John Lettieri, President and CEO of Economic Innovation Group | Official Website
John Lettieri, President and CEO of Economic Innovation Group | Official Website
Among all government transfer programs, Medicaid was the second smallest contributor in the county. Social Security was the largest contributor, totaling $115.83 million, equating to $3,213 per capita and making up 37.5% of total transfers.
Comparatively, Medicaid transfers across Iowa amounted to $6.99 billion, ranking second lowest among all transfer types within the state. This translates to an average of $2,185 per capita, or 20.3% of total government transfers. Including all transfer types, government transfer payments totaled $34.48 billion, accounting for 17.9% of residents’ total income, with an average of $10,773 per resident.
Medicare was the second largest contributor in Sioux County in 2022, accounting for $92.15 million, averaging $2,556 per capita, representing 29.9% of transfers. Income Maintenance transfers provided another $21.05 million, averaging $584 per capita and comprising 6.8% of government support, making them the smallest contributors.
Government transfer payments are non-repayable funds provided by federal, state, or local governments to support individuals in need. These payments aim to stabilize economic conditions and provide financial support during hardships. Key programs include Social Security transfers (retirement benefits), Medicare transfers (healthcare for seniors), Medicaid transfers (healthcare for low-income individuals), and income maintenance transfers (financial assistance for basic needs).
With 16.4% of the population aged 65 and older, Sioux County has a significant demand for programs like Social Security and Medicare. Despite this aid, the total per capita income in Sioux County, excluding government transfers was $58,789, which is below the county's total income of $67,349, emphasizing the role of government transfers in overall income.
When comparing 2022 to the previous year, Sioux County saw no change in its Medicaid transfer dependency.
Government transfers have long been a modest financial safety net, historically comprising only a small fraction of Americans' income. However, since the 1970s—sometimes dubbed the “Great Transfer-mation”—dependency has surged from 8.2% (or $2,022 per capita in inflation-adjusted 2022 dollars) in 1970 to 17.6% (or $11,542 per capita) in 2022 nationwide. In Sioux County, reliance on government transfers has similarly increased from 7.1% (or $1,501 per capita) in 1970 to 12.7% (or $8,560 per capita) in 2022.
