Latest Census Bureau Report on Poverty, Income and Health Insurance in the US-(2008) Released 9/10/09

INCOME, POVERTY AND HEALTH INSURANCE
COVERAGE IN THE UNITED STATES: 2008

The U.S. Census Bureau announced today that real median household income in the United States fell 3.6 percent between 2007 and 2008, from $52,163 to $50,303. This breaks a string of three years of annual income increases and coincides with the recession that started in December 2007.

The nation’s official poverty rate in 2008 was 13.2 percent, up from 12.5 percent in 2007. There were 39.8 million people in poverty in 2008, up from 37.3 million in 2007.

Meanwhile, the number of people without health insurance coverage rose from 45.7 million in 2007 to 46.3 million in 2008, while the percentage remained unchanged at 15.4 percent.

These findings are contained in the report Income, Poverty, and Health Insurance Coverage in the United States: 2008. The following results for the nation were compiled from information collected in the 2009 Current Population Survey (CPS) Annual Social and Economic Supplement (ASEC):

Income

Race and Hispanic Origin (Race data refer to people reporting a single race only. Hispanics can be of any race.)

• Between 2007 and 2008, the real median income of non-Hispanic white households declined 2.6 percent (to $55,530); for blacks, it declined 2.8 percent (to $34,218); for Asians, it declined 4.4 percent (to $65,637); and for Hispanics, it declined 5.6 percent (to $37,913). Except for the difference between the declines for non-Hispanic white and Hispanic households, all other differences between the declines were not statistically significant.

Regions

• Between 2007 and 2008, real median household income declined in the South by 4.9 percent (to $45,590), declined in the Midwest by 4.0 percent (to $50,112) and declined in the West by 2.0 percent (to $55,085). Income in the Northeast was statistically unchanged ($54,346). The apparent differences in the declines in median household income between the South and Midwest, and the Midwest and West were not statistically significant. The apparent difference between the median household incomes for the West and Northeast was not statistically significant.

Nativity

• Native- and foreign-born households, including those maintained by a naturalized citizen, had declines in real median income between 2007 and 2008. Income was statistically unchanged for households maintained by a noncitizen. The decline for native-born households was 3.5 percent; the decline for foreign-born households was 5.3 percent; and the decline for those maintained by a naturalized citizen was 4.8 percent. The apparent differences among the declines in median income for native-born, foreign-born and naturalized citizen households were not statistically significant.

Earnings

• In 2008, the earnings of women who worked full time, year-round was 77 percent of that for corresponding men, not statistically different from the 2007 ratio.
• The real median earnings of men who worked full time, year-round declined by 1.0 percent between 2007 and 2008, from $46,846 to $46,367. For women, the corresponding drop was 1.9 percent, from $36,451 to $35,745.

Income Inequality

• Income inequality was statistically unchanged between 2007 and 2008, as measured by shares of aggregate household income by quintiles and the Gini index. The Gini index was 0.466 in 2008. (The Gini index is a measure of household income inequality; 0 represents perfect income equality and 1 perfect inequality.)

Poverty

Overview

• The increase in the poverty rate between 2007 and 2008 was the first statistically significant annual increase since 2004. The 2008 poverty rate (13.2 percent) was the highest since 1997.
• In 2008, the family poverty rate and the number of families in poverty were 10.3 percent and 8.1 million, respectively, up from 9.8 percent and 7.6 million in 2007.
• For married-couple families, both the poverty rate and the number in poverty increased — 5.5 percent (3.3 million) in 2008, up from 4.9 percent (2.8 million) in 2007. Both measures, however, showed no statistical change in 2008 for female-householder-with-no-husband-present families (28.7 percent and 4.2 million) and for male-householder-no wife-present families (13.8 percent and 723,000).

Thresholds

• As defined by the Office of Management and Budget and updated for inflation using the Consumer Price Index, the weighted average poverty threshold for a family of four in 2008 was $22,025; for a family of three, $17,163; for a family of two, $14,051; and for unrelated individuals, $10,991.

Race and Hispanic Origin (Race data refer to people reporting a single race only. Hispanics can be of any race.)

• In 2008, the poverty rate increased for non-Hispanic whites (8.6 percent in 2008, up from 8.2 percent in 2007), Asians (11.8 percent in 2008, up from 10.2 percent in 2007) and Hispanics (23.2 percent in 2008, up from 21.5 percent in 2007). The poverty rate in 2008 was statistically unchanged for blacks (24.7 percent).

Age

• The poverty rate increased for children younger than 18 (19.0 percent in 2008, up from 18.0 percent in 2007) and people 18 to 64 (11.7 percent in 2008, up from 10.9 percent in 2007), while it remained statistically unchanged for people 65 and older (9.7 percent).
• Similar to the patterns observed for the poverty rate in 2008, the number of people in poverty increased for children younger than 18 (14.1 million in 2008, up from 13.3 million in 2007) and people 18 to 64 (22.1 million in 2008, up from 20.4 million in 2007) but remained statistically unchanged for seniors 65 and older (3.7 million).

