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WASHINGTON — A record number of Americans — 49.1 million — are poor, based on a new census measure that for the first time takes into account rising medical costs and other expenses.

The numbers released Monday are part of a first-ever supplemental poverty measure aimed at providing a fuller picture of poverty.

Although considered experimental, they promise to stir fresh debate over Social Security, Medicare and programs to help the poor as a congressional supercommittee nears a Nov. 23 deadline to make more than $1 trillion in cuts to the federal budget.

Based on the revised formula, the number of poor people exceeds the record 46.2 million, or 15.1 percent, that was officially reported in September.

Americans 65 or older sustained the largest increases in poverty under the revised formula — nearly doubling to 15.9 percent, or 1 in 6 — because of medical expenses that are not accounted for in the official rate. Those include rising Medicare premiums, deductibles and expenses for prescription drugs.

“As seniors choose between food and medicine, some lawmakers are threatening lifeline programs that provide a boost to those in poverty or a safety net to those grasping at the middle class,” said Jo Ann Jenkins, president of AARP Foundation, which represents the needs of older Americans. “With nearly 16 percent of seniors already living in poverty, our country cannot afford to slide further backward.”

Under the revised formula, the West had the most people in poverty at 19.4 percent. It was followed by the South (16.3 percent), the Northeast (14.5 percent) and the Midwest (13.1 percent).

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