According to the Economic Innovation Group’s analysis, these trends are not merely short-term responses to economic pressures but rather reflect a profound, long-term transformation in how government support is integrated into American life. The study illustrates that structural shifts—from rising healthcare expenses and demographic changes to stagnant wages—have significantly increased dependency on government transfers.
| County | Rank | Dependency on Transfers (%) | % Population 65+ | Social Security Transfers (%) | Medicare Transfers (%) | Medicaid Transfers (%) | Income Maintenance Transfers (%) | Per Capita Transfers ($) |
|---|---|---|---|---|---|---|---|---|
| Polk County | 1 | 15% | 14% | 5.3% | 3.1% | 3.7% | 1.5% | $9,413 |
| Linn County | 2 | 16.9% | 17.3% | 6.5% | 3.9% | 3.6% | 1.4% | $10,324 |
| Scott County | 3 | 17.7% | 17.6% | 6.3% | 4% | 3.9% | 1.9% | $11,177 |
| Black Hawk County | 4 | 21.2% | 17.8% | 7.7% | 4.8% | 4.7% | 2.2% | $11,318 |
| Johnson County | 5 | 12.2% | 13.3% | 4.8% | 2.6% | 2.4% | 1.2% | $7,627 |
| Pottawattamie County | 6 | 23.9% | 18.8% | 7.8% | 5.5% | 5.5% | 2.2% | $12,497 |
| Woodbury County | 7 | 21.1% | 15.6% | 6.7% | 4.6% | 5.4% | 2.4% | $10,754 |
| Dubuque County | 8 | 18.1% | 19.3% | 7.1% | 4.5% | 3.4% | 1.4% | $10,866 |
| Story County | 9 | 15% | 13.4% | 6% | 3.6% | 2.4% | 1.1% | $7,479 |
| Dallas County | 10 | 7.8% | 12.8% | 3.4% | 1.7% | 1.3% | 0.5% | $6,201 |
| Clinton County | 11 | 24.8% | 20.4% | 8.8% | 6.1% | 5.4% | 2.1% | $13,023 |
| Cerro Gordo County | 12 | 20.2% | 23.7% | 7.5% | 5.3% | 4% | 1.4% | $13,655 |
| Des Moines County | 13 | 23.1% | 21.4% | 8% | 5.5% | 4.8% | 2.2% | $13,973 |
| Warren County | 14 | 15.1% | 16.7% | 6.3% | 3.8% | 2.4% | 0.9% | $9,127 |
| Marshall County | 15 | 24.8% | 18.3% | 8.6% | 5.4% | 6.2% | 2.2% | $12,085 |
| Muscatine County | 16 | 20.8% | 18.3% | 7.8% | 4.9% | 4.5% | 2% | $11,296 |
| Wapello County | 17 | 28.4% | 18.6% | 8.8% | 6.9% | 7.1% | 3% | $12,990 |
| Lee County | 18 | 27.3% | 22% | 9.8% | 6.5% | 5.9% | 2.5% | $13,652 |
| Webster County | 19 | 22.9% | 19.7% | 7.8% | 5.6% | 5% | 2% | $12,228 |
| Jasper County | 20 | 21.8% | 19.7% | 8.7% | 5.1% | 4.4% | 1.7% | $11,022 |
| Marion County | 21 | 17.9% | 19.5% | 7.2% | 4.6% | 3.2% | 1.1% | $10,706 |
| Sioux County | 22 | 12.7% | 16.4% | 4.8% | 3.8% | 2.1% | 0.9% | $8,560 |
| Boone County | 23 | 20.8% | 20% | 8.2% | 4.9% | 4% | 1.3% | $11,247 |
| Benton County | 24 | 15% | 19.6% | 6.4% | 3.7% | 2.6% | 1% | $10,395 |
| Fayette County | 25 | 26% | 22.9% | 8.8% | 7.3% | 5.4% | 2% | $13,683 |
| Bremer County | 26 | 17.4% | 19.7% | 7.6% | 5% | 2.3% | 1% | $10,380 |
| Plymouth County | 27 | 15.1% | 19.5% | 6.1% | 4.4% | 2.4% | 0.9% | $10,186 |
| Washington County | 28 | 14.6% | 20.3% | 5.6% | 4.1% | 2.7% | 1% | $11,508 |
| Jackson County | 29 | 22.8% | 22.1% | 8.5% | 6.3% | 4.1% | 1.6% | $12,656 |
