Background How to finance progress towards universal health coverage in low-income and middle-income countries is a subject of intense debate. We investigated how alternative tax systems aff ect the breadth, depth, and height of health system coverage. Methods We used cross-national longitudinal fi xed eff ects models to assess the relationships between total and diff erent types of tax revenue, health system coverage, and associated child and maternal health outcomes in 89 low-income and middle-income countries from 1995–2011.