Health Insurance Coverage in 2013: Gains in Public Coverage Continue to Offset Loss of Private Insurance

Overview, Data and Methods
  1. Blavin, F., Holahan, J., Kenney, G., and Chen, V. 2013. A Decade of Coverage Losses: Implications for the Affordable Care Act. The Urban Institute. Available at: http://www.urban.org/UploadedPDF/412514-Implications-for-the-Affordable-Care-Act.pdf.

    ← Return to text

  2. Holahan, J. and McGrath, M. 2014. As the Economy Improves, the Number of Uninsured is Falling but not because of a Rebound in Employer Sponsored Insurance. Kaiser Family Foundation. Available at: https://www.kff.org/uninsured/issue-brief/as-the-economy-improves-the-number-of-uninsured-is-falling-but-not-because-of-a-rebound-in-employer-sponsored-insurance/ ; Holahan, J. and McGrath, M. 2013. Reversing the Trend? Understanding the Recent Increase in Health Insurance Coverage among the Nonelderly Population. Kaiser Family Foundation. Available at: https://www.kff.org/uninsured/issue-brief/reversing-the-trend-understanding-the-recent-increase-in-health-insurance-coverage-among-the-nonelderly-population/; and Holahan, J. and Chen, V. 2011. Changes in Health Insurance Coverage in the Great Recession, 2007-2010. Kaiser Family Foundation. Available at: https://www.kff.org/medicaid/issue-brief/changes-in-health-insurance-coverage-in-the/.

    ← Return to text

  3. O’Hara, B. and Medalia, C. 2014. CPS and ACS Health Insurance Estimates: Consistent Trends from 2009-2012. SEHSD Working Paper 2014-29. Available at: https://www.census.gov/hhes/www/hlthins/data/incpovhlth/2013/CPS_ACS_Trends.pdf

    ← Return to text

  4. United States Census Bureau. Fact Sheet – Differences Between CPS ASEC and ACS. Available at: https://www.census.gov/hhes/www/poverty/about/datasources/factsheet.html.

    ← Return to text

  5. The HIU is a unit of analysis for determining family income that more accurately reflects eligibility for public assistance than does analysis at the household level. The HIU includes members of a family who can be covered under one health insurance policy, such as the policyholder, spouse, children under age 19, and full-time students under age 23. The household, by contrast, may include other relatives or unrelated individuals.

    ← Return to text

  6. Steven Ruggles, J. Trent Alexander, Katie Genadek, Ronald Goeken, Matthew B. Schroeder, and Matthew Sobek. Integrated Public Use Microdata Series: Version 5.0 [Machine-readable database]. Minneapolis: University of Minnesota, 2010. Further information on the creation of the ACS iPUMS files is available at: www.ipums.org.

    ← Return to text

  7. For further details, see Lynch, V. Kenney, G.M., Haley, J., and Resnick, D. 2011. Improving the Validity of the Medicaid/CHIP Estimates on the American Community Survey: The Role of Logical Coverage Edits. Report to the U.S. Census Bureau. Available at: http://www.census.gov/hhes/www/hlthins/publications/Improving%20the%20 Validity%20of%20the%20Medicaid-CHIP%20Estimates%20on%20the%20ACS.pdf

    ← Return to text

  8. Ibid and Haley, J.M., Lynch, V., and Kenney, G.M. 2014. The Urban Institute Health Policy Center’s Medicaid/CHIP Eligibility Simulation Model. The Urban Institute. Available at: http://www.urban.org/publications/413069.

    ← Return to text

  9. Ibid

    ← Return to text

Issue Brief
  1. Bureau of Labor Statistics. “Labor Force Statistics from the Current Population Survey.” March 19, 2015. Available at: http://data.bls.gov/timeseries/LNS14000000.

    ← Return to text

  2. The public use file of the American Community Survey does not include a postmark or interview date, so it is not possible to determine whether the 200,000 additional young adults with private non-group coverage enrolled before or after October 2013.

    ← Return to text

  3. While 2007 may provide a better pre-recession measure, the ACS did not begin asking about health insurance until the 2008 survey year. Official recession dates from National Bureau of Economic Research.

    ← Return to text

  4. Given the relative stability of and limited eligibility for military and Medicare coverage among the nonelderly population, this coverage is not shown throughout this brief.

    ← Return to text

  5. This coverage type includes Medicaid, CHIP, and other state coverage programs for those with low incomes or a disability.

    ← Return to text

  6. Sommers, B.D, Kenney, G.M., and Epstein, A.M. 2014. “New Evidence on the Affordable Care Act: Coverage Impacts of Early Medicaid Expanions.” Health Affairs 33(1): 78-87.

    ← Return to text

  7. Sommers, B.D., Buchmueller, T., Decker, S.L., Carey, C., and Kronick, R. 2013. The Affordable Care Act Has Led to Significant Gains in Health Insurance and Access to Care for Young Adults. Health Affairs 32(1): 165-174.

    ← Return to text

  8. The other group includes Asians, Pacific Islanders, American Indians, Alaska Natives, and anyone reporting two or more races.

    ← Return to text

  9. High ESI industries are those with ESI coverage rates of more than 80 percent in 2012 and consist primarily of finance, manufacturing, information and communications firms. Low ESI industries had ESI coverage rates of less than 80 percent in 2012 and consist primarily of agriculture, construction, and wholesale and retail trade.

    ← Return to text