Using an experimental "supplemental poverty measure," the Census Bureau finds that when health care costs are subtracted from family incomes, 10 million more people in the United States become officially poor. In a blog post, The Commonwealth Fund's Sara Collins, Ph.D., and colleagues says that of all the new dimensions in the supplemental poverty measure—which also takes into account in-kind income transfers like food stamps as well as significant costs like payroll taxes—out-of-pocket health care spending has the greatest overall effect on poverty.