In 2022, Medicare transfers in Douglas County totaled $1.18 billion, amounting to $2,006 per capita, or 22.3% of total government transfers, according to information from the Economic Innovation Group.
Among all government transfer programs, Medicare was the second largest contributor in the county. Social Security was the largest contributor, totaling $1.82 billion, equating to $3,104 per capita and making up 34.4% of total transfers.
Comparatively, Medicare transfers across Nebraska amounted to $5.04 billion, ranking second highest among all transfer types within the state. This translates to an average of $2,561 per capita, or 25% of total government transfers. Including all transfer types, government transfer payments totaled $20.2 billion, accounting for 16% of residents’ total income, with an average of $10,262 per resident.
Medicaid was the third largest contributor in Douglas County in 2022, accounting for $1.06 billion, averaging $1,810 per capita, representing 20.1% of transfers. Income Maintenance transfers provided another $580.6 million, averaging $990 per capita and comprising 11% 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 14.1% of the population aged 65 and older, Douglas County has a demand for programs like Social Security and Medicare. Despite this aid, the total per capita income in Douglas County, excluding government transfers was $64,834, which is below the county’s total income of $73,848, emphasizing the role of government transfers in overall income.
When comparing 2022 to the previous year, Douglas County saw no change in its Medicare 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 Douglas County, reliance on government transfers has similarly increased from 7.5% (or $1,960 per capita) in 1970 to 12.2% (or $9,013 per capita) in 2022.
According to the Economic Innovation Group’s analysis, these trends are not merely short-term responses to economic pressures but rather reflect a profound, long-term transformation in how government support is integrated into American life. The study illustrates that structural shifts—from rising healthcare expenses and demographic changes to stagnant wages—have significantly increased dependency on government transfers.
| County | Rank | Dependency on Transfers (%) | % Population 65+ | Social Security Transfers (%) | Medicare Transfers (%) | Medicaid Transfers (%) | Income Maintenance Transfers (%) | Per Capita Transfers ($) |
|---|---|---|---|---|---|---|---|---|
| Douglas County | 1 | 12.2% | 14.1% | 4.2% | 2.7% | 2.5% | 1.3% | $9,013 |
| Lancaster County | 2 | 15.2% | 15.4% | 5.4% | 3.5% | 2.8% | 1.3% | $9,158 |
| Sarpy County | 3 | 12.9% | 12.9% | 4.6% | 2.8% | 1.2% | 0.9% | $8,006 |
| Hall County | 4 | 18.7% | 15.7% | 6.1% | 4.1% | 3.7% | 2% | $10,069 |
| Buffalo County | 5 | 15% | 16.4% | 5.3% | 3.8% | 2.4% | 1.1% | $9,681 |
| Lincoln County | 6 | 22.2% | 21.2% | 5.4% | 5.8% | 3.4% | 1.5% | $14,359 |
| Scotts Bluff County | 7 | 24.8% | 20.9% | 7.9% | 6.2% | 4.8% | 2.3% | $13,225 |
| Dodge County | 8 | 20.2% | 18.9% | 7.3% | 5.3% | 3.8% | 1.6% | $11,958 |
| Madison County | 9 | 18.2% | 17.6% | 6.2% | 4.6% | 3.7% | 1.4% | $11,375 |
