August 6, 2021

Bucks: About Half of Adults Lacked Adequate Health Coverage in 2012

About half of United States adults ages 19 to 64 didn’t have health insurance for at least part of last year or were underinsured, a new report from the Commonwealth Fund says.

The fund,  a private nonprofit organization that finances research into health care and health policy issues, conducts the health insurance survey every two years.

One bright spot, the report found, is that the proportion of young adults without health insurance fell significantly over the last two years, probably because of a provision of the Affordable Care Act that allows young adults to stay on their parents’ health plans until age 26. The rule took effect in September 2010.

Nearly eight out of 10 (79 percent) young adults reported that they were insured, up from 69 percent in 2010. That marks “an abrupt reversal in a decadelong climb” in the number of uninsured young adults, the report said.

Uninsured rates for other age groups, however, either rose or stayed the same. About half of adults ages 19 to 64 didn’t have health insurance for all of 2012 or were underinsured, meaning that they had insurance but struggled to pay for medical costs anyway.

At the time of the survey, about 30 percent said they were uninsured or were insured but hadn’t been at some point during the year. Another 16 percent had insurance, but had such high out-of-pocket medical costs relative to their income that they were effectively uninsured.

The survey also found that people are increasingly skipping needed health care because they can’t afford it (about 43 percent answered yes to that question).  That’s up from 37 percent in 2003, the report noted.

The report found that about two out of every five adults had trouble paying medical bills last year or were paying off medical debt over time, and that many of those struggling with medical debt (42 percent) said they had received a lower credit rating as a result.

The results are based on a telephone survey of 4,432 adults by Princeton Survey Research Associates International from April 25 to August 19, 2012. The margin of sampling error is plus or minus 2 percentage points.

The report is the last one the fund will conduct before the major provisions of the Affordable Care Act are scheduled to go into effect, in January 2014.

Did you have a gap in insurance coverage last year? Do you expect the health care law to help provide you with coverage?


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Child Care Costs Are Up, Census Finds

The report suggested that more families appear to be availing themselves of alternatives, including care provided by relatives and after-school programs. It also found that the proportion of elementary school-age children living with a single working parent and regularly caring for themselves declined to 14 percent in 2011 from 24 percent in 1997.

“More children are in after-school programs as funding for them has increased,” said Lynda Laughlin, a family demographer with the bureau and the author of the report. “Additionally, parents’ work schedules may now be more closely mirroring school schedules.”

The report, “Who’s Minding the Kids,” found that families with an employed mother and children under 15 paid $143 weekly on average for child care in 2011, compared with $84 (in 2011 dollars) in 1985. But the proportion of families that reported using paid child care at all dipped to 32 percent from 42 percent. And the share of monthly family income over all spent on child care has remained constant since 1997, at about 7 percent.

Despite the increased cost of paid child care for families who use it, the report found that the median wages of full-time child care workers remained flat. The median was $19,098 in 2011 compared with $19,680 (in constant dollars) in 1985.

While the report explained that the figure might be understated, only 6 percent of parents who paid for child care said they received help from the government, the other parent, their employer or some other source. Families below the poverty line spent 30 percent of their monthly income on child care, compared with 8 percent among other families.

“What really struck me is the fact that more families who are in deep poverty are paying 30 percent of their income for child care and more families who are below poverty are relying on government support to make ends meet for child care, and those subsidies are being cut dramatically,” said Melanie Hartzog, the executive director of the Children’s Defense Fund in New York.

“If families don’t have stable child care they’re not able to work,” she continued, “and while there’s an uptick in relative care — and families are paying to some degree for relatives to watch their children — relative or informal care is not always a stable source of care.”

Five percent of children ages 5 to 11 and 27 percent ages 12 to 14 regularly cared for themselves, the census survey found. Among children ages 5 to 14, 23 percent spent more than 10 hours a week unsupervised.

