The Census Bureau’s annual data-release of income, poverty, and health coverage statistics offers important insight into the economic circumstances of children and families in the previous year. The aggregate data released last week paints a picture of relative stability, with no significant changes to median income, poverty, and health insurance coverage rates between 2023 and 2024. But a closer look at the disaggregated data raises deep concerns about the impact of administrative actions and policy decisions that cause individuals and families to lose access to programs that meet their basic needs, and are a harbinger of the much deeper hardship to come as states prepare to implement the new paperwork requirements and cuts to food assistance and health coverage enacted in the recent budget law.
According to Census Bureau data, in 2024:
- Overall median income was $83,730, keeping pace with inflation.
- The poverty rate as measured by the Supplemental Poverty Measure (SPM) also held steady, with 12.9 percent of all people and 13.4 percent of children living with income and resources below the poverty thresholds. The SPM is a more helpful measure of families’ economic circumstances than the Official Poverty Measure (OPM) because it takes into account the impact of public investments. While the OPM only considers cash benefits and income among families’ resources, the SPM counts non-cash benefits such as food and housing assistance as well as refundable tax credits among families’ resources, while also subtracting certain expenses that limit their spending power. In 2024, the SPM poverty threshold was $39,430 for a two-adult, two-child family who rented their housing. Research has consistently shown that families with incomes well above these thresholds experience serious material hardships and struggle to make ends meet. The data indicate that the share of individuals with incomes up to twice the SPM thresholds also held steady between 2023 and 2024, with 28.5 percent of individuals having incomes between 1 and 1.99 times the SPM thresholds in 2024, compared to 28.4 in 2023.
- The share of all people with health coverage also held steady at 92 percent. While there was a .8 percentage point decrease in public coverage between 2023 and 2024, as sates resumed regular eligibility redeterminations in Medicaid following the end of the pandemic’s continuous enrollment policy, there was a.7 percentage point increase in private coverage, primarily through direct purchase or Marketplace coverage as enhanced premium tax credits continued to make Marketplace coverage more affordable for millions of people.
In short, the data indicates that on average families were treading water last year, as public investments such as refundable tax credits, food and housing assistance, health insurance subsidies, and public health coverage worked together and in tandem with the labor market and the broader economy to keep families in a relatively stable economic position.
But more granular data paints a troubling picture of children and families falling through the cracks when policymakers restrict eligibility and add administrative hurdles to critical programs. Last year we saw this play out with health coverage. The continuous enrollment policy in Medicaid that was in place during the pandemic had two distinct but related virtues: it enabled people to maintain their health coverage even if their income or household circumstances changed, and it eliminated the regular paperwork that families need to complete to prove their eligibility. In other words, this single policy eliminated both the benefits cliff and the administrative burdens that families have consistently identified as problems with existing economic supports, creating a more reliable and universal program.
But when continuous enrollment ended and people lost their Medicaid coverage, the disaggregated data shows that some groups did not successfully transition to private coverage, leaving them uninsured. While on average declines in public coverage did not lead to increases in the share of people who were uninsured, because of corresponding increases in private coverage, this was not true for all:
- Medicaid coverage declined significantly in 30 states, and contributed to an increase in the share of people without health coverage in 18 of these states.
- Black adults saw a statistically significant increase in their uninsured rate, up 1.2 percentage points to 12.3 percent.
This data suggests that the unwinding of continuous enrollment was not experienced the same way by everyone, everywhere—and may have compounded existing inequities. This is especially concerning because of indications in the data that Black families are facing a more difficult economy, with the labor market and public investments creating instability and hardship. In 2024 Black people were the only racial or ethnic group to see a drop in median income (to $52,370) and a statistically significant increase in poverty, up 2.2 percentage points to 20.7 percent using the SPM.
The recently-passed budget law moves us further in the wrong direction, with even more frequent eligibility redeterminations, increased paperwork and red tape, and eligibility restrictions that will cause millions more to lose their health coverage and food assistance.
Families deserve more reliable, durable, and universal programs so they can meet their needs and thrive. For a short time during the pandemic, families experienced what it was like to have supports that were easier to access and more universal, with continuous enrollment in Medicaid, an expanded Child Tax Credit, and more. For that brief time, policies’ provided stability and effectively promoted families’ health and well-being. The data reflected the success of these changes, with child poverty falling to historic lows during the pandemic. Centering families’ well-being in policy decisions can and should be a core priority. We have done it before, and we can do it again.
