112 million Americans struggle to afford healthcare

 

High prices, low value -- Two new composite scores from West Health and Gallup illustrate America’s healthcare cost crisis

An estimated 112 million (44%) American adults are struggling to pay for healthcare, and more than double that number (93%) feel that what they do pay is not worth the cost. The findings come from two new composite scores developed by the nonprofit, nonpartisan organization West Health and Gallup, the global analytics and advice firm, to assess the healthcare cost crisis.

The West Health-Gallup Healthcare Affordability Index and Healthcare Value Index are drawn from the opinions of more than 6,600 American adults and represent findings from one of the largest surveys fielded during the pandemic on the state of healthcare in America. Each index is comprised of three unique metrics and classifies adults into corresponding categories based on their experiences. The Healthcare Affordability Index assesses the public’s ability to afford the healthcare they need, while the Healthcare Value Index synthesizes Americans’ perceptions of the quality-of-care relative to cost. West Health and Gallup developed these metrics after the rate of Americans reporting skipping needed care due to cost tripled during 2021. 

“These indices are tracking the healthcare cost crisis in America and its impact on everyday Americans,” said Tim Lash, President of West Health. “Bottom line – Americans are increasingly getting priced out of the system and many of those who can still afford to pay don’t think they’re getting their money’s worth relative to the cost. We must begin to change this trajectory with smarter policies that put patients over profits.”

National health spending is over $4 trillion in this country, and current projections indicate it will continue to grow at an annual rate of 5.4%, topping $6.2 trillion by 2028.

According to the Healthcare Affordability Index, respondents are considered “cost desperate” if they report experiencing three key financial challenges:

1. Unable to pay for needed medical treatment over the prior three months.
2. Skipped prescribed medication due to cost over the prior three months.
3. Unable to afford quality care if it was needed today.

Those classified as “cost insecure” have one or two of these affordability challenges, while cost secure individuals report none of these challenges and are able to consistently access and pay for prescription medications and quality care.

Based on these classifications, 36% of Americans are "cost insecure," 8% are “cost desperate" and 56% are “cost secure.” The likelihood of being cost desperate is more than four times greater for those in households earning under $48,000 per year (13%) compared to those earning $90,000+ per year (3%). Men were more likely to be cost secure than women (60% to 53%) and Hispanic adults were less likely to be cost secure than their Non-Hispanic White counterparts (51% to 58%).

Over one-third (35%) of cost desperate adults report that they have cut back on utilities, and half have cut back on food in the past 12 months to pay for necessary healthcare, rates that are 10 times greater than their cost secure counterparts. Another 14% of this group know a friend or family member who has died in the last 12 months after not receiving treatment due to an inability to pay for it—double the rate of “cost insecure” individuals and seven times greater than “cost secure” individuals.  

Beyond affordability, few Americans believe they get good value when they weigh the quality of their care against the amount that they pay for it. The Healthcare Value Index classifies respondents in the following ways:

1. “High Perceived Value": These persons (5% of the U.S. adult population) report that both their household and Americans generally are paying the right amount (or too little) relative to the quality of care they receive and that their most recent care experience was worth the cost.
2. "Inconsistent Perceived Value": These persons (50% of the U.S. adult population) report that either their household or Americans generally are paying too much for the quality of the care that they receive or that their most recent care experience was not worth the cost.
3. "Poor Perceived Value": These persons (45% of the U.S. adult population) report that both their household and Americans generally are paying too much for the quality of the care they receive and that their most recent care experience was not worth the cost.

“These estimates are important resources for policymakers, researchers, and the public to evaluate and understand the burden of high healthcare costs,” said Dan Witters, a senior researcher for Gallup. “The indices paint a comprehensive picture of why Americans are unable to keep pace with the rising costs and don't see value in the care they are receiving.”

 

Methodology

The results are based on a nationally representative survey conducted by web over successive field periods of Sept. 27-30 and Oct. 18-21 of 6,663 American adults aged 18 and older, living in all 50 U.S. states and the District of Columbia, as a part of the Gallup Panel. For results based on these monthly samples of national adults, the margin of sampling error at the 95% confidence level is +1.5 percentage points. For reported subgroups, such as by age, political identity, household income or race/ethnicity, the margin of error is larger, typically ranging from ±3 to ±5 percentage points.
 

