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Texans’ Experiences with Health Care Affordability and Access

The Kaiser Family Foundation/Episcopal Health Foundation Texas Health Policy Survey was conducted by telephone March 28 – May 8, 2018 among a random representative sample of 1,367 adults age 18 and older living in the state of Texas (note: persons without a telephone could not be included in the random selection process). Interviews were administered in English and Spanish, combining random samples of both landline (439) and cellular telephones (928, including 688 who had no landline telephone). Sampling, data collection, weighting and tabulation were managed by SSRS in close collaboration with Kaiser Family Foundation and Episcopal Health Foundation researchers. Episcopal Health Foundation paid for the costs of the survey fieldwork, and Kaiser Family Foundation contributed the time of its research staff. Both partners worked together to design the survey and analyze the results.

The sampling and screening procedures included an oversample component designed to increase the number of respondents ages 18-64 with Medicaid or non-group health insurance coverage. This included 180 respondents who were reached by calling back respondents in Texas who had previously completed an interview on either the SSRS Omnibus poll or the Kaiser Health Tracking Polls and indicated they fit one of the oversample criteria (based on age and type of health insurance coverage). It also included an oversample of counties with higher shares of Medicaid recipients.

The dual frame cellular and landline phone sample was generated by Marketing Systems Group (MSG) using random digit dial (RDD) procedures. All respondents were screened to verify that they resided in Texas. For the landline sample, respondents were selected by asking for the youngest adult male or female currently at home based on a random rotation. If no one of that gender was available, interviewers asked to speak with the youngest adult of the opposite gender. For the cell phone sample, interviews were conducted with the qualifying adult who answered the phone.

A multi-stage weighting design was applied to ensure an accurate representation of the Texas adult population. The first stage of weighting involved corrections for sample design, including accounting for oversampling of high-Medicaid counties, as well as non-response for the callback sample. In the second weighting stage, demographic adjustments were applied to account for systematic non-response along known population parameters. Population parameters included gender, age, race, Hispanicity (broken down by nativity), educational attainment, phone status (cell phone only or reachable by landline), state region, and residence in a low-income county. This stage excluded the Medicaid and non-group oversample components. Based on this second stage of weighting, estimates were derived for types of health insurance coverage (Medicaid, non-group, employer-sponsored, all else) in the Texas population. The last stage of weighting included all respondents and included health insurance coverage based on the previous stage’s outcomes. Weighting parameters were based on estimates from the U.S. Census Bureau’s March 2017 Current Population Survey (CPS), with the exception of population density of the respondent’s county of residence which was based on the 2010 Census, and telephone use (cell phone-only, landline-only, dual-user) which was based on data from the January-June 2016 National Health Interview Survey.

The margin of sampling error including the design effect for the full sample is plus or minus 3 percentage points. For results based on subgroups, the margin of sampling error may be higher. Sample sizes and margins of sampling error for subgroups are available by request. Note that sampling error is only one of many potential sources of error in this or any other public opinion poll. Kaiser Family Foundation public opinion and survey research is a charter member of the Transparency Initiative of the American Association for Public Opinion Research.

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Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in Menlo Park, California.