Earmarked Taxes for Mental Health Services in the United States: A Local and State Legal Mapping Study.
earmarked tax
excise tax
mental health
public policy
taxation
Journal
The Milbank quarterly
ISSN: 1468-0009
Titre abrégé: Milbank Q
Pays: United States
ID NLM: 8607003
Informations de publication
Date de publication:
06 2023
06 2023
Historique:
revised:
09
03
2023
received:
29
11
2022
accepted:
23
03
2023
pmc-release:
01
06
2024
medline:
14
6
2023
pubmed:
19
4
2023
entrez:
18
4
2023
Statut:
ppublish
Résumé
Policy Points Local governments are increasingly adopting policies that earmark taxes for mental health services, and approximately 30% of the US population lives in a jurisdiction with such a policy. Policies earmarking taxes for mental health services are heterogenous in their design, spending requirements, and oversight. In many jurisdictions, the annual per capita revenue generated by these taxes exceeds that of some major federal funding sources for mental health. State and local governments have been adopting taxes that earmark (i.e., dedicate) revenue for mental health. However, this emergent financing model has not been systematically assessed. We sought to identify all jurisdictions in the United States with policies earmarking taxes for mental health services and characterize attributes of these taxes. A legal mapping study was conducted. Literature reviews and 11 key informant interviews informed search strings. We then searched legal databases (HeinOnline, Cheetah tax repository) and municipal data sources. We collected information on the year the tax went into effect, passage by ballot initiative (yes/no), tax base, tax rate, and revenue generated annually (gross and per capita). We identified 207 policies earmarking taxes for mental health services (95.7% local, 4.3% state, 95.7% passed via ballot initiative). Property taxes (73.9%) and sales taxes/fees (25.1%) were most common. There was substantial heterogeneity in tax design, spending requirements, and oversight. Approximately 30% of the US population lives in a jurisdiction with a tax earmarked for mental health, and these taxes generate over $3.57 billion annually. The median per capita annual revenue generated by these taxes was $18.59 (range = $0.04-$197.09). Per capita annual revenue exceeded $25.00 in 63 jurisdictions (about five times annual per capita spending for mental health provided by the US Substance Abuse and Mental Health Services Administration). Policies earmarking taxes for mental health services are diverse in design and are an increasingly common local financing strategy. The revenue generated by these taxes is substantial in many jurisdictions.
Identifiants
pubmed: 37070393
doi: 10.1111/1468-0009.12643
pmc: PMC10262390
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
457-485Informations de copyright
© 2023 Milbank Memorial Fund.
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