Sixty-one percent of preschoolers were in a regular child care arrangement. Those whose mothers were employed spent about 36 hours a week in child care. Grandparents cared for 24 percent, fathers for 18 percent (typically while the mother worked) and another 10 percent were cared for by a sibling or other relative. Among children living only with their father, 30 percent were regularly cared for by their mother. About 3.5 percent of women who worked cared for their children themselves.

The report found that 13 percent of the children were in a day care center, 6 percent in nursery or preschool, a slightly smaller share in Head Start or kindergarten programs and about 11 percent were cared for by other nonrelatives.

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Off the Charts: Recovery Has Brought More Jobs for Men Than Women

From December 2009 through last month, the economy added 5.3 million jobs, according to the Labor Department’s monthly survey of households. Only 30 percent of them went to women. To some extent, that is simply a reflection of the fact that the recession hit men much harder than women, but the result has been at least a temporary reversal of the long trend of women holding an ever-increasing share of jobs.

The proportion of jobs held by women, which was around 28 percent when the household survey began in 1948, rose to a peak of 47.5 percent in January 2010, just after the economy hit bottom. During that period, there was only one substantial setback to the trend, in 1952 and 1953, when the end of the Korean War brought soldiers back to the civilian economy.

But in the first months of this recovery, that number fell as low as 46.6 percent, and it was at just 46.8 percent in January.

The household survey is separate from the establishment survey, which asks employers how many people are on their payrolls. That survey hit bottom in February 2010, and showed 5.5 million jobs had been added. But it does not collect information on gender, as the household survey does.

The accompanying charts show the changing employment patterns since the end of 2009 for men and women in various age groups, from 20 to 24 years to over 55. Because demographic shifts have been abrupt for some groups, like the baby boomers — there are a lot more people over 55 now, and fewer people aged 35 to 54 — the charts look at changes in the employment-to-population ratio.

That ratio differs from the more widely noted unemployment rate in that it compares the number of people who have jobs with the total population, not just with the total number of people who say they were working or looking for jobs during the month.

In January, 54.6 percent of women over the age of 20 had jobs. That was the lowest proportion since 1993, and 0.8 percentage points lower than the figure in December 2009. By contrast, 67.6 percent of men over 20 had jobs, a rate that is 1.3 percentage points higher than it was at the end of 2009, although still below prerecession levels.

The sharpest declines in employment for women were in the 20-to-24 and 45-to-54 age groups. The decline in the younger group may reflect the difficulties young people face in trying to start a career, but the decline in the middle-aged group is not so easily explained.

Ian Shepherdson, chief economist at Pantheon Macroeconomic Advisors, said it might be a result of who has, and has not, been hiring. He pointed to the Institute for Supply Management’s survey of manufacturers, which has indicated that companies are hiring, and to the survey by the National Federation of Independent Business, which indicates that its members are not. “Women are more likely to be employed by small service-sector companies than by large manufacturers,” he said.

The largest increase in the proportion of women with jobs has come among those over 55, which is also the group that is growing the fastest. It seems likely that more men and women are delaying retirement. The proportion of women aged 55 to 59 with jobs does not appear to be increasing, but the proportion of women aged 60 to 64 with jobs has been rising.

Floyd Norris comments on finance and the economy at

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Off the Charts: Global Manufacturing Edges Up, Except in Europe

Surveys of manufacturing companies around the world indicated that in December nearly as many companies reported that orders were rising as said that orders were continuing to decline.

The gains were concentrated in developing countries; China reported its best month in nearly two years.

But much of the euro zone remained weak. France reported its worst monthly figure since early 2009, when the credit crisis was at its worst.

The figures are based on monthly surveys of manufacturers begun in the United States by the Institute for Supply Management and later imitated in more than a dozen countries by Markit, a British firm. Companies are asked whether business is better than in the previous month, both over all and by several measurements. The accompanying charts focus on whether companies say the volume of new orders coming in is improving or getting worse.

The I.S.M. numbers use 50 as a neutral point. Any number above that indicates that more companies are reporting good news than are reporting that things are getting worse. In the charts, the numbers are adjusted so that such a neutral reading is shown as zero, with higher figures showing an ever greater proportion of companies reporting good news.

