In Her Hands (IHH) is a guaranteed income (GI) initiative aimed at addressing persistent economic insecurity among women in neighborhoods with some of Georgia’s highest poverty rates. Co-designed with local residents, the program delivered $20,400 over two years to 654 low-income women across urban, suburban, and rural areas.  

Findings: Unconditional cash transfers enabled participants to stabilize their finances, reduce debt, and build resilience against economic shocks. Over time, participants increased savings, pursued educational and employment goals, improved access to food and healthcare, and invested in their families and communities. As one of the first and largest GI programs in the U.S. South — and the first to include a rural site — IHH offers compelling evidence of the role guaranteed income can play in fostering financial security, advancing equity, and informing inclusive economic policy. 

This study examines the equity implications of high-deductible health plans within the context of racial and ethnic wealth disparities. Using restricted data from the Medical Expenditure Panel Survey, authors evaluate the net worth (in 2011–2018) and financial assets (in 2011–2016) of families with private insurance and those in high-deductible health plans with and without an associated health savings account.

Findings: Results represent the first estimates of racial and ethnic wealth disparities within these populations. Results show that white households consistently held significantly more wealth than did Black and Hispanic households across income levels. In the lowest income quartile, privately insured white families had more than 350% more in financial assets than their Black counterparts. Low-income Black and Hispanic families with high-deductible health plans but no savings accounts had median financial assets ($2,200 and $2,000, respectively) that were well below the average family coverage deductible.

Study findings highlight the role of systemic racial wealth disparities, beyond that of income, to establish a unique pathway whereby high deductibles can exacerbate health care inequities.
 

“Public option” health plans, particularly as enacted in Washington State, have had difficulty meeting their goals of improving affordability for patients and reducing overall health care costs. Some states have instead created a Basic Health Program (BHP), an alternative form of coverage authorized by the Affordable Care Act that replaces marketplace coverage for residents with low incomes who are eligible for premium subsidies. This policy brief analyzes the evolution of Washington’s public option and policy changes made in other states in response to initial rollout challenges and compares these with the policy goals and outcomes of BHPs.

Findings: Washington’s public option initially struggled with provider network participation and price competitiveness. Without sufficient network participation and robust enrollment, public options have few means to improve affordability or lower health care costs. BHPs are unlikely to face the same challenges. They contract with safety-net providers at Medicaid-like rates to cover all households with incomes between 138 percent and 200 percent of the federal poverty level who would otherwise be eligible for marketplace subsidies. A BHP can provide robust affordability with minimal out-of-pocket spending at a low cost to states and the federal government.

Authors propose a new, nationwide program of monthly cash payments that would automatically begin when economic indicators signal a recession and continue until the national unemployment rate begins to decrease. Building upon the successful pandemic direct cash payments which dramatically decreased poverty, this policy would provide automatic, monthly payments to working-class families at the first sign of recession, staving off unemployment and stabilizing families and the American economy. The report outlines key design features of a timely, effective, and anti-racist automatic cash payments policy and provides estimates of its benefits for families by race and income.