Statement by Census Bureau Director John H. Thompson on Improved Health Insurance Questions in the Current Population Survey

WASHINGTON, April 15, 2014 /PRNewswire-USNewswire/ -- The recent changes to the Current Population Survey's questions related to health insurance coverage is the culmination of 14 years of research and two national tests in 2010 and 2013 clearly showing the revised questions provide more precise measures of health insurance through improved respondent recall. 

This change was announced in September 2013 and implemented because the evidence showed that reengineering the questions provides demonstrably more accurate results. The Census Bureau only implements changes in survey methodology based on research, testing, and evidence presented for peer review.

The revised questions were implemented in the Current Population Survey beginning in February 2014 in time for data collection covering calendar year 2013, and thus will provide a more accurate baseline for assessments of changes in insurance coverage, including that of the Affordable Care Act.

Additional Background

Based on more than a decade of comprehensive research to improve the measure of the Nation's uninsured population and give the country better data, the U.S. Census Bureau redesigned the health insurance coverage questions for the Current Population Survey. The new method captures current health insurance coverage, in addition to coverage throughout the entire year.  Results from two separate national test of the new questions in 2010 and 2013 showed that the new method captured health insurance coverage better than the old method. Specifically, it improved the respondent recall of when they were covered by health insurance and then works backwards through time about specific months of coverage. Based on the test results and 14 years of research, the new questions were included in this the February, March and April CPS (reflecting the collection of data for 2013). The CPS will act to provide an accurate baseline for 2013 to facilitate the assessment of the impact of the Affordable Care Act implemented in 2014.

Additionally, The American Community Survey, the largest household survey conducted by the Census Bureau, has collected health insurance coverage information since 2008 and provides additional measure of health insurance coverage at the nation, state and local levels on an annual basis.  However, unlike the Current Population Survey, the ACS only asks respondents about a specific point in time.

Published Research 

2013 Content Test

Changing the CPS Health Insurance Questions And The Implications On The Uninsured Rate: Redesign and Production Estimates
http://www.census.gov/hhes/www/hlthins/publications/sehsd_wp_2014-16.pdf

2010 Survey of Health Insurance and Program Participation

SHADAC Report: SHADAC Analysis of the Survey of Health Insurance and Program Participation
http://www.shadac.org/files/shadac/publications/SHIPP_final_report.pdf

Previous Research Leading to the Redesigned Questionnaire

2009: Findings from a Pretest of a New Approach to Measuring Health Insurance in the Current Population Survey
http://www.census.gov/srd/papers/pdf/rsm2009-07.pdf

2007: Measuring Health Insurance in the U.S.
http://www.census.gov/srd/papers/pdf/rsm2007-11.pdf

2002: The Effects of Person-Level VS. Household-Level

Questionnaire Design on Survey Estimates and Data Quality
http://www.census.gov/srd/papers/pdf/rsm2002-05.pdf

Research Unavailable Online

Pascale, Joanne, Marc I. Roemer and Dean M. Resnick, 2009. Medicaid Underreporting in the CPS: Results from a Record Check Study. 2010. Survey Methodology for Public Health Researchers: Selected Readings from 20 years of Public Opinion Quarterly. Frank J. Fowler Jr. (guest editor). Online ISSN 1537-5331 - Print ISSN 0033-362X. Also in Public Opinion Quarterly 2009 73: 497-520.

Pascale, J. (2009). "Health Insurance Measurement: A Synthesis of Cognitive Testing Results."  Paper presented at the Questionnaire Evaluation Standards (QUEST) meeting, Bergen, Norway.

Pascale, J. (2009). "Survey Measurement of Health Insurance Coverage Cognitive Testing Results of Experimental Questions on Integrated Current and Calendar Year Coverage." Unpublished Census Bureau report. February 3, 2009.

Pascale, Joanne (2008/9). "Assessing Measurement Error in Health Insurance Reporting: A Qualitative Study of the Current Population Survey." Inquiry Journal 45(5) Winter 2008/2009 pp 422-437.

Pascale, J. (2007), "Questionnaire Design Experimental Research Survey (QDERS) 2004 Results Overview." Unpublished Census Bureau report. August 29, 2007.

Pascale, J. (2006), "Measuring Health Insurance in the U.S." Proceedings of the American Association for Public Opinion Research (AAPOR), American Statistical Association, 2006.

Pascale, J. (2004), "Medicaid and Medicare Reporting in Surveys: An Experiment on Order Effects and Program Definitions." Proceedings of the American Association for Public Opinion Research (AAPOR), American Statistical Association.

Pascale, J. (2003) Questionnaire Design Experimental Research Survey (QDERS) 2004 Cognitive Testing Results on Health Insurance Questions. Unpublished Census Bureau report. November 5, 2004.

Pascale, J.  (2001), "Measuring Private and Public Health Coverage: Results from a Split-Ballot Experiment on Order Effects."  Paper presented at the 2001 Annual Meetings of the American Association for Public Opinion Research, Proceedings of the Section on Survey Research Methods, American Statistical Association, 2001.

Hess, J., J. Moore, J. Pascale, J. Rothgeb, and C. Keeley (2001), "The Effects of Person-level vs. Household-level Questionnaire Design on Survey Estimates and Data Quality." Public Opinion Quarterly Winter 2001 65:574-584.

Pascale, J. (1999) "Methodological Issues in Measuring the Uninsured."  Paper presented at the Seventh Health Survey Research Methods Conference, Proceedings. U.S. Dept. of Health and Human Services, National Center for Health Statistics. Hyattsville, Maryland, pp. 167-173.

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SOURCE U.S. Census Bureau