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34 Hardships in America
FIGURE C Proportion of people in families below 200% of poverty
experiencing hardships by work status
80%
70%
0.6446 64.5%
0.7297 73.0%
0.6429 64.3%
Percent of Americans
60%
50%
40%
30%
20%
0.2964 29.6% 0.2861 28.6%
0.2336 23.3%
10%
0%
One or more critical hardships
One or more serious hardships
No Workers in family Part-time worker(s) in family
Full-time worker(s) in family
Source: Authors’ calculations from 1997 NSAF (for calendar year 1996).
2.4.4 Health insurance
The lack of health insurance is both a hardship and a strong predictor of
experiencing other hardships. High proportions of families go without health
insurance, more so for families living below 200% of poverty (36%) than those
above (10%). Table 12 shows that, among families living below 200% of
poverty, those without private health insurance are more likely to have healthrelated
hardships. Families that receive Medicaid are generally more likely to
experience hardships overall, relative to families that have no health insurance
at all, except for health-related hardships, which families without health insurance
are more likely to experience. This is probably due to selection bias; that is,
within the group of families living below 200% of poverty, Medicaid families
are, on average, poorer than families without health insurance at all since, in
order to get Medicaid, an adult must often either be on public assistance or have
recently left public assistance for employment. “Working poor” adults are, in
most states, left without health insurance coverage even though they have only
marginally higher incomes.
The correlation of hardships and health insurance status holds even when
accounting for other variations among families. Table 10 shows that one of the
largest predictors of a family experiencing any hardships is whether or not it
has health insurance. 10 Families with private health insurance are unlikely to