What a great idea: Creating a state-level child tax credit

 Connecticut Voices For Children

Complete report :"The Case For The Connecticut Child Tax Credit." http://ow.ly/2io050HPuZo

As addressed a recent tax report—“Steps To A Fairer Tax System”—half of Connecticut’s families in 2021 had difficulty paying their usual expenses (e.g., food, housing, utilities).1 The problem has continued in 2022 and appears to be getting worse. In January, 53 percent of the state’s families had difficulty paying their usual expenses, and the percentage was even higher for certain subgroups, especially working-class and lower-middle-class families (78 percent and 62 percent), Black and Latino/a/x families (77 percent and 74 percent), and families with children (65 percent).

Income inequality and the racial income gap make it difficult for working- and middle-class families, especially families of color, to make ends meet; and over time, through both the “investment” and “stress” pathways, income inequality and the racial income gap negatively impact the children from working- and middle-class families, especially families of color, in “virtually every dimension, from physical and mental health, to educational attainment and labor market success, to risky behaviors and delinquency.”

These problems in turn weaken Connecticut’s economy and thereby decrease the state’s ability to make critical investments and pay down long-term obligations, which ultimately hurts all of the state’s families. 

The recent report cited above showed that Connecticut’s approach to taxation contributes to the above problems. The report also showed that making Connecticut’s tax system fairer requires tax reform, transparency, and timely support, all of which, in simple terms, would put more money in the pockets of working and middle-class families, especially families of color.

This companion report provides a detailed overview of one especially problematic component of the tax system: Connecticut is the only high cost of living state in the U.S. with an income tax that does not adjust for family size or child care expenses, which makes the state’s unfair tax system even more unfair for working- and middle-class families with children, especially those that require child care. 

In addition to making it harder for families with children to make ends meet compared to the average family, the lack of tax support for the high and growing cost of raising children directly contributes to the state’s slow economic growth by slowing the state’s population growth, which is a function of both a declining natural rate of population change (i.e., the birth rate minus the death rate) and a negative net migration rate (i.e., the number of families moving to the state minus the number of families leaving).

Property tax reform urgently needed in Connecticut

 Connecticut has a rare opportunity, due to its positive budget situation, to correct the greatest inadequacy and inequity in its tax structure: the longstanding over-reliance on the local property tax. Property tax reform should be focused on correcting the serious flaws associated with this tax; which now constitutes the major source of funding for municipalities, and makes up 41.9% of the total tax burden for Connecticut residents. 

There are two fundamental flaws in Connecticut’s property tax system. (1) Horizontal inequity: owners of property with similar values are taxed at different rates depending on which town they live in, and owners paying similar tax rates receive widely different services. (2) Vertical inequity: low- and moderate-income households are subjected to far higher effective property tax rates than high-income households. 

Property tax reform must be done in a way that corrects these structural flaws. If we fail to correct both the vertical and horizontal inequities, we will continue down a path of widely disparate educational opportunity, fractured and inefficient delivery of needed services, hollowed out cities, widening racial and economic disparities, sprawling suburbs, fleeing businesses and an out-migration of the next generation of talent. 

Complete report

Midterms optimism and “When are we going to start hitting Republicans?"

 KRISTIAN RAMOS of Autonomy Strategies said he’s “more optimistic than others.” He said the “economy is incredible” and Democrats will have a better story to tell about the Biden record this year if they pass some version of Build Back Better, get children under 5 vaccinated, confirm the first Black woman to the Supreme Court and highlight the implementation of the infrastructure law.

But he’s bewildered by what he sees as his party’s restraint when it comes to attacking the GOP. “When are we going to start hitting Republicans?” he asked. “When are we going to start pointing out these people are fascist light and don’t believe in democracy?”

The Republican Party declared the deadly January 6th Capitol attack “legitimate political discourse.”

 

Robert Reich 

Today, the Republican Party formally passed a resolution declaring the deadly January 6th Capitol attack “legitimate political discourse.” The Party also censured Reps. Adam Kinzinger and Liz Cheney, the two Republicans serving on the January 6th committee investigating the riot. RNC Chairwoman Ronna McDaniel doubled down on the resolution in a statement, claiming Kinzinger and Cheney are engaging in a “persecution of ordinary citizens who engaged in legitimate political discourse.”

Yes: according to the Republican Party, sending lawmakers running for their lives and chanting about hanging the Vice President is simply “legitimate political discourse.” Trump is running in 2024. State Republicans are suppressing the vote and gerrymandering their way back into power. The entire party is beholden to the Big Lie. Make no mistake: the GOP is dragging us into outright fascism. Democrats must take this threat seriously — before it’s too late.

