The percentage of U.S. adults with high medical costs held steady, at around 19 percent, during the period 2006 to 2009, despite the severe recession during this time, a new Health Affairs study finds. According to Peter Cunningham, Ph.D., the author of the Commonwealth Fund–supported analysis, declines in family income during the recession were offset by a decrease in out-of-pocket spending on health services—a reflection, he says, of greater reliance on generic prescription drugs, not a decrease in the use of services.