The global figure, compiled by J. P. Morgan based on all the surveys, remained in negative territory in December, but it came closer to breaking even than it had in any month since May.

In the United States, according to the Institute for Supply Management survey, a plurality of companies reported declining orders for three months through September, but since then the figures have been positive, although by very narrow margins in November and December. Export orders appeared to be stronger in December than domestic orders, perhaps indicating some caution from domestic buyers as the so-called fiscal cliff deadline approached.

The weakness in the euro zone has lasted more than a year, but for most of that period it was the peripheral countries that were holding down the reports. In December, though, both Germany and France, the two largest economies in the currency union, had worse order reports than the zone as a whole, something that had happened only once before since the end of 2007.

For much of this year, most of the major developing country exporters were reporting declining levels of new orders. But China and Brazil have shown positive margins for three months as the year ended, and South Korea had a narrowly positive number in December, its first in seven months.

Floyd Norris comments on finance and the economy at

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Bulletproofing Your Finances

Ralph Bruce, 78, works as a casino security guard. He took the job because his Social Security wasn’t enough to cover the basics.

Pushing 80, and Still Punching the Clock

Workers age 75 and older make up less than 1 percent of the United States work force, according to federal data, but that proportion is likely to increase as conventional retirement funds dwindle.

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Off the Charts: A Reversal for Real Estate After Some Mild Gains

Indexes of the two markets showed this week that the latest declines had almost wiped out the mild gains the two markets had shown after prices appeared to have hit bottom.

The Standard Poor’s/Case-Shiller index of home prices ended February 3.3 percent below where it was a year earlier, and just 0.5 percent above the low reached in May 2009. The Moody’s/REAL Commercial Property Price Index was reported to be down 4.9 percent over the last 12 months, but still 0.8 percent above its low, reached last August.

In both cases, sales volumes are far below what they were when the markets were booming, and a large proportion of the properties that are being sold were in trouble before the sale. The National Association of Realtors estimates that about 40 percent of existing homes that changed hands in March were either in foreclosure or were so-called short sales in which the house was sold for less than was owed on the existing mortgage.

The commercial property index, which is based on data collected by Real Capital Analytics, shows that 29 percent of transactions in February involved distressed properties — including those already in foreclosure or default, as well as those whose owners had filed for bankruptcy.

“Only when the share of distressed sales meaningfully drops off will we be able to enter the recovery phase,” said Tad Philipp, Moody’s director of commercial real estate research.

As can be seen from the accompanying charts, home prices nationally peaked in 2006 but did not begin to plunge until 2007.

At first, that was widely viewed as a result of problems in the subprime mortgage market. Commercial real estate prices rose until early 2008, but then declined rapidly. The latest values for the indexes show national home prices down 31 percent from peak levels, while the commercial real estate index shows a fall of 45 percent.

The charts show the trend of prices since December 2000. Home prices are about 27 percent higher than they were then, but commercial real estate is up just 6 percent. Meanwhile, in a tortoise-versus-hare tale, home rental rates are higher than they ever were even though they failed to boom when real estate prices soared.

Both indexes are based on repeat sales of the same property, and the relative lack of commercial property transactions — the index counted only 107 in February for more than $2.5 million each — means that the figures are far from exact. But they do show trends.

According to data from Moody’s, hotels and apartments are in the most distress, with about 16 percent of loans in each category classified as delinquent. About 10 percent of loans on industrial property are in trouble, while the figures for offices and retail properties are lower, at around 7 percent.

Over all, the proportion of commercial loans in distress climbed from under 1 percent at the end of 2008 to over 9 percent now. But it has been stable in recent months, providing some hope that the market is no longer deteriorating.

On a regional basis, the same markets tend to have problems in both commercial and residential real estate. The three states with the highest proportion of commercial loans in distress, according to Moody’s, are Nevada, Arizona and Michigan. In Nevada, more than 30 percent of loans are classified as being in trouble, nearly double Arizona’s 16 percent figure.

Floyd Norris comments on finance and the economy on his blog at

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