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Analysis of Transition Events in Health Insurance Coverage
Contents
Data
Health Insurance Dynamics
Obtaining Coverage: Transitions out of the Uninsured State
Changing and Losing Coverage: Transitions into the Uninsured State
Conclusion
Policy Implications
Research Priorities
Overview of the Uninsured in the United States: A Summary of the 2011 Current Population Survey
According to the Census Bureau's 2011 Current Population Survey (CPS), there were 49.9 million uninsured individuals in 2010, or 16.3% of the total population. Those that lack insurance are a diverse group. Understanding the uninsured population is important for policy makers looking to design solutions to the problem. [5 PDF pages]
ib.pdf
Analysis of Transition Events in Health Insurance Coverage
The number of people lacking health insurance coverage in the U.S. is sustained by a set of dynamic processes. Comparatively few of the uninsured remain in that state indefinitely, but uninsured persons who gain coverage are offset by insured persons who lose their coverage. In good economic times the balance shifts toward the gainers, and uninsur
index.pdf
An Overview of the US Health System Chart Book
This chart book provides data on various aspects of the US health system including public and private health care coverage, provider data, and international comparisons of the US to OECD countries. [128 PDF pages]
report.pdf
Understanding Estimates of the Uninsured: Putting The Differences In Context
A discussion of the various government surveys that produce estimates of the number of people without health insurance.
ib.pdf
Overview of the Uninsured in the United States: an Analysis of the 2005 Current Population Survey
According to the Census Bureau's 2005 Current Population Survey (CPS), 45.8 million individuals in 2004 or 15.7% of the civilian non-institutionalized population were uninsured. Those that lack insurance represent a diverse group. Understanding the uninsured population is important for policy makers looking to design solutions to the problem. This
ib.pdf
TRIM3's 2001 Baseline Simulation of the Medicaid and SCHIP Eligibility and Enrollment: Methods and Results
The TRIM microsimulation model produces a baseline of Medicaid and SCHIP eligibility and enrollment using adjustments that correct for the undercount in program participation on the Current Population Survey (CPS). This report presents a detailed explanation of the TRIM mmethodology.
report.pdf
Estimating the Number of Individuals in the U.S. Without Health Insurance
The Census Bureau's Current Population Survey (CPS) has long served as the most widely-cited source of statistics on the nation's uninsured. But over time, the CPS has undergone several methodological changes that create some inconsistency in the time series of uninsured date. This report presents the Acturarial Research Corporation's (ARC) adjust
report.pdf
TechAppendix.pdf
Understanding Estimates of the Uninsured: Putting the Differences in Context
ASPE ISSUE BRIEF
Understanding Estimates of the Uninsured: Putting the Differences in Context
U.S. Department of Health and Human Services Office of the Assistant Secretary for Planning and Evaluation
Updated September 2005
ib.pdf
TRIM3's 2001 Baseline Simulation of the Medicaid and SCHIP Eligibility and Enrollment: Methods and Results,
TRIM3's 2001 Baseline Simulation of Medicaid and SCHIP Eligibility and Enrollment:
Methods and Results
TRIM3 Microsimulation Project Technical Paper
April 2005
By: Linda Giannarelli, Paul Johnson, Sandi Nelson, and Meghan Williamson Urban Institute
report.pdf
Estimating the Number of Individuals in the U.S. Without Health Insurance. Executive Summary
Although there are multiple sources of data on the uninsured, the Census Bureau’s Annual Social and Economics Supplement (ASEC) to the Current Population Survey (CPS) is often the main focus of analytic work. Some of the reasons for this are: it is the most widely cited source of data, it has the largest sample size of any major survey with data
Estimating the Number of Individuals in the U.S. Without Health Insurance. Conclusions
We have presented a series of refinements to the CPS to create a consistent time series of data on insured lives from 1989 to 2003. The major differences between the unadjusted and adjusted data during this time period are in the distributions by age (children's uninsured rates are substantially lower) and by income (the proportion of the uninsure
Estimating the Number of Individuals in the U.S. Without Health Insurance. Implications of the Adjusted CPS Estimates
The estimates from the March 2004 CPS can tell two stories: one of level and one of trend. Starting with the unadjusted CPS data, the level of uninsured was 45.0 million with a relatively flat trend since 1994, with the exception of a change due to the introduction of the verification questions. With the adjustment for verification, the trend beco
Estimating the Number of Individuals in the U.S. Without Health Insurance. Medicaid Undercount
As mentioned previously, the CPS has historically generated an “ever covered” count of Medicaid persons well below that reported by CMS administrative data for the civilian noninstitutionalized population. For CY 1995, the CPS showed just over 30 million persons covered by Medicaid.
Estimating the Number of Individuals in the U.S. Without Health Insurance. Adjusting for SCHIP
In 1998, the State Children’s Health Insurance Program (SCHIP) was implemented, and since then has become a growing source of coverage for children. In March 2001, the CPS added a question to measure coverage under SCHIP. 8 As with the verification question, the methodology mimicked the effect of the new SCHIP question as if it has been asked i
Estimating the Number of Individuals in the U.S. Without Health Insurance. Adjusting for Verification
The March 2000 CPS added a question to verify that individuals who indicate they lack coverage are indeed uninsured. 7 The uninsured on the CPS had historically been a “residual” of those who answered they did not have other coverage types.
Research from other surveys suggested that asking individuals directly if they were uninsured would c
Estimating the Number of Individuals in the U.S. Without Health Insurance. Employer Sponsored Insurance (ESI) Adjustments
Due to changes in the CPS over time, as well as Census assumptions in recoding the unadjusted data, there were significant discontinuities in the ESI estimates that needed to be adjusted for, in order to be able present a consistent time series. Our three main issues are: age of ESI policy holder, addressing coverage from outside the household, an
Estimating the Number of Individuals in the U.S. Without Health Insurance. Updating the Survey Weights
The March CPS includes a supplement weight which allows the records to sum to the total non-institutionalized population. Each person is assigned a weight based on person characteristics (such as race, etc) such that the records sum to the total population in accordance with the Bureau’s projections of Decennial Census population levels.
Estimating the Number of Individuals in the U.S. Without Health Insurance. Survey Revisions Through Time
As noted earlier, there have been changes to the CPS over time that have clarified the estimates of specific insurance classes as well as changes that have affected the measurement of overall levels of insurance coverage. These changes have included the following: