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Financial Burden of Medical Spending by State and the Implications of the 2014 Medicaid Expansions

April 10, 2014 Comments off

Financial Burden of Medical Spending by State and the Implications of the 2014 Medicaid Expansions
Source: Urban Institute

This study is the first to offer a detailed look at medical spending burden levels, defined as total family medical out-of-pocket spending as a proportion of income, for each state. It further investigates which states have greater shares of individuals with high burden levels and no Medicaid coverage, but would be Medicaid eligible under the 2014 rules of the Affordable Care Act should their state choose to participate in the expansion. This work suggests which states have the largest populations likely to benefit, in terms of lowering medical spending burden, from participating in the 2014 adult Medicaid expansions.

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Do Financial Knowledge, Behavior, and Well-Being Differ by Gender?

April 3, 2014 Comments off

Do Financial Knowledge, Behavior, and Well-Being Differ by Gender?
Source: Urban institute

Using the National Financial Capability Survey, we examine differences among men and women in financial knowledge, behavior, and well-being. We find that women are less financially knowledgeable than men. Women are less willing than men to take financial risks and have more credit cards than men. However, women are equally likely to pay their credit cards in full every month and are equally likely to save for retirement. More differences by gender arise when we separate men and women by family type. Unmarried women with dependent children are worse-off and likely have other financial stresses.

Who among the Uninsured Do Not Plan to Look for Health Insurance in the ACA Marketplaces?

March 27, 2014 Comments off

Who among the Uninsured Do Not Plan to Look for Health Insurance in the ACA Marketplaces?
Source: Urban Institute

New enrollment figures for both state and federal health insurance Marketplaces created by the Affordable Care Act (ACA) show that participation is picking up steam after a slow start, with data as of March 17, 2014 reflecting 5 million enrolled. But with open enrollment closing on March 31, the pace of enrollment will need to accelerate further to reach the revised target of 6 million people. Previous research suggests that the initial low levels of Marketplace enrollment were driven as much by gaps in awareness of the ACA’s coverage provisions as by the widely publicized problems with the federal website. For example, only about one-third of adults had heard some or a lot about the Marketplaces on the eve of the Marketplace rollout (Long and Goin 2014). By December 2013, about one-fifth of uninsured adults had looked at that time and another third planned to look (Blavin et al. 2014). Additional research finds that many uninsured are not looking for coverage in the Marketplaces because they are unaware that financial help is available there.

Taxes and Inequality

March 24, 2014 Comments off

Taxes and Inequality
Source: Urban Institute

This paper reviews historical trends in economic inequality and tax policy’s role in reducing it. It documents the various reasons why income inequality continues to rise, paying particular attention to the interplay between regressive and progressive federal and state taxes. The report also considers the trade-off between the social welfare gains that a more equal distribution of incomes would provide, and the economic costs of using the tax system to reduce inequality, highlighting the fact that income inequality reflects an amalgam of factors. The optimal policy response reflects that complexity.

Characteristics of Families Receiving Multiple Public Benefits

March 19, 2014 Comments off

Characteristics of Families Receiving Multiple Public Benefits
Source: Urban Institute

Little is known about the extent to which low-income households receive multiple public benefits and in what combinations; studies to date estimate low levels of multiple benefit receipt. This brief builds on what is known by investigating the number and types of benefits low-income families with children receive, and the characteristics of families receiving different benefit packages. We find that multiple benefit receipt is common among low-income families, but a minority of families receives benefits beyond food assistance and public health insurance, such as shelter assistance, cash assistance, or work supports.

Estimating the Size and Structure of the Underground Commercial Sex Economy in Eight Major US Cities

March 13, 2014 Comments off

Estimating the Size and Structure of the Underground Commercial Sex Economy in Eight Major US Cities
Source: Urban Institute

The underground commercial sex economy (UCSE) generates millions of dollars annually, yet investigation and data collection remain under resourced. Our study aimed to unveil the scale of the UCSE in eight major US cities—Atlanta, Dallas, Denver, Kansas City, Miami, Seattle, San Diego, and Washington, DC. Across cities, the UCSE’s worth was estimated between $39.9 and $290 million in 2007, but decreased since 2003 in all but two cities. Interviews with pimps, traffickers, sex workers, child pornographers, and law enforcement revealed the dynamics central to the underground commercial sex trade—and shaped the policy suggestions to combat it.

Tax Subsidies for Asset Development: An Overview and Distributional Analysis

March 12, 2014 Comments off

Tax Subsidies for Asset Development: An Overview and Distributional Analysis
Source: Urban Institute

The federal government channels much of its support for asset building through the tax code. Asset-building tax subsidies, primarily for homeownership and retirement saving, totaled $384 billion in 2013. This report reviews federal tax expenditures for housing, retirement, savings, business development, and higher education. We highlight research on the effectiveness of and justifications for these expenditures, find limited efficacy in their current form, and note possible adjustments. We estimate the distributional effect of major tax expenditures and find that the vast majority of subsidies benefit the top two income quintiles. Last, we review prospective policies such as matched saving accounts and automatic enrollment.

Higher Education Earnings Premium: Value, Variation, and Trends

February 28, 2014 Comments off

Higher Education Earnings Premium: Value, Variation, and Trends
Source: Urban Institute

Postsecondary education leads to significant financial benefits for most students, and average earnings premiums have grown over time. However, there is considerable variation in outcomes across individuals, types of credentials, occupations, and geographical locations. This brief discusses some of the different ways the financial benefits of higher education can be measured and documents the high average payoff to college degrees. It emphasizes the importance of recognizing that this high payoff does not eliminate disappointing outcomes for some individuals, while highlighting the fact that focusing on recent college graduates leads to under-estimation of the returns.
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Child-Related Benefits in the Federal Income Tax

February 8, 2014 Comments off

Child-Related Benefits in the Federal Income Tax
Source: Urban Institute

The federal income tax system provides substantial benefits to families with children. In 2013, the Tax Policy Center estimates that five major child-related tax benefits – the earned income tax credit (EITC), the child tax credit, the child and dependent care tax credit, the dependent exemption, and head of household filing status – will reduce taxes and provide credits totaling $171 billion (roughly $3,400 per family) for families with children. Nearly all families benefit, but low- and middle-income families tend to benefit most. This paper highlights who benefits from each major provision and how much benefit is received.

Corporate Income Tax Reform: Dreaming On

February 7, 2014 Comments off

Corporate Income Tax Reform: Dreaming On
Source: Urban Institute

Both political parties are calling for corporate tax reform without agreement on specifics. Proposals to broaden the corporate tax base to pay for lower rates or to eliminate taxes on corporate repatriations while trying to prevent income shifting do not address the main problems of taxing multinational corporations in a global economy. This article discusses the need for more fundamental structural reforms and offers up two ideas – securing international agreement on better rules to allocate profits of multinationals among taxing jurisdictions or, alternatively, replacing the U.S. corporate tax with full taxation of dividends and accrued capital gains of U.S. shareholders.

Do Homeownership and Rent Subsidies Protect Individuals from Material Hardship? Evidence from the Great Recession

February 6, 2014 Comments off

Do Homeownership and Rent Subsidies Protect Individuals from Material Hardship? Evidence from the Great Recession
Source: Urban Institute

Do homeownership and rent subsidies protect individuals from experiencing material hardships? Do the relationships differ by race and ethnicity? Using the Survey of Income and Program Participation, we find that the likelihood of experiencing any material hardship is 5.6 percentage points lower for homeowners than renters without rent subsidies, a reduction of about 25 percent. Owning a home over ten years provides a larger protection than owning a home less than four years. Homeownership’s role in shielding people from material hardship is at least as important for non-Hispanic blacks and Hispanics as for non-Hispanic whites.

New Perspectives on Homeownership Tax Incentives

January 14, 2014 Comments off

New Perspectives on Homeownership Tax Incentives
Source: Urban Institute

This report presents three tax reforms designed to promote homeownership through a channel other than the deductibility of mortgage interest. These reforms include a first-time homebuyer tax credit, a refundable tax credit for property taxes paid, and an annual flat amount tax credit for homeowners—all paid for by limiting current tax expenditures for housing. Although far from perfect, these reforms would provide a more efficient and equitable allocation of housing subsidies. Our simulations show that relative to existing incentives, each policy would raise home prices and make the tax code more progressive.

The War on Poverty Moves to the Tax Code

January 14, 2014 Comments off

The War on Poverty Moves to the Tax Code
Source: Urban Institute

In 1975, the federal income tax code joined the “War on Poverty” with the enactment of the earned income tax credit (EITC). Today, tax credits form some of the largest and most effective anti-poverty programs in the US. In 2012, the Census Bureau estimated that tax credits cut poverty (under a broad measure that includes the effect of programs like Supplemental Nutrition Assistance Program benefits and the EITC) by 3 percentage points – more than SNAP (1.6 points) and TANF (0.2 points). The tax credits cut child poverty by a whopping 6.7 percentage points.

New Urban Institute Research Briefs on “Low Income Men”

January 13, 2014 Comments off

New Urban Institute Research Briefs on “Low Income Men”
Source: Urban Institute

+ Education and Employment of Disconnected Low-Income Men
Margaret Simms, Karina Fortuny, Marla McDaniel, William Monson
This brief explores the education and employment outcomes of disconnected low-income men in 2008–10. These men have lower education levels than higher-income men. Among low-income men, Hispanics are less likely than African Americans and whites to complete high school. Low-income men are more likely to be unemployed and underemployed; African Americans are the most likely to be unemployed. Education and employment rates for low-income men vary considerably by metropolitan area.

+ Summary of an Urban Ethnographers’ Symposium on Low-Income Men
Margaret Simms, Marla McDaniel, William Monson
The Urban Institute, with funding from the Office of the Assistant Secretary for Planning and Evaluation, US Department of Health and Human Services, convened a symposium to explore the state of knowledge on disconnected low-income men and promising strategies for improving their well-being, focusing particularly on men of color. The participants included ethnographers and other qualitative researchers, social service providers, foundation program officers, and federal government staff. The candid insights offered enriched understanding of the complex problems faced by low-income men, the programs currently serving their needs, and some of the issues about which more study is needed.

+ Imprisonment and Disenfranchisement of Disconnected Low-Income Men
Marla McDaniel, Margaret Simms, William Monson, Karina Fortuny
Incarceration rates have risen over time and vary by race and ethnicity, reflecting changes in federal and state crime policies over the past few decades. In 2011, African American men were six times more likely and Hispanics nearly two and half times more likely to be imprisoned than white men. This brief summarizes some of the disparate impacts these policies have had on African American and Hispanic men and the consequences for their families and communities.

+ Low-Income Men at the Margins: Caught at the Intersection of Race, Place and Poverty
Margaret Simms, Marla McDaniel, William Monson, Karina Fortuny
A large number of US men of prime working age are neither gainfully employed nor pursuing education or other training, suggesting a potentially significant disconnection from mainstream economic and social life. This paper concentrates on the experiences and challenges of men at the margins between the ages of 18 and 44, when most American males are engaged in such activities as working and building skills, forming and strengthening families, and linking to social institutions. The review focuses on their experiences in five domains: education, employment, family, criminal justice, and health, featuring key themes from ethnographic and other qualitative research.

+ The Health of Disconnected Low-Income Men
Margaret Simms, Marla McDaniel, William Monson, Karina Fortuny
This brief examines the health insurance coverage and health status of disconnected low-income men from 2008 to 2010, focusing primarily on men’s connections to health care providers and systems. Less than half of low-income men age 18–44 in the United States have any insurance coverage; coverage rates vary significantly by state, citizenship, ethnicity, and education. Compared with higher-income men the same age, low-income men also have lower access to routine health care and have worse health outcomes.

+ A Demographic Snapshot of Disconnected Low-Income Men
Marla McDaniel, Margaret Simms, Karina Fortuny, William Monson
In 2008-10, 16.5 million civilian men nationwide age 18-44 lived in families with incomes below 200 percent of the federal poverty level; 15 million of these men lacked college degrees. Low-income men are more likely to have never married than men the same age nationwide, and they are disproportionately African American or Hispanic. Using data from the American Community Survey, this brief presents estimates of the number of low-income men in the 50 states and the District of Columbia, focusing on metropolitan areas with at least 50,000 low-income men.

