Full Citation
Title: Comparison of 2017 to 2018 Changes in Insurance Coverage Across Surveys
Citation Type: Miscellaneous
Publication Year: 2020
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Abstract: This brief compares changes in health coverage between 2017 and 2018 as measured by the American Community Survey (ACS), the Current Population Survey (CPS), and the National Health Interview Survey (NHIS). Estimates of health insurance coverage vary across surveys because of differences in question design, question order, sampling strategy, and sample size. Additionally, surveys request information about health insurance coverage questions from different time frames, such as coverage at the time of the survey or over the past calendar year. Prior research found increasing uninsurance as measured by the ACS between 2016 and 2017, despite economic improvements. Our analysis of the 2018 ACS found insurance coverage continued declining between 2017 and 2018, though at a slower rate than reported by the U.S. Census Bureau using the CPS. These declines in coverage occurred despite economic improvements such as increasing household incomes, increasing employment, and falling poverty, which we would expect to increase coverage rates. However, health insurance gains from these economic improvements may have been offset to some degree by losses of Medicaid coverage due to increasing incomes and changes in health insurance marketplace policies that may have limited enrollment. Between 2017 and 2018, funding for federal marketplace navigators and outreach programs fell. In addition, the Trump Administration ceased making cost-sharing reduction payments to marketplace insurers in 2018 while the law continued to require those insurers to offer reduced cost-sharing to low-income enrollees, substantially increasing premiums for enrollees ineligible for incomebased subsides. Finally, in 2018, the marketplace open enrollment window lasted only six weeks, from November 1 to mid-December, compared to a three-month open enrollment window in prior years. In addition, an aggressive, albeit ultimately unsuccessful, legislative effort to repeal the Affordable Care Act (ACA) led to considerable confusion among consumers that may have reduced 2018 enrollment. This brief explores how coverage changes between 2017 and 2018 compare among the ACS, CPS, and NHIS. Comparing across multiple surveys allows for triangulation of the likely “true” change in uninsurance, Medicaid, and private nongroup coverage between 2017 and 2018.
User Submitted?: No
Authors: Aarons, Joshua; Skopec, Laura
Publisher: Robert Wood Johnson Foundation
Data Collections: IPUMS USA, IPUMS CPS, IPUMS Health Surveys - NHIS
Topics: Population Health and Health Systems
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