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Over 40 million Americans under age 65--the overwhelming majority of them in working families--lack health insurance. The public ultimately shoulders the burden of paying for the medical treatment of those lacking insurance, either through higher taxes or higher health care costs. Expanding health coverage through the tax system may not be the most efficient path, but tax subsidies appear the only game in town for expanding the federal role in the provision of health insurance. This policy brief examines implications of major expansions in tax credits for health insurance, starting with the President's refundable tax credit proposal.