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The Number of Uninsured: Challenges in Measuring a Key Health Indicator

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The Number of Uninsured: Challenges in Measuring a Key Health Indicator

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    3. Data Sources for Counting the Uninsured Current Population Survey (CPS) Survey of Income and Program Participation (SIPP) Medical Expenditure Panel Survey (MEPS) National Health Interview Survey (NHIS)

    4. Advantages of Using the CPS Largest sample size Allows analysis of sub-populations Allows analysis of all 50 states Data released within months of completed interviews Allows for trend analysis over time

    5. Problems with the CPS Estimates Likely over-count of those uninsured throughout the previous full calendar year Likely under-count of those covered by Medicaid at some point in the previous calendar year

    6. Estimates of the Number of Uninsured, 2002 (in Millions)

    7. Access and Utilization of Care by Duration of Health Coverage, 1998-99

    8. Medicaid Estimates, 2000, “Ever Covered/Enrolled”

    9. Examples of Types of Recall Error Short periods of Medicaid coverage forgotten Unaware of continued coverage for all household members (e.g., automatic continuous eligibility) Medicaid-HMO cards

    10. Sources of Potential Error in Medicaid Program Enrollment Data Change in Medicaid eligibility examples: family income, move to new state Duplication on Medicaid enrollment lists examples: children identified as living in both of separated parents’ households

    11. CPS Adjustments for Medicaid Enrollment Census adjusts Medicaid estimate based on: Eligibility for public assistance Imputations for missing responses Adjustment has grown less valid as Medicaid and cash assistance were delinked

    12. Adjusted CPS Full-Year Uninsured Estimates

    13. Experimental Studies: Percent of Medicaid/SCHIP Enrollees Who Report Being Uninsured

    14. Reasons why the CPS remains the most widely-used uninsured estimate Largest sample size of 4 national surveys Allows for key subpopulations to be studied Allows for annual state estimates Data released soon after survey completed Provides trends in health insurance coverage over several years

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