Addressing Deep and Persistent Poverty: A Framework for Philanthropic Planning and Investment

January 9, 2014 Comments off

Addressing Deep and Persistent Poverty: A Framework for Philanthropic Planning and Investment
Source: Urban Institute

The JPB Foundation engaged the Urban Institute to provide background on the problem of deep and persistent poverty in the United States. This paper summarizes the history of US antipoverty policies, synthesizes existing knowledge about poverty and deep poverty, and presents a framework for understanding the complex and multi-faceted landscape of antipoverty efforts today. It also draws on interviews with over 30 experts, philanthropists, and thought leaders in the field to review and distill the most current thinking about promising strategies for tackling deep and persistent poverty. Drawing on these facts and insights, we present a series of questions and choices that any foundation wishing to invest in this area would be well-advised to consider.

Low-Income Families and the Cost of Child Care; State Child Care Subsidies, Out-of-Pocket Expenses and the Cliff Effect

December 30, 2013 Comments off

Low-Income Families and the Cost of Child Care; State Child Care Subsidies, Out-of-Pocket Expenses and the Cliff Effect
Source: Urban Institute

Child care subsidies provide assistance for low-income families, often to support work activities. Depending on the state of residence, families’ out-of-pocket expenses can vary widely, both while receiving the subsidy and at the point when families no longer qualify for assistance. In this paper, we look at how state policies affect families’ child care expenses, focusing on the point when families no longer qualify for assistance. We find that when families’ incomes increase just enough to make them ineligible for child care assistance, the potential increase in out-of-pocket child care expenses can be much greater than the increase in income.

More than 11 Million: Unauthorized Immigrants and Their Families — Fact Sheet

December 24, 2013 Comments off

More than 11 Million: Unauthorized Immigrants and Their Families — Fact Sheet
Source: Urban Institute

The effects of immigration reform proposals will extend well beyond the 11 million unauthorized U.S. residents. Those unauthorized immigrants share their homes with 8.7 million people who legally reside in the United States. Three quarters of those legal residents are U.S. born citizens and 60 percent are children.

Nonprofit-Government Contracts and Grants: Findings from the 2013 National Survey

December 11, 2013 Comments off

Nonprofit-Government Contracts and Grants: Findings from the 2013 National Survey
Source: Urban Institute

This report discusses the results of the 2013 National Survey of Nonprofit-Government Contracts and Grants. Expanding on the 2010 study of human service nonprofits, we examine most types of nonprofits with expenses of $100,000 or more. This report documents the size and scope of government financing, administration of contracts and grants, and nonprofit perceptions of problems and improvements in these processes and reports on the financial status of nonprofits in 2012. The study also examines how human service nonprofits have managed since the recession ended and how their relationships with government agencies have changed since 2009.

Stabilizing Premiums Under the Affordable Care Act: State Efforts to Reduce Adverse Selection

December 8, 2013 Comments off

Stabilizing Premiums Under the Affordable Care Act: State Efforts to Reduce Adverse Selection
Source: Urban institute

As a consequence of the ACA’s reformed nongroup insurance market, some have raised concerns about short-term “rate shock” — an increase in premiums as a result of enhanced consumer protections and more risk-sharing compared with the pre-reform market – as well as longer-term instability due to adverse selection – the phenomenon by which particular insurance plans or markets attract an enrollment with higher than average health care risks. While the ACA includes strategies intended to mitigate these effects, some states are introducing additional strategies to strengthen the protections. This paper explores policies designed to address these concerns being implemented in 11 states.

Closing the Wealth Gap: Empowering Minority-Owned Businesses to Reach Their Full Potential for Growth and Job Creation

December 4, 2013 Comments off

Closing the Wealth Gap: Empowering Minority-Owned Businesses to Reach Their Full Potential for Growth and Job Creation
Source: Urban Institute

The racial wealth gap grows sharply with age. When people are in their 30s and 40s, whites have about 3.5 times more wealth than people of color. By the time people reach their 60s whites have about 7 times more wealth. Skewed federal subsidies exacerbate wealth disparities and the racial wealth gap. Five suggestions to close the racial wealth gap are: make homeownership tax subsidies more progressive; promote retirement savings through IRAs and expand the Saver’s Credit; reauthorize the Assets for Independence program; increase access to high-quality education; and improve access to micro and small business capital for low-wealth groups.

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