Nativity

• Among the native-born population, 12.6 percent (33.3 million) were in poverty in 2008, up from 11.9 percent (31.1 million) in 2007.
• Among the foreign-born population, the poverty rate and the number in poverty increased to 17.8 percent and 6.5 million in 2008, up from 16.5 percent and 6.2 million, respectively, in 2007. The poverty rate in 2008 for naturalized citizens, 10.2 percent, was statistically unchanged from 2007, while the poverty rate for those who were not U.S. citizens rose to 23.3 percent in 2008, up from 21.3 percent in 2007.

Regions

• The Midwest and West experienced increases in both their poverty rate and the number in poverty. The Midwest poverty rate increased to 12.4 percent (8.1 million) in 2008, up from 11.1 percent (7.2 million) in 2007, and the West poverty rate increased to 13.5 percent (9.6 million) in 2008, up from 12.0 percent (8.4 million) in 2007. The poverty rates for the Northeast (11.6 percent) and the South (14.3 percent) were both statistically unchanged.

Health Insurance Coverage

Overview

• The number of people with health insurance increased from 253.4 million in 2007 to 255.1 million in 2008.
• The number of people without health insurance coverage rose from 45.7 million in 2007 to 46.3 million in 2008.
• Between 2007 and 2008, the number of people covered by private health insurance decreased from 202.0 million to 201.0 million, while the number covered by government health insurance climbed from 83.0 million to 87.4 million. The number covered by employment-based health insurance declined from 177.4 million to 176.3 million.
• The number of uninsured children declined from 8.1 million (11.0 percent) in 2007 to 7.3 million (9.9 percent) in 2008. Both the uninsured rate and number of uninsured children are the lowest since 1987, the first year that comparable health insurance data were collected.
• Although the uninsured rate for children in poverty declined from 17.6 percent in 2007 to 15.7 percent in 2008, children in poverty were more likely to be uninsured than all children.

Race and Hispanic Origin (Race data refer to those reporting a single race only. Hispanics can be of any race.)

• The uninsured rate and number of uninsured for non-Hispanic whites increased in 2008 to 10.8 percent and 21.3 million, from 10.4 percent and 20.5 million in 2007. The uninsured rate and number of uninsured for blacks in 2008, meanwhile, were not statistically different from 2007, at 19.1 percent and 7.3 million. The uninsured rate for Asians in 2008 rose to 17.6 percent, up from 16.8 percent.
• The percentage of uninsured Hispanics decreased to 30.7 percent in 2008, from 32.1 percent in 2007. The number of uninsured Hispanics was not statistically different in 2008, at 14.6 million.
• Based on a three-year average (2006-2008), 31.7 percent of people who reported American Indian and Alaska Native as their race were without coverage. The three-year average uninsured rate for Native Hawaiians and Other Pacific Islanders was 18.5 percent.

Nativity

• The uninsured rates for the native-born and foreign-born populations were statistically unchanged at 12.9 percent and 33.5 percent, respectively, in 2008. Among the foreign-born population, the uninsured rates for both naturalized citizens (18.0 percent) and noncitizens (44.7 percent) were statistically unchanged.

Regions

• At 11.6 percent, the Northeast and the Midwest had lower uninsured rates in 2008 than the West (17.4 percent) and the South (18.2 percent). The 2008 rates for the Northeast, Midwest and South were not statistically different from their respective 2007 rates. The uninsured rate for the West increased to 17.4 percent in 2008, up from 16.9 percent in 2007.

The CPS ASEC is subject to sampling and nonsampling errors. All comparisons made in the report have been tested and found to be statistically significant at the 90 percent confidence level, unless otherwise noted.

For additional information on the source of the data and accuracy of the estimates for the CPS, visit <http://www.census.gov/hhes/www/p60_236sa.pdf>

