

The earliest filers, those who 收到了 refunds in February, 对退税的反应更为强烈，76天内医疗支出增加了38%, 相比之下，3月份收到退款的人增加了22%，4月或5月收到退款的人增加了11%. Among the earliest filers, 他们对退款的医疗保健支出的64%用于延迟医疗保健服务(以在医疗保健提供者处亲自付款的支出表示)。, compared with just over 55 percent for accounts held by the latest filers. Almost all of the remaining healthcare spending response in all groups went to paying deferred medical bills; only a tiny fraction went to paying for healthcare goods that could be stockpiled.

“越来越明显的是，家庭正在利用他们的退税作为零利率储蓄工具. 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,” Diana Farrell, President and CEO, 12bet官方 研究所. “这些消费者将从其他储蓄工具或更灵活的退款系统中受益，这样他们就可以在需要的时候获得医疗保健储蓄."

The new report’s key takeaways include:

• 即使在不同的收入或年龄群体中，那些被拖欠更多退款的人往往更早提交申请.
  • Among tax filers who are owed refunds, lower income and 年轻的人 file earlier in the season, perhaps because they have greater need for the cash infusion. 另外, 支付给低收入申报人的大部分退款可能是由可退还的税收抵免推动的, 比如劳动所得税抵免——他们只有通过退税才能获得这笔钱.
• 医疗保健 spending out of accounts held by earlier filers, 年轻的人, 女性, and lower income people increased by the largest proportion in response to the tax refund.
  • 最早的申报人(那些在2月份收到退税的人)在退税后的医疗支出增加了38%, 相比之下，3月份收到退款的人增加了22%，4月或5月收到退款的人增加了11%.
• Regardless of income, 那些在本季度早些时候提交申请的人把大部分退款用于延期医疗支出.
  • Those who filed their tax refunds earliest, receiving a refund in February, put 64 percent of their spending response toward paying for deferred care, compared with 55 percent for those who filed latest. 在两组中, almost all of the remaining spending response went to paying bills with service providers; only a tiny fraction went to paying for drugs or other supplies that could be stockpiled.
• 递延医疗在早期申报者的医疗支出反应中占较大比例, 女性, and low-income account holders.
  • Sixty-five percent of the response from accounts held by 女性 represented deferred care, compared with only 57 percent from accounts held by men.
  • 来自收入最低的五分之一的账户持有人的回复中，69%的人表示推迟了护理, compared with 54 percent for those in the highest income quintile.
• 即使在高收入群体中，现金流动态也会影响自费医疗支付的时间.

Given the dramatic link between healthcare spending and tax refunds, 政策制定者可以考虑可能的改革，使消费者更容易在全年获得医疗保健资金. Possible solutions include:

• Periodic tax refund payments that reduce the deferral of care outside of refund season.
• Increasing the flexibility in the timing of when the lump sum becomes available. 将一年中最大的现金流事件之一限定在2月中旬到5月中旬之间，实际上保证了一些美国人将不得不推迟医疗.
• 另一种储蓄工具——比如以雇主为基础的sidecar账户——与预扣税有一些相同的特点(包括对消费者的内置承诺和“先存后忘”的透明度)，但消费者可以更直接地控制时间.

In January 2018, the 12bet官方 研究所 released new findings 在支票账户收到退税的那一周，递延医疗支出增加了60%.

该报告发现，在收到退税后的一周内，医疗保健支出的总体水平比收到退税前100天内的典型一周高出60%. In the week after receiving a tax refund, out-of-pocket healthcare spending on debit cards increased by 83 percent, 虽然信用卡消费没有抵消变化，但这表明退税提供的现金注入是推动医疗支出行为变化的主要决定因素. 此外, 退税引发的额外医疗支出中，62%是由医疗服务提供者亲自支付的. This means that cash flow dynamics influenced not just when consumers 支付 healthcare but also when they 收到了 it.

The reports leverage data on daily healthcare spending for 1.2 million checking account holders in the 12bet官方 研究所 医疗保健 Out-of-Pocket 支出 Panel (JPMCI HOSP) who 收到了 a tax refund in 2016. The HOSP data asset was first constructed in September 2017. The asset follows a sample of 2.从2013年1月到2016年12月，共有300万名年龄在18岁至64岁之间的大通常客. 该研究所将自费医疗保健支出定义为向医疗保健提供者和药店支付的任何观察到的付款, including co-payments, 共同保险, deductibles and other point-of-service medical, 牙科, or drug spending.

Click here to read the full report.