| Carroll County | 30 | 18.3% | 21.5% | 6.9% | 4.7% | 3.9% | 1.3% | $11,862 |
| Mahaska County | 31 | 21.5% | 19.2% | 7.8% | 5.3% | 4.5% | 1.9% | $11,039 |
| Dickinson County | 32 | 17.6% | 28.2% | 8.2% | 4.9% | 2.1% | 0.9% | $13,066 |
| Henry County | 33 | 23.2% | 19.8% | 8.6% | 6.1% | 4.4% | 1.9% | $11,630 |
| Clayton County | 34 | 21.2% | 25% | 7.8% | 6.5% | 3.5% | 1.3% | $13,690 |
| Jones County | 35 | 20.4% | 21% | 8.3% | 5.5% | 3.4% | 1.4% | $10,902 |
| Buchanan County | 36 | 18.1% | 18.7% | 7.2% | 4.8% | 3.2% | 1.3% | $10,847 |
| Winneshiek County | 37 | 18.2% | 23.1% | 7.5% | 5% | 2.3% | 0.9% | $11,134 |
| Page County | 38 | 26.9% | 24% | 9.4% | 8.8% | 4.8% | 1.8% | $14,318 |
| Hardin County | 39 | 19% | 23.7% | 7% | 5.8% | 3.1% | 1.3% | $13,078 |
| Jefferson County | 40 | 24.3% | 26.9% | 9.4% | 6.3% | 4.6% | 1.9% | $13,339 |
| Buena Vista County | 41 | 18.5% | 16.8% | 6% | 4.9% | 4% | 2% | $10,025 |
| Floyd County | 42 | 22.4% | 22.6% | 8.1% | 6.1% | 4.6% | 1.7% | $13,242 |
| Tama County | 43 | 20.4% | 20.7% | 7.9% | 5.2% | 4.1% | 1.6% | $11,840 |
| Poweshiek County | 44 | 19.2% | 21.5% | 8.2% | 4.9% | 3% | 1.3% | $10,792 |
| Clay County | 45 | 19.5% | 22.4% | 7.7% | 5.2% | 3.7% | 1.4% | $12,073 |
| Cass County | 46 | 25% | 23.5% | 8.8% | 7.5% | 5% | 1.8% | $14,767 |
| Kossuth County | 47 | 20% | 25.2% | 7.8% | 6.4% | 3% | 1.2% | $13,300 |
| Mills County | 48 | 18.3% | 20.5% | 6.3% | 4.3% | 4.1% | 1.1% | $12,959 |
| Harrison County | 49 | 21.3% | 20.1% | 7.4% | 5.9% | 3.9% | 1.5% | $12,406 |
| Cedar County | 50 | 15.1% | 21.3% | 6.9% | 3.7% | 2.3% | 0.9% | $9,879 |
| Crawford County | 51 | 20.3% | 18.4% | 7.2% | 5.4% | 4.4% | 1.8% | $11,087 |
| Delaware County | 52 | 16.6% | 21.5% | 6.9% | 4.4% | 2.7% | 1.1% | $10,098 |
| Butler County | 53 | 20.7% | 23.5% | 8.5% | 6.1% | 3.1% | 1.2% | $12,423 |
| Iowa County | 54 | 17.6% | 20% | 7.4% | 5% | 2.6% | 1% | $10,671 |
| Appanoose County | 55 | 30.3% | 24% | 10.2% | 7.8% | 6.6% | 2.7% | $14,476 |
| Hamilton County | 56 | 18.3% | 20.9% | 7% | 5.5% | 2.8% | 1.3% | $11,633 |
| Wright County | 57 | 19.3% | 22.4% | 6.5% | 5.5% | 4.4% | 1.3% | $13,586 |
| Union County | 58 | 28.8% | 21.1% | 9% | 8.1% | 6% | 2.4% | $14,422 |
| O'Brien County | 59 | 18.4% | 21.5% | 6.8% | 5.1% | 3.9% | 1.2% | $11,958 |
| Madison County | 60 | 16.9% | 17.5% | 6.9% | 4.3% | 2.6% | 1.1% | $9,830 |
| Allamakee County | 61 | 21.7% | 23.4% | 8.3% | 5.6% | 3.5% | 1.7% | $11,955 |
| Shelby County | 62 | 20.1% | 23.6% | 7.5% | 6.2% | 3.5% | 1.3% | $13,397 |
| Montgomery County | 63 | 29.4% | 22.3% | 10.1% | 9% | 5.6% | 2.3% | $14,815 |
| Guthrie County | 64 | 20% | 24% | 8.1% | 5.5% | 3.4% | 1.2% | $13,600 |