Healthy Children in a Sick Country

To the extent that this country has had a commitment to anything like universal health care, that commitment has focused on children. And the current decision to extend health care for low-income children in California makes it clear that the commitment is, at least in some places, bipartisan.
But something is missing from the calculations that justify public health care only for low-income children. As a housing advocate in western Pennsylvania, I routinely saw human examples of this failed calculus. Working homeless parents who had serious health issues but lacked insurance and were over the (very low) income limit for Medicaid would tell me on intake that they h ad personally not seen a doctor for the past two years, although the last one they saw mentioned that they had hypertension or diabetes.
Some reported health-related problems at work. The boss was threatening to fire one father because he passed out when he picked up heavy bags of concrete. A mother was having trouble keeping her fast food job because her leg went numb if she stood too long.
The good news was that these parents had children who were up to date on shots and had seen a doctor right on schedule. The bad news was that these healthy children had parents who were chronically ill.
Ugly ironies turned up daily. There was the single mom who brought her child in so that I could help with filling out the paperwork needed to get braces for his crooked teeth. The state's low-income insurance program for children would pay for the braces once the right boxes had been checked. The mom had been about to lose the family's trailer when her hours got cut at the gas station where she worked. Then she had a spot of luck- she got hired on part-time at Walmart. With two jobs, she could just manage.
But, as always happens in the low-income world, things went south again. The local Walmart notoriously found reasons to fire cashiers who lost front teeth. Too-visible dental problems gave a poor impression and upset the customers. The mom, who hadn't been to the dentist in more than eight years, bit into an apple one day and left a front tooth in its flesh. Mom was still on probation at Walmart. She had no dental insurance, made too much for Medicaid, and lost her job.
As I filled out the paperwork for her child's braces, the family was heading into the sort of semi-homelessness common in the low-income world. Mom, her son, and his new braces would have to move out of their trailer. They would be joining a former sister-in-law and her three kids in a single-wide, one and a half-bedroom trailer in the worst trailer park in town.
Cancer was worse. Some of the uninsured low-income parents who came for housing help had advanced stage cancer- they hadn't been to the doctor for years, nothing was ever caught early Sometimes you could solve the problem of providing income if they couldn't work, but that did little to solve the real problem. Too many children were faced with the possibility that mom or dad might die in the near future and, while waiting to die, mom or dad was usually too shell-shocked and ill to do much effective parenting. Early detection, of course, would not have prevented all these scenarios, but the thing is this: Our country doesn't even try.
The really amazing thing was that no uninsured parent, no matter how ill, ever made the obvious comparison between his or h er lack of medical and dental care and the services available for his or her children. No-one ever expressed envy, became angry, or questioned the arrangement- there was just acceptance of the situation, and pride that the kids had their immunization paperwork in order and had a regular doctor.
It is not just these parents who are at risk of serious untreated illness, however. The society that permits these untenable choices is on the critical list and on the way to an ethical flat-line.

No Public Option and Publics With No Option

Remember the psychological experiment in which participants were asked to press a button that would cause pain to someone whom they could not see? The results were depressing: those with the button were quite willing to cause pain, ratcheting up the voltage with abandon.
As a nation, we are experimenting with social policy along these lines. The removal of the public option from health care reform is one more upward tick of the voltage. Some people may feel pain, but they are, after all, people whom we have learned as a society not to see.
Most of the individuals and families who are are uninsured fall into one of two groups. One group is uninsured because they lack employer-provided coverage and are unable to afford or unable to be approved for private plans. A second group is uninsured because their employers offer plans that require contributions that are too high or because employer plans will not accept individuals with specific pre-existing conditions.
This is what we know about the uninsured. About 79% are citizens, according to a 2005 report by The Office of Health and Human Services. Blacks are slightly over-represented in relation to their proportion in the population, comprising 12% of the population but 15 % of the uninsured. . Hispanics are considerably over-represented, comprising 14% of the population but 30% of the uninsured. Whites are under-represented: they make up 67% of the population but only 47% of those without insurance.
Most uninsured individuals are below the age of 35, and the vast majority, work at full (46%) or or part-time (28%) jobs. Although some are relatively wealthy individuals whose incomes are above 300% of the poverty line, over half have earnings that place them below 200% of the poverty line. And some of the individuals in the wealthier group may have pre-existing conditions that make them unable to obtain insurance.
It is important to note that most individuals are not chronically uninsured. For most, the lack of insurance comes and goes with job changes or with changes in the terms of employer-offered benefits. Here, something like a lottery structures their ability to afford medical care.
And many other individuals, of course, are underinsured or simply lack the financial resources to meet co-pays in the face of catastrophic medical expenses. These individuals help account for the very high proportion of personal bankruptcies attributable to medical costs.
But, like addicts in a state of denial, we as a nation have learned to see only what serves our purposes. Our addiction is to the status quo, and what we have learned not to focus on is the pain suffered by those who lose under the current arrangement.
Like any practiced addict, we don't just deny. We rationalize and justify. Just as every addict can explain fluently why his or her situation is unique, why that case of beer finished in one afternoon does not, in his or her particular instance, constitute binge drinking, opponents of public health insurance can explain why they are not morally bankrupt.
We explain that the uninsured could get better or steadier jobs; that they could eat more tofu and less Cheetos; that those who have insurance should not be forced to pay taxes to support losers; that no-one that whom we know personally has these problems or, alternatively,that if they do it's because they were not as careful as we were. And many of these uninsured individuals belong to groups that make us uncomfortable in any event.
And we have another problem.
Like good addicts, we have developed an attachment to our suppliers. They've done well by some of us, after all. As long as you have money to pay, the dealer is your pal. We know what we need to do to keep the arrangement going. And our suppliers have said they feel the pain of the uninsured- they're going to help them out. Oh, sure, we'll still be addicts, but the suppliers will try to arrange things so that our buzz isn't ruined by noise from the losers outside.
These suppliers- the insurance, pharmaceutical, and medical industries, along with their representatives in Congress- assure us that they will co-operate on a solution. We can continue to use, but it will be a kinder, gentler sort of addiction. And how long will this co-operation last? If history is any example, just until the impetus for reform begins to nod out.
Any recovering addict can tell you this: for an addict, supply creates its own demand. One is too many and a thousand is never enough, the saying goes. You either quit or you don't. In the end, the surest -and in the case of health reform the only- route to recovery is to go cold turkey.