Data Dictionary: ACS 2009 (1-Year Estimates)
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Data Source: U.S. Census Bureau
Table: B27015. Health Insurance Coverage Status And Type By Household Income In The Past 12 Months (In 2009 Inflation-Adjusted Dollars) [26]
Universe: Civilian population living in households
Table Details
B27015. Health Insurance Coverage Status And Type By Household Income In The Past 12 Months (In 2009 Inflation-Adjusted Dollars)
Universe: Civilian population living in households
Relevant Documentation:
Excerpt from: Social Explorer; U.S. Census Bureau; American Community Survey 2009 Summary File: Technical Documentation.
 
Health Insurance Coverage
In 2009, data on health insurance coverage were derived from answers to Question 16, which was asked of all respondents. Respondents were instructed to report their current coverage and to mark "yes" or "no" for each of the eight types listed (labeled as parts 16a to 16h).

  1. Insurance through a current or former employer or union (of this person or another family member)
  2. Insurance purchased directly from an insurance company (by this person or another family member)
  3. Medicare, for people 65 and older, or people with certain disabilities
  4. Medicaid, Medical Assistance, or any kind of government-assistance plan for those with low incomes or a disability
  5. TRICARE or other military health care
  6. VA (including those who have ever used or enrolled for VA health care)
  7. Indian Health Service
  8. Any other type of health insurance or health coverage plan


Respondents who answered "yes" to question 16h were asked to provide their other type of coverage type in a write-in field.

Health insurance coverage in the ACS and other Census Bureau surveys define coverage to include plans and programs that provide comprehensive health coverage. Plans that provide insurance for specific conditions or situations such as cancer and long-term care policies are not considered coverage. Likewise, other types of insurance like dental, vision, life, and disability insurance are not considered health insurance coverage.

In defining types of coverage, write-in responses were reclassified into one of the first seven types of coverage or determined not to be a coverage type. Write-in responses that referenced the coverage of a family member were edited to assign coverage based on responses from other family members. As a result, only the first seven types of health coverage are included in the microdata file.

An eligibility edit was applied to give Medicaid, Medicare, and TRICARE coverage to individuals based on program eligibility rules. TRICARE or other military health care was given to active-duty military personnel and their spouses and children. Medicaid or other means-tested public coverage was given to foster children, certain individuals receiving Supplementary Security Income or Public Assistance, and the spouses and children of certain Medicaid beneficiaries. Medicare coverage was given to people 65 and older who received Social Security or Medicaid benefits.

People were considered insured if they reported at least one "yes" to Questions 16a to 16f. People who had no reported health coverage, or those whose only health coverage was Indian Health Service, were considered uninsured. For reporting purposes, the Census Bureau broadly classifies health insurance coverage as private health insurance or public coverage. Private health insurance is a plan provided through an employer or union, a plan purchased by an individual from a private company, or TRICARE or other military health care. Respondents reporting a "yes" to the types listed in parts a, b, or e were considered to have private health insurance. Public health coverage includes the federal programs Medicare, Medicaid, and VA Health Care (provided through the Department of Veterans Affairs); the Childrens Health Insurance Program (CHIP); and individual state health plans. Respondents reporting a "yes" to the types listed in c, d, or f were considered to have public coverage. The types of health insurance are not mutually exclusive; people may be covered by more than one at the same time.

The U.S. Department of Health and Human Services, as well as other federal agencies, use data on health insurance coverage to more accurately distribute resources and better understand state and local health insurance needs.

Question/Concept History
The ACS began asking questions about health insurance coverage in 2008. Because 2008 was the first year of collection, the Census Bureau limited the number and type of data products to simple age breakdowns of overall, private, and public coverage status. The evaluation of the 2008 data suggested that the data were of good quality, so the Census Bureau expanded the data products to include estimates of the specific types of coverage along with estimates about social, economic, and demographic details for people with and without health insurance.

For the 2008 data released September 2009, there was no eligibility edit applied. The eligibility edit that was developed for the 2009 was applied to the 2008 data during spring 2010. New estimates of health insurance coverage with this data are available at http://www.census.gov/hhes/www/hlthins/hlthins.html.

Limitation of the Data
The universe for most health insurance coverage estimates is the civilian noninstitutionalized population, which excludes active-duty military personnel and the population living in correctional facilities and nursing homes. Some noninstitutionalized GQ populations have health insurance coverage distributions that are different from the household population (e.g., the prevalence of private health insurance among residents of college dormitories is higher than the household population). The proportion of the universe that is in the noninstitutionalized GQ populations could therefore have a noticeable impact on estimates of the health insurance coverage. Institutionalized GQ populations may also have health insurance coverage distributions that are different from the civilian noninstitutionalized population, the distributions in the published tables may differ slightly from how they would look if the total population were represented.