| Adams County | 10 | 20.7% | 19.4% | 7% | 5.2% | 4.1% | 1.6% | $12,381 |
| Gage County | 11 | 25.4% | 22.2% | 7.4% | 5.6% | 8.1% | 1.4% | $16,200 |
| Platte County | 12 | 17.4% | 18.5% | 6.7% | 4.9% | 2.4% | 1.3% | $9,803 |
| Cass County | 13 | 16.9% | 18.7% | 6.3% | 4.4% | 2.1% | 0.9% | $10,854 |
| Dawson County | 14 | 20.1% | 16.7% | 6.2% | 6% | 3.6% | 2% | $10,605 |
| Saunders County | 15 | 16.2% | 18.3% | 5.8% | 4.6% | 2.5% | 0.8% | $10,539 |
| Washington County | 16 | 14.5% | 19.1% | 6% | 4% | 2% | 0.7% | $10,127 |
| Otoe County | 17 | 21% | 20.4% | 7.4% | 6.5% | 3.3% | 1.2% | $12,166 |
| Dakota County | 18 | 17.2% | 14% | 6% | 3.5% | 3.6% | 2.2% | $8,971 |
| Seward County | 19 | 17.7% | 17.9% | 6.8% | 4.9% | 2.8% | 0.8% | $10,483 |
| York County | 20 | 20.1% | 20.4% | 7% | 5.4% | 4.2% | 1.1% | $12,192 |
| Box Butte County | 21 | 28.3% | 21.5% | 5.5% | 7.3% | 4.4% | 1.8% | $15,648 |
| Holt County | 22 | 23.5% | 23.3% | 6.7% | 7.5% | 4% | 1.4% | $14,862 |
| Saline County | 23 | 20.4% | 15.7% | 6.8% | 5.6% | 4.1% | 1.5% | $10,566 |
| Custer County | 24 | 24.3% | 22.7% | 7.1% | 7.9% | 3.8% | 1.3% | $14,225 |
| Red Willow County | 25 | 24.6% | 21.4% | 7.6% | 7.1% | 4.1% | 1.4% | $13,808 |
| Cheyenne County | 26 | 26.3% | 22.4% | 9.1% | 8.4% | 3.6% | 1.6% | $13,298 |
| Knox County | 27 | 25.5% | 25.7% | 8% | 7.3% | 4.7% | 1.6% | $14,975 |
| Richardson County | 28 | 26.3% | 24.9% | 8.5% | 9.4% | 3.5% | 1.7% | $15,378 |
| Phelps County | 29 | 21.1% | 20.2% | 7.1% | 6.2% | 3.9% | 1.2% | $13,143 |
| Keith County | 30 | 24.3% | 27.1% | 9.1% | 7.1% | 2.7% | 1.6% | $13,088 |
| Cuming County | 31 | 15.8% | 21.8% | 5.8% | 5% | 1.8% | 0.9% | $11,880 |
| Hamilton County | 32 | 16.7% | 20.6% | 6.8% | 4.7% | 2.1% | 0.9% | $11,143 |
| Jefferson County | 33 | 25% | 24.5% | 8.5% | 7.7% | 4.2% | 1.6% | $14,370 |
| Dawes County | 34 | 26.2% | 20.4% | 7.8% | 6.2% | 4% | 1.9% | $12,038 |
| Merrick County | 35 | 23.1% | 21.2% | 8.1% | 6.1% | 4.2% | 1.4% | $12,744 |
| Butler County | 36 | 18.9% | 20.4% | 6.9% | 5.3% | 3% | 1.1% | $11,363 |
| Cedar County | 37 | 18.2% | 22.6% | 6.6% | 5.7% | 1.9% | 1% | $11,411 |
| Burt County | 38 | 25.6% | 24.8% | 9.5% | 7.2% | 4.6% | 1.5% | $13,978 |
| Kearney County | 39 | 20.5% | 20.9% | 5.3% | 4.9% | 6.7% | 1% | $14,044 |
| Nemaha County | 40 | 23.7% | 20.5% | 7.8% | 6.9% | 4.5% | 1.5% | $13,078 |
| Colfax County | 41 | 15.4% | 14.1% | 4.8% | 4.1% | 2.8% | 1.6% | $8,585 |
| Wayne County | 42 | 17.3% | 16.2% | 5.8% | 4.4% | 3.1% | 1.1% | $8,962 |
| Thurston County | 43 | 23.1% | 12.7% | 5% | 5.1% | 7.1% | 4.4% | $13,122 |
| Antelope County | 44 | 19.5% | 24.5% | 6.2% | 5.7% | 3% | 1.2% | $13,420 |
| Fillmore County | 45 | 21.5% | 24.3% | 7.8% | 6.7% | 3% | 1% | $14,254 |
| Furnas County | 46 | 28.8% | 25.3% | 8.7% | 10.2% | 4.5% | 1.5% | $17,213 |
| Thayer County | 47 | 24.3% | 24.7% | 7.3% | 7.7% | 5.2% | 1.2% | $16,105 |
| Pierce County | 48 | 12.4% | 19.8% | 4.3% | 3.8% | 1.8% | 0.7% | $10,592 |
| Howard County | 49 | 20.9% | 22.4% | 7.3% | 6.7% | 2.1% | 1.2% | $11,799 |
| Clay County | 50 | 21.1% | 20.8% | 7.7% | 5.7% | 3.4% | 1.4% | $12,535 |
| Sheridan County | 51 | 20.9% | 27.3% | 6.6% | 5.9% | 3% | 1.5% | $14,692 |
