7. Virginia
> Supplemental poverty rate 2011-2013: 13.6% (24th highest)
> Official poverty rate: 10.9% (10th lowest)
> State price level:10th highest
> Pct. without health insurance: 12.3% (20th lowest)

Under the official poverty measure, about 880,000 Virginia residents, or 10.9%, lived in poverty between 2011 and 2013. This was the 10th lowest rate in the nation. However, under the supplemental poverty measure, nearly 1.1 million Virginians, or 13.6%, lived in poverty in that time, 211,000 higher than the official measure. Moreover, the supplemental poverty rate was among the top half of all states. Among the factors that may contribute to this disparity are the relatively low share of households participating in federal social safety net programs. Just 28.3% of households received Social Security payments last year, 10% of households received food stamps, and 4.1% received Supplemental Security Income, in each case among the bottom 15 states nationwide.

6. Maryland
> Supplemental poverty rate 2011-2013: 13.4% (25th highest)
> Official poverty rate: 9.9% (2nd lowest)
> State price level:5th highest
> Pct. without health insurance: 10.2% (10th lowest)

Less than 10% of Maryland residents lived below the official poverty line last year, lower than in every state except for New Hampshire. Yet, after taxes and supplemental measures were taken into account, this rate increased 3.5 percentage points. Maryland residents are exceptionally wealthy. For example, an average retirement-aged resident had an income of $30,678 in 2013, the highest nationwide. Despite the relatively high retirement income, poverty among Maryland seniors was more than twice as high based on the supplemental measure than under the official measure, according to a 2013 report from the Kaiser Family Foundation.

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5. Nevada
> Supplemental poverty rate 2011-2013: 20.0% (2nd highest)
> Official poverty rate: 16.3% (13th highest)
> State price level:21st highest
> Pct. without health insurance: 20.7% (2nd highest)

Nevada’s average poverty rate from 2011 to 2013 using the supplemental poverty measure was 20%, the second highest in the nation. One reason for the high rate may be the state’s relatively low EITC participation rate. Just 71.5% of eligible income tax filers claimed an earned income tax credit in the 2010 tax year, among the lowest rates nationwide. Additionally, many households may have to contend with high levels of out-of-pocket medical expenses. Last year, 20.7% of residents did not have health care coverage, the second highest rate in the nation. According to the Census Bureau, under the supplemental poverty measure, out-of-pocket medical costs are the top reason people fall into poverty.