Health Insurance Coverage in 2013: Gains in Public Coverage Continue to Offset Loss of Private Insurance
Overview, Data and Methods
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.
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/.
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
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.
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.
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.
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
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.
Bureau of Labor Statistics. “Labor Force Statistics from the Current Population Survey.” March 19, 2015. Available at: http://data.bls.gov/timeseries/LNS14000000.
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.
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.
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.
This coverage type includes Medicaid, CHIP, and other state coverage programs for those with low incomes or a disability.
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.
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.
The other group includes Asians, Pacific Islanders, American Indians, Alaska Natives, and anyone reporting two or more races.
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.