Posts Tagged "poverty"

Good News on Health Insurance in Pandemic

To paraphrase a U.S. senator in 1977, the moral test of government is how it treats the sick, the poor, and its children. That rings especially true during an historic public health emergency like COVID.

Congress came through with financial relief to blunt the pandemic’s impact, and the money that flowed through the economy provided more Americans with health insurance, while also reducing poverty.

Several newly released U.S. Census reports “show how much vigorous policies can do to prevent poverty and preserve access to health care,” the Center on Budget and Policy Priorities concluded.

The Uninsured. During the pandemic, the share of all adults lacking health insurance declined from 9.2% in 2019 to 8.6% in 2021, reversing the trend of a rising uninsured rate in prior years. The rate dropped as Congress improved access and affordability during COVID by passing large premium reductions for policies purchased on the federal and state exchanges and by requiring states that receive Medicaid funds to expand their coverage of poor and low-income workers during the pandemic.

Congress has extended the premium reductions through 2025, but the federal enhancements to Medicaid are set to expire, leaving states to determine the extent to which they will cover their low-income workers in the future.

The Poor. The COVID aid passed by Congress lifted nearly 14 million Americans out of poverty over the past two years, according to Census. This statistic aligns with earlier research showing the financial assistance was particularly effective in helping low-income workers and people who were struggling financially prior to the pandemic. …Learn More

How Disabilities are Tied to Food Insecurity

People with disabilities have high rates of food insecurity because they earn less or can’t work at all. Add to that their unusually large expenses for health care and assistive equipment like wheelchairs and special computers.

But the roots of food insecurity run deeper than just the financial constraints. Even middle-income people with disabilities are more food insecure, which the USDA defines as either deficiencies in nutrition or not having enough to eat.

Part of the problem is where they tend to live, according to a new Urban Institute study. Counties with unusually large disability populations have fewer places to shop for groceries and an oversupply of fast food restaurants, convenience stores, and small grocery stores with limited shelf space. Snack foods and sweet beverages are abundant in these establishments but the selection of fruits, vegetables and lean meats is limited.

A shortage of stores that sell healthy food is a bigger problem in the cities with the highest disability rates than in similar rural areas, the researchers found. But food deserts – a shortage of options for grocery shopping – are more concentrated in the less populated Southeast and Appalachia, as well as rural pockets in Maine, Michigan and New Mexico. The researchers used two sources of disability data: general disability rates in the U.S. Census, as well as data on people with disabilities severe enough to qualify them for Social Security benefits.

Two rural municipalities dramatically illustrate the difference in access to food establishments between areas with high and low disability rates. One in four residents reported having a disability in Hickman, a city tucked into the southwestern corner of Kentucky. But Hickman has fewer than three establishments that sell food for each 1,000 residents.

At the other extreme, Billings, Montana’s disability rate is half that of Hickman’s and there are 13 food establishments per 1,000 residents. …Learn More

retired couple on a boat

Health and Wealth Drive Retirees’ Spending

Previous research has shown that spending drops immediately at the moment the paychecks stop, and a few studies have found that households, once retired, reduce their consumption over time.

But a new study that also takes the long view suggests that the spending decline is not what retirees want to do but what is necessitated by their financial and health constraints.

The analysis, which used data from two national consumption surveys, divided retired households into groups to get a sense of what goes into their spending decisions. The researchers compared the consumption patterns of retirees at three different wealth levels over a 20-year period and then compared consumption for three states of health.

The evidence that financial resources drive behavior is that the wealthier households’ consumption was relatively constant, declining just one-third of 1 percent a year.

While these retirees have the financial wherewithal to largely maintain their spending, retirees in the bottom wealth tier saw bigger drops of 1 percent a year. When accumulated over 20 years, the declines produced much lower spending levels than when they first retired.

Health is a second factor in retirees’ decisions. Again, the extremes tell the story. Spending in the top tier – very good or excellent health – held fairly flat, while the retirees in fair or poor health saw relatively large declines. Even if they can afford to travel or eat out frequently, health problems may be preventing them from enjoying their money. …Learn More

Mental Health Crisis is an Inequality Problem

The connection between Americans’ socioeconomic status (SES) and their health was established long ago and the evidence keeps piling up.

"Healing: Our Path from Mental Illness to Mental Health" book coverLess-educated, lower-income workers suffer more medical conditions ranging from arthritis to obesity and diabetes. And the increase in life expectancy for less-educated 50-year-olds was, in most cases, roughly 40 percent of the gains for people with higher socioeconomic status between 2006 and 2018.

More recently researchers have connected SES and mental health. The foundations are laid in childhood. In one study, the children and teenagers of parents with more financial stresses – job losses, large debts, divorce, or serious illness – have worse mental health. And COVID has only aggravated the nation’s mental health crisis.

In a new book, Dr. Thomas Insel, former director of the National Institute of Mental Health, is concerned about the impact of inequality.