| Cherry County | 52 | 24.1% | 22.5% | 7.6% | 7.3% | 3.3% | 1.8% | $13,029 |
| Boone County | 53 | 19.9% | 23.5% | 6.9% | 6.3% | 2.5% | 1.1% | $12,555 |
| Morrill County | 54 | 21.5% | 22.9% | 5.5% | 6.6% | 4% | 1.5% | $14,925 |
| Nuckolls County | 55 | 25.9% | 27.9% | 8.4% | 8.1% | 4.3% | 1.3% | $16,440 |
| Polk County | 56 | 18.3% | 24% | 7.3% | 5.5% | 2.3% | 1% | $11,929 |
| Dixon County | 57 | 19.7% | 22.6% | 7% | 6.2% | 2.6% | 1.4% | $10,866 |
| Valley County | 58 | 24% | 25% | 7.4% | 6.9% | 4.3% | 1.5% | $14,556 |
| Johnson County | 59 | 23.5% | 18.7% | 7% | 8.5% | 3.7% | 1.4% | $10,088 |
| Kimball County | 60 | 28.1% | 27.3% | 10.1% | 8.6% | 4.4% | 1.7% | $15,481 |
| Webster County | 61 | 26.8% | 22.4% | 7.9% | 8.5% | 5.3% | 1.6% | $15,214 |
| Chase County | 62 | 18.5% | 23.2% | 5.8% | 6.2% | 2.8% | 1% | $13,435 |
| Franklin County | 63 | 27.8% | 27.5% | 8.5% | 9.2% | 4.1% | 1.6% | $16,865 |
| Harlan County | 64 | 24.7% | 27.3% | 8.4% | 8.8% | 3% | 1.4% | $15,595 |
| Stanton County | 65 | 14.2% | 21% | 5.8% | 2.8% | 1.8% | 1% | $8,311 |
| Sherman County | 66 | 25.6% | 27.2% | 8.7% | 6.8% | 4.1% | 1.6% | $14,398 |
| Nance County | 67 | 26.7% | 20.6% | 7.5% | 4.4% | 8.1% | 1.7% | $12,729 |
| Hitchcock County | 68 | 27% | 25.6% | 9.1% | 7.2% | 4.5% | 1.7% | $15,826 |
| Brown County | 69 | 22.2% | 25.5% | 7.2% | 6.7% | 3.6% | 1.2% | $14,151 |
| Perkins County | 70 | 15.1% | 24.1% | 5.6% | 4.2% | 2.1% | 0.8% | $12,963 |
| Boyd County | 71 | 26.3% | 31.1% | 7.2% | 8.8% | 5.5% | 1.1% | $20,621 |
| Pawnee County | 72 | 23.7% | 29% | 7.8% | 7.7% | 3.7% | 1.6% | $13,260 |
| Garden County | 73 | 35.1% | 29.5% | 10.6% | 11% | 5% | 2% | $18,080 |
| Greeley County | 74 | 22.9% | 25.1% | 7.2% | 6.4% | 3.2% | 1.5% | $14,269 |
| Garfield County | 75 | 33.1% | 29.9% | 8.9% | 9.9% | 5.6% | 1.6% | $16,172 |
| Frontier County | 76 | 19.5% | 26% | 7% | 5.9% | 1.6% | 1.4% | $10,418 |
| Deuel County | 77 | 30.6% | 27.2% | 11.2% | 9.4% | 4.3% | 1.8% | $14,269 |
| Dundy County | 78 | 19.2% | 28.6% | 6% | 6.8% | 3.3% | 0.9% | $16,965 |
| Gosper County | 79 | 22.6% | 24.3% | 8.4% | 6.9% | 2.3% | 1.1% | $14,842 |
| Rock County | 80 | 17.6% | 28.5% | 6.8% | 3.8% | 2.6% | 1.1% | $12,648 |
| Keya Paha County | 81 | 24.4% | 31.6% | 8.2% | 8.4% | 1.5% | 1.1% | $14,254 |
| Hayes County | 82 | 16.3% | 27% | 5% | 5.4% | 1.5% | 1.1% | $12,453 |
| Hooker County | 83 | 34% | 28.6% | 12.2% | 9.2% | 5.4% | 1.7% | $14,815 |
| Sioux County | 84 | 13.7% | 31.2% | 6.2% | 3.2% | 0.4% | 1% | $8,988 |
| Thomas County | 85 | 22.4% | 29.5% | 7.3% | 7.2% | 1.5% | 1.2% | $14,823 |
| Loup County | 86 | 23% | 29.6% | 7.7% | 5.9% | 2.7% | 1.1% | $14,519 |
| Grant County | 87 | 30.2% | 24.3% | 10.3% | 9.9% | 1.9% | 1.9% | $14,686 |
| Wheeler County | 88 | 17.8% | 29% | 6.7% | 4.8% | 1.2% | 1.2% | $10,090 |
| Logan County | 89 | 21.9% | 26.3% | 7.7% | 6.3% | 1.9% | 1.8% | $11,551 |
| Banner County | 90 | 17.3% | 26.3% | 10.4% | 3.8% | 0.7% | 1.3% | $10,576 |
| Blaine County | 91 | 23.2% | 21.9% | 7% | 6.6% | 2.4% | 1.9% | $12,653 |
| Arthur County | 92 | 20.6% | 22.8% | 9.6% | 6.3% | 2% | 1.7% | $9,194 |
| McPherson County | 93 | 17.7% | 28.2% | 5.4% | 4.8% | 1.5% | 2% | $9,882 |
