Including Health Insurance in Poverty Measurement : The Impact of Massachusetts Health Reform on Poverty

We develop and implement what we believe is the first conceptually valid health-inclusive poverty measure (HIPM)--a measure that includes health care or insurance in the poverty needs threshold and health insurance benefits in family resources--and we discuss its limitations. Building on the Census Bureau's Supplemental Poverty Measure, we construct a pilot HIPM for the under-65 population under ACA-like health reform in Massachusetts. This pilot is intended to demonstrate the practicality, face validity and value of a HIPM. Results suggest that public health insurance benefits and premium subsidies accounted for a substantial, one-third reduction in the poverty rate. Among low-income families who purchased individual insurance, premium subsidies reduced poverty by 9.4 percentage points