Mental health in disadvantaged communities “is worse because of the world outside of health care. It’s our housing crisis, our poverty crisis, our racial crisis, our increasing social disparities that weigh heaviest on those in need,” he writes in “Healing: Our Path from Mental Illness to Mental Health.” …Learn More

Low-Income Retiree Gets Financial Coach

Every state should have what Delaware has: a program that helps low- and moderate-income seniors find a financial survival strategy.

Stand by me logoSince it opened in 2013, the program, Stand by Me 50+, has connected more than 2,300 older residents – mostly retirees – with federal and state aid programs, advised them of Social Security’s rules, and helped them pay medical bills or eliminate debt. The services are free.

Kathleen Rupert, a financial coach and head of the organization, helped one man in his 70s pay off $13,000 in debt. Another retiree doubled his income from Social Security after she determined that he was eligible for his late wife’s $1,700 benefit. About 44 percent of the program’s clients have monthly income of $1,500 or less.

“We go wherever the need is – to senior housing, senior centers, community centers, libraries,” she said. “We set up appointments at Panera Bread or Hardee’s – wherever they’re available.”

Squared Away interviewed three clients who said the financial solutions they got from the program have given them peace of mind. Here is the first client’s account of how Stand by Me 50+ helped her.

Peggy Grasty with great granddaughters, Aaliyah Gale and Quamiylah Sease.Peggy Grasty with great granddaughters, Aaliyah Gale and Quamiylah Sease.

Peggy Grasty retired in 2010 after two decades at Elwyn, a non-profit social services agency where she was a supervisor and worked with people with mental disabilities. She continues to help people – voluntarily. The 71-year-old takes other retirees under her wing who need assistance because they have trouble walking or aren’t as capable as her.

She initially contacted Stand by Me because she couldn’t make ends meet. She has a comfortable, federally subsidized apartment in Wilmington, Delaware. But her income is limited to a $1,500 Social Security check and a $53 pension from a job long ago waxing floors and driving a bus for a Pennsylvania middle school.

Stand by Me got help for Grasty through two programs: federal SNAP food stamps and a Delaware non-profit that pays low-income residents’ medical bills. By doing this type of work, the program addresses a real need. Although myriad financial assistance programs are available for low-income workers and retirees, they are frequently unaware of the programs, assume they don’t qualify, or may need help navigating the application process. …Learn More

Working Multiple Jobs to Make Ends Meet

If people need to work and can work, they will work. That’s my takeaway from a new set of data that sketches a clearer picture of U.S. workers who are holding down multiple jobs.

US workers with more than one jobNearly 8 percent of workers had two or more jobs in 2018, the latest year of data available from the U.S. Census Bureau. The data also show that holding two or more jobs becomes more common during economic expansions, when jobs are plentiful, and falls during recessions, when the opportunities dry up.

But the longer-term trend is up: the share of people holding multiple jobs has slowly increased over the past two decades. In a recent webinar, Census Bureau economist James Spletzer provided a couple of reasons.

First, the country has lost millions of manufacturing jobs over several decades. They have been replaced by lower-quality jobs in retail and in service industries like health care, hotels and food preparation – and that’s where multiple job holders tend to work.

A second, related reason for working in multiple jobs is the “stagnation of earnings at the lower end of the earnings distribution,” Spletzer said. …Learn More

ACA Eased the Financial Burden on Families

Woman and baby at the doctors

The Affordable Care Act (ACA) has reduced families’ medical costs significantly.

The ACA’s main goal was to provide coverage for the first time to workers who lack employer health insurance. But the expansion of free or subsidized health care to millions of parents with low and modest incomes has improved their financial stability and freed up money for their families’ other critical needs, concluded a new University of California at Davis study.

The main way the ACA expanded coverage was by giving states the option of providing Medicaid to workers earning up to 138 percent of the federal poverty level. The law also increased the number of children with health insurance, because federal and state outreach during the Medicaid expansion raised parents’ awareness of two separate insurance programs that had long been available to children: Medicaid and the Children’s Health Insurance Program. To help families with modest incomes, the health care law put a cap on their annual medical spending.

Prior to the ACA’s passage, out-of-pocket medical costs were a high financial burden for 15 percent of U.S. families. That has fallen to about 10 percent of families in the years since passage, the researchers said.

What qualifies as a high cost burden depends on the family’s income. One example: the researchers determined that a family earning $75,000 had a high cost burden if they paid more than 8.35 percent of their income for out-of-pocket deductibles and copayments.

However, the study is not a current picture of the situation, because it was based on data from health care spending surveys in 2000 through 2017, prior to the pandemic. During the past year, millions of people were laid off and lost their employer health insurance when they may need it most.

But the ACA’s benefits are clear, the researchers said. Another aspect of the reform was to allow workers who earn too much to qualify for Medicaid to purchase subsidized private health insurance on the state exchanges. The law capped the total that workers spend on health care – once they reach the cap, their care is fully covered. …Learn More