| Chickasaw County | 65 | 13.8% | 22.8% | 5.3% | 4.4% | 2.1% | 0.8% | $12,294 |
| Cherokee County | 66 | 15% | 25.1% | 6.1% | 4% | 2.6% | 0.9% | $12,473 |
| Winnebago County | 67 | 22.9% | 22.1% | 8.5% | 6.7% | 3.6% | 1.5% | $12,584 |
| Grundy County | 68 | 16.2% | 21.3% | 7.4% | 4.7% | 2.1% | 0.8% | $10,590 |
| Hancock County | 69 | 18% | 24% | 7% | 5.9% | 2.5% | 1% | $12,013 |
| Calhoun County | 70 | 20.5% | 23.6% | 7.8% | 6.6% | 3.3% | 1.3% | $13,175 |
| Keokuk County | 71 | 23.3% | 22.4% | 8.4% | 6.8% | 4.3% | 1.8% | $12,889 |
| Emmet County | 72 | 24.9% | 23.5% | 8.8% | 7.4% | 3.9% | 1.8% | $13,469 |
| Sac County | 73 | 16.2% | 24.2% | 6.5% | 5.1% | 2.3% | 1% | $12,638 |
| Mitchell County | 74 | 12.1% | 21.6% | 4.6% | 3.9% | 1.8% | 0.7% | $11,594 |
| Greene County | 75 | 22.4% | 23.9% | 8.4% | 6.7% | 4% | 1.6% | $13,863 |
| Franklin County | 76 | 18.7% | 22.2% | 7% | 5.4% | 3.3% | 1.3% | $12,147 |
| Louisa County | 77 | 21.2% | 20.3% | 8.4% | 5.5% | 3.9% | 1.6% | $11,229 |
| Monona County | 78 | 23.3% | 24.1% | 8.5% | 6.8% | 4.2% | 1.7% | $14,095 |
| Humboldt County | 79 | 20.3% | 21.7% | 7.3% | 6.4% | 3.4% | 1.3% | $12,297 |
| Clarke County | 80 | 24.5% | 19.2% | 8.2% | 6.6% | 5.3% | 2% | $11,832 |
| Howard County | 81 | 19% | 20.4% | 6.9% | 5.7% | 2.9% | 1.4% | $11,986 |
| Lyon County | 82 | 12.9% | 18.9% | 4.9% | 4.1% | 1.7% | 0.9% | $9,240 |
| Palo Alto County | 83 | 19.6% | 22.9% | 7.1% | 5.5% | 3.9% | 1.3% | $12,755 |
| Lucas County | 84 | 26% | 22.2% | 9.2% | 6.9% | 5.2% | 2.4% | $12,808 |
| Decatur County | 85 | 30% | 21.1% | 9.2% | 8.2% | 6.3% | 2.9% | $13,362 |
| Van Buren County | 86 | 27.7% | 22.9% | 9.7% | 9.2% | 4.5% | 2.1% | $13,284 |
| Monroe County | 87 | 22.9% | 20.2% | 8.1% | 6.7% | 4% | 1.7% | $12,571 |
| Fremont County | 88 | 23.3% | 24.4% | 8.5% | 7.1% | 3.9% | 1.6% | $14,565 |
| Adair County | 89 | 18.3% | 22.6% | 6.5% | 5.7% | 3.3% | 1.3% | $12,370 |
| Davis County | 90 | 18.7% | 18.4% | 6.7% | 5.6% | 3.2% | 1.4% | $9,666 |
| Pocahontas County | 91 | 19.6% | 24.1% | 7.6% | 5.5% | 3.3% | 1.5% | $12,435 |
| Ida County | 92 | 16% | 22.1% | 5.9% | 5.1% | 2.6% | 1.1% | $12,303 |
| Worth County | 93 | 20.1% | 22.6% | 8.1% | 5.2% | 3.2% | 1.4% | $11,130 |
| Taylor County | 94 | 24.1% | 22.5% | 8% | 8.3% | 3.8% | 1.9% | $13,862 |
| Wayne County | 95 | 22.7% | 22.8% | 8.4% | 6.2% | 4.3% | 2% | $12,089 |
| Audubon County | 96 | 19.8% | 25% | 7.5% | 6.1% | 3.3% | 1.3% | $13,703 |
| Ringgold County | 97 | 26.6% | 23.1% | 8.4% | 8.8% | 4.9% | 1.8% | $15,253 |
| Osceola County | 98 | 17.2% | 23% | 6.6% | 4.9% | 2.7% | 1.4% | $11,259 |
| Adams County | 99 | 22.3% | 24.6% | 7.2% | 7.7% | 4% | 1.7% | $15,106 |
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