People wait for lunch at a soup kitchen in Clarksburg on August 22, 2018 in Clarksburg, West Virginia.
Photo: Getty

A new study by the Urban Institute published Tuesday found that 40 percent of Americans can’t meet at least one basic need—food, healthcare, housing, or utilities—even as the economy approaches nearly full employment with only a 4.4 percent unemployment rate. Remember this as the president boasts about the stock market, as he does frequently, without realizing it’s an indictment of his policies: The people the president cares about are making obscene amounts of cash while the rest of America is falling behind.

The findings in the study reveal how widespread the struggle to meet basic needs is among Americans. Sixty percent of those who reported at least one hardship reported experiencing two or more. Almost a quarter of adults overall—23 percent—reported experiencing food insecurity in the last year. A total of 35 percent reported either problems paying medical bills or having an unmet medical need that they couldn’t afford to treat. More than half of black and Hispanic respondents reported experiencing at least one hardship compared to 34 percent of white people.

One interesting wrinkle: families who made just above the poverty line were more likely to report problems with medical bills than those below it, likely because of Medicaid, although a quarter of those below the poverty still reported struggling with medical bills. (The federal poverty level is $24,600 for a family of four.) This is the inevitable result of means testing access to government-funded healthcare and an indictment of how absurdly expensive healthcare is, even on the Affordable Care Act exchange.

Most devastating of all, the sickest are also the most vulnerable: 66 percent of those whose health was “fair or poor” experienced hardship. This echoes previous findings from the Kaiser Family Foundation, which found that even those with health insurance struggle to pay for care—their analysis found just under half of people in fair or poor health “are either uninsured or have affordability problems despite having health insurance.” The Urban Institute also found that 55 percent of those who had an unmet medical need experienced food insecurity, too—meaning those who are too poor to pay for medical care are also more likely to be too poor to eat.

All of this will only continue to get worse. Medicaid work requirements will push more people into that most vulnerable category of being sick, poor, and uninsured; the Trump administration’s plans to raise rents for the poorest will increase the likelihood of evictions and homelessness. The question you must ask yourself is: If unemployment is as low as it is and the stock market is at an all time high, where is all the money going?