Health Inclusive Poverty Measure in the United States: 2025

• In Event: Medicaid Expansions and Contractions: the OBBBA, Poverty & Financial Insecurity

Abstract

The U.S. Census Bureau publishes annual statistics on economic well-being using the official poverty measure and the Supplemental Poverty Measure (SPM). This paper continues estimates of a third series, the Health Inclusive Poverty Measure (HIPM), building on previous releases over the last three years. HIPM builds on the SPM by expanding the treatment of health care in the poverty measure beyond out-of-pocket medical expenses. HIPM adds a value of health insurance to existing SPM thresholds and resources and caps the deduction of out-of-pocket medical expenses based on health plan parameters. The addition of a value of health insurance allows researchers to examine how inequalities in economic well-being can arise due to access to health insurance, with previous research showing disparities between the insured and the uninsured population using HIPM (Creamer 2024; 2025). The measure also allows for estimation of the impact of key public health programs, particularly Medicare, Medicaid, and health insurance subsidies, on a measure of economic well-being. This is important in comparison to other public policy programs such as Social Security.The presentation will provide poverty estimates in 2025 using the HIPM, the official poverty measure, and the SPM. In addition to these national level differences, HIPM and SPM rates will be provided across states. This helps show how state health policy impacts SPM and HIPM poverty rates at the national level. Lastly, the presentation will provide estimates of the impact of Medicare, Medicaid, and health insurance subsidies on poverty rates, assuming no changes in behavior. These estimates highlight the role these public health programs play in reducing poverty in comparison to other key anti-poverty policies like Social Security. The estimates provided in this presentation are vital in a time of policy change. The timing of the survey data and policy environment means that the estimates capture the last period of time before changes in health insurance legislation and the expiration of policy responses to the Covid-19 pandemic are fully implemented.

Author

• John Creamer, U.S. Census Bureau
  Presenting Author