HCR Update from Mark Sanna: Americans seem to be paying the price for the unrelenting rise in health care costs in this country, according to several studies being published last week in Health Affairs, an academic journal. The higher cost of coverage has taken a huge cut in the increase in income earned by the average family, says one study, and lower-income families are particularly hard hit, according to another. Meanwhile, the numbers of people who cannot afford insurance or do not have enough coverage have significantly increased, according to a third study.