Comparability
Health insurance coverage was added to the 2008 ACS and so no equivalent measure is available from previous ACS surveys or Census 2000. Because of the addition of the eligibility edit to 2009 ACS health insurance, data users should be careful as to which 2008 ACS estimates they use to make comparisons. National, state, county and place-level 2008 1-year data incorporating the eligibility edit are available at http://www.census.gov/hhes/www/hlthins/data/acs/2008/re-run.html; they are comparable to the 2009 estimates in American Fact Finder. For more information on the logical coverage (eligibility) edits, please see http://www.census.gov/hhes/www/hlthins/publications/coverage_edits_final.pdf.

Because coverage in the ACS references an individual's current status, caution should be taken when making comparisons to other surveys which may define coverage as "at any time in the last year" or "throughout the past year." A discussion of how the ACS health insurance estimates relate to other survey health insurance estimates can be found in "A Preliminary Evaluation of Health Insurance Coverage" in the 2008 American Community Survey (http://www.census.gov/hhes/www/hlthins/acs08paper/2008ACS_healthins.pdf).

Income of Households
This includes the income of the householder and all other individuals 15 years old and over in the household, whether they are related to the householder or not. Because many households consist of only one person, average household income is usually less than average family income. Although the household income statistics cover the past 12 months, the characteristics of individuals and the composition of households refer to the time of interview. Thus, the income of the household does not include amounts received by individuals who were members of the household during all or part of the past 12 months if these individuals no longer resided in the household at the time of interview. Similarly, income amounts reported by individuals who did not reside in the household during the past 12 months but who were members of the household at the time of interview are included. However, the composition of most households was the same during the past 12 months as at the time of interview.

Excerpt from: Social Explorer; U.S. Census Bureau; American Community Survey 2009 Summary File: Technical Documentation.
 
Income Type in the Past 12 Months
The eight types of income reported in the American Community Survey are defined as follows:

Wage or salary income
Wage or salary income includes total money earnings received for work performed as an employee during the past 12 months. It includes wages, salary, Armed Forces pay, commissions, tips, piece-rate payments, and cash bonuses earned before deductions were made for taxes, bonds, pensions, union dues, etc.

Self-employment income
Self-employment income includes both farm and non-farm self-employment income.

Farm self-employment income includes net money income (gross receipts minus operating expenses) from the operation of a farm by a person on his or her own account, as an owner, renter, or sharecropper. Gross receipts include the value of all products sold, government farm programs, money received from the rental of farm equipment to others, and incidental receipts from the sale of wood, sand, gravel, etc. Operating expenses include cost of feed, fertilizer, seed, and other farming supplies, cash wages paid to farmhands, depreciation charges, rent, interest on farm mortgages, farm building repairs, farm taxes (not state and federal personal income taxes), etc. The value of fuel, food, or other farm products used for family living is not included as part of net income.

Non-farm self-employment income includes net money income (gross receipts minus expenses) from ones own business, professional enterprise, or partnership. Gross receipts include the value of all goods sold and services rendered. Expenses include costs of goods purchased, rent, heat, light, power, depreciation charges, wages and salaries paid, business taxes (not personal income taxes), etc.

Interest, dividends, or net rental income
Interest, dividends, or net rental income includes interest on savings or bonds, dividends from stockholdings or membership in associations, net income from rental of property to others and receipts from boarders or lodgers, net royalties, and periodic payments from an estate or trust fund.

Social Security income
Social Security income includes Social Security pensions and survivor benefits, permanent disability insurance payments made by the Social Security Administration prior to deductions for medical insurance, and railroad retirement insurance checks from the U.S. government. Medicare reimbursements are not included.

Supplemental Security Income (SSI)
Supplemental Security Income (SSI) is a nationwide U.S. assistance program administered by the Social Security Administration that guarantees a minimum level of income for needy aged, blind, or disabled individuals. The Puerto Rico Community Survey questionnaire asks about the receipt of SSI; however, SSI is not a federally-administered program in Puerto Rico. Therefore, it is probably not being interpreted by most respondents in the same manner as SSI in the United States. The only way a resident of Puerto Rico could have appropriately reported SSI would have been if they lived in the United States at any time during the past 12-month reference period and received SSI.

Public assistance income
Public assistance income includes general assistance and Temporary Assistance to Needy Families (TANF). Separate payments received for hospital or other medical care (vendor payments) are excluded. This does not include Supplemental Security Income (SSI) or noncash benefits such as Food Stamps. The terms "public assistance income" and "cash public assistance" are used interchangeably in the 2009 ACS data products.

Retirement, survivor, or disability income
Retirement income includes: (1) retirement pensions and survivor benefits from a former employer; labor union; or federal, state, or local government; and the U.S. military; (2) disability income from companies or unions; federal, state, or local government; and the U.S. military; (3) periodic receipts from annuities and insurance; and (4) regular income from IRA and Keogh plans. This does not include Social Security income.

All other income
All other income includes unemployment compensation, workers compensation, Department of Veterans Affairs (VA) payments, alimony and child support, contributions received periodically from people not living in the household, military family allotments, and other kinds of periodic income other than earnings.