Connecticut Democratic Party 

1h  · 

As the RNC reframes the unlawful attempt to overturn the election of President Biden as “legitimate,” we again call for the CT GOP, Bob Stefanowski, and all other CT Republican candidates to condemn Trump’s incitement of the riot.

De-escalation training in police departments can make police encounters with the public safer

 A first of its kind study by University of Cincinnati criminal justice researchers shows that de-escalation training in police departments can make police encounters with the public safer for everyone.

“Despite widespread promotion and proliferation of de-escalation trainings, until now, no research had empirically demonstrated that these trainings reduce use of force in the field,” says the study’s lead author Robin Engel, a professor in UC’s School of Criminal Justice who has been researching policing strategies for over two decades.  

The study, which appears in the American Society of Criminology’s flagship journalCriminology & Public Policy, took place in collaboration with the Louisville, Kentucky, Metro Police Department.  

Researchers looked at the post-training impact of the 2019 implementation of Integrating Communications, Assessment and Tactics (ICAT) de-escalation training developed by the Police Executive Research Forum (PERF).

Using a randomized, controlled trial design, the study results demonstrated statistically significant reductions in use of force incidents, citizen injuries and officer injuries in the post-training period.

“The results were impressive, to say the least,” says PERF executive director Chuck Wexler. The research, Wexler says, “found that training officers in ICAT was associated with 28% fewer use-of-force incidents, 26% fewer injuries to community members and 36% fewer injuries to police officers.”

According to the research, these significant reductions were larger than any changes in the Louisville police department arrest patterns during the same period.

“We add several statistical analyses to determine if the reductions in use of force were due to factors other than the training. After considering these alternative possibilities, the evidence led to the conclusion that it was indeed the training that had such a powerful impact” said co-author Nicholas Corsaro, an associate professor and criminal justice researcher also in UC’s School of Criminal Justice. 

The findings, both say, suggest that agencies should continue to implement and evaluate de-escalation trainings and adopt other resiliency-based approaches to police training.

To facilitate long-term changes in police behavior, Engel says, a holistic approach is recommended that supports training tenets with complementary policies, supervisory oversight, managerial support and community involvement in reform efforts.

The university recently announced a partnership with Jigsaw, a unit within Google, to test the company’s virtual reality police training platform. The training is aimed at diffusing tense situations officers may encounter on patrol, Engel says.

“Our research efforts and strategic partnerships are specifically focused on making police interactions with the public safer and improving the conditions and quality of life in our neighborhoods,” she says.

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JOURNAL

Criminology & Public Policy

DOI

10.1007/s41465-021-00231-6 

The critical importance of the Earned Income Tax Credit (EITC)

 

Today is the 16th annual Earned Income Tax Credit (EITC) Awareness Day. This is a time to bring attention to the critical support the EITC and other refundable tax credits provide to families and individuals with low to moderate incomes.

This support has become even more vital during the pandemic, when Congress enacted a temporary expansion of the EITC for working adults without children. Even before this expansion, in 2020, about 25 million working households claimed nearly $60 billion in federal EITCs.

EITC Awareness Day provides an opportunity to help connect more eligible people to the EITC. That includes over 17 million adults who work in low-wage jobs, don’t have children, and would benefit from the expanded EITC. The American Rescue Plan Act nearly temporarily tripled the maximum credit value, increasing it from $538 to $1,502. The Rescue Plan also expanded the age range of eligible workers to include those aged 19-24 (excluding students aged 19-23 who attended school at least half time for at least five months of the tax year), as well as people aged 65 and older. Additionally, homeless youth and former foster youth who are at least 18 years old and who work are eligible to claim this credit, even if they are enrolled in school. Prior to this expansion, the federal tax code taxed an estimated 5.8 million people aged 19 to 65 into, or deeper into, poverty in part because their EITC was so small. This is why extending the expansion of the EITC for working adults without children is so important.

Roughly 80-85 percent of people eligible for the EITC for families with children claim it, but many fewer people claim the EITC for working adults without children (an estimated 65 percent), according to IRS estimates for tax year 2016. Awareness and outreach are particularly essential to reach people newly eligible for the expanded EITC, those who were eligible for a very small credit in the past, and people who may have missed out on other tax credit expansions under the Rescue Plan, such as the third round of economic stimulus payments or the advance Child Tax Credit payments.

Center on Budget and Policy Priorities

Also see:

Build Back Better’s Child Tax Credit Changes Would Protect Millions From Poverty — Permanently

NOVEMBER 11, 2021