In 2023, just over 50 percent of Americans had an annual household income that was less than 75,000 U.S. dollars. The median household income was 80,610 U.S. dollars in 2023. Income and wealth in the United States After the economic recession in 2009, income inequality in the U.S. is more prominent across many metropolitan areas. The Northeast region is regarded as one of the wealthiest in the country. Maryland, New Jersey, and Massachusetts were among the states with the highest median household income in 2020. In terms of income by race and ethnicity, the average income of Asian households was 94,903 U.S. dollars in 2020, while the median income for Black households was around half of that figure. What is the U.S. poverty threshold? The U.S. Census Bureau annually updates its list of poverty levels. Preliminary estimates show that the average poverty threshold for a family of four people was 26,500 U.S. dollars in 2021, which is around 100 U.S. dollars less than the previous year. There were an estimated 37.9 million people in poverty across the United States in 2021, which was around 11.6 percent of the population. Approximately 19.5 percent of those in poverty were Black, while 8.2 percent were white.

About 50.4 percent of the household income of private households in the U.S. were earned by the highest quintile in 2023, which are the upper 20 percent of the workers. In contrast to that, in the same year, only 3.5 percent of the household income was earned by the lowest quintile. This relation between the quintiles is indicative of the level of income inequality in the United States. Income inequalityIncome inequality is a big topic for public discussion in the United States. About 65 percent of U.S. Americans think that the gap between the rich and the poor has gotten larger in the past ten years. This impression is backed up by U.S. census data showing that the Gini-coefficient for income distribution in the United States has been increasing constantly over the past decades for individuals and households. The Gini coefficient for individual earnings of full-time, year round workers has increased between 1990 and 2020 from 0.36 to 0.42, for example. This indicates an increase in concentration of income. In general, the Gini coefficient is calculated by looking at average income rates. A score of zero would reflect perfect income equality and a score of one indicates a society where one person would have all the money and all other people have nothing. Income distribution is also affected by region. The state of New York had the widest gap between rich and poor people in the United States, with a Gini coefficient of 0.51, as of 2019. In global comparison, South Africa led the ranking of the 20 countries with the biggest inequality in income distribution in 2018. South Africa had a score of 63 points, based on the Gini coefficient. On the other hand, the Gini coefficient stood at 16.6 in Azerbaijan, indicating that income is widely spread among the population and not concentrated on a few rich individuals or families. Slovenia led the ranking of the 20 countries with the greatest income distribution equality in 2018.

This paper employs a recently developed instrumental quantile regression method to investigate the effect of Medicaid on household savings across different wealth groups. It finds that the disincentive effect of Medicaid on household savings is heavily concentrated in the middle net-worth households. In contrast, the effects on the bottom and top net-worth households are quite small and insignificant. These heterogeneous incentive effects are partly explained by Medicaid asset tests. Our findings hold regardless of whether affluence is measured in terms of wealth or income. They suggest that despite generating substantial crowd-out for the mean household, Medicaid expansions are unlikely to discourage the savings of the poorest households.