Data Dictionary: ACS 2010 -- 2012 (3-Year Estimates)
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Data Source: U.S. Census Bureau
Table: B27021. Health Insurance Coverage Status And Type By Living Arrangement [53]
Universe: Universe: Civilian noninstitutionalized population
Table Details
B27021. Health Insurance Coverage Status And Type By Living Arrangement
Universe: Universe: Civilian noninstitutionalized population
Variable Label
B27021001
B27021002
B27021003
B27021004
B27021005
B27021006
B27021007
B27021008
B27021009
B27021010
B27021011
B27021012
B27021013
B27021014
B27021015
B27021016
B27021017
B27021018
B27021019
B27021020
B27021021
B27021022
B27021023
B27021024
B27021025
B27021026
B27021027
B27021028
B27021029
B27021030
B27021031
B27021032
B27021033
B27021034
B27021035
B27021036
B27021037
B27021038
B27021039
B27021040
B27021041
B27021042
B27021043
B27021044
B27021045
B27021046
B27021047
B27021048
B27021049
B27021050
B27021051
B27021052
B27021053
Relevant Documentation:
Excerpt from: Social Explorer; U.S. Census Bureau; American Community Survey 2012 3yr Summary File: Technical Documentation.
 
Health Insurance Coverage
In 2012, data on health insurance coverage were derived from answers to Question 16 in the American Community Survey, 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 Children's 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 (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
(http://www.census.gov/hhes/www/hlthins/data/acs/2008/re-run.html); they are comparable to the 2009 estimates in American Fact Finder. Please see
http://www.census.gov/hhes/www/hlthins/publications/coverage_edits_final.pdf for more information on the logical coverage (eligibility) edits.

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/data/acs/2008/2008ACS_healthins.pdf).

Excerpt from: Social Explorer; U.S. Census Bureau; American Community Survey 2012 3yr Summary File: Technical Documentation.
 
Household Type and Relationship
The data on relationship to householder were derived from answers to Question 2 in the 2012 American Community Survey, relationship to the householder, which was asked of all people in housing units. The question on relationship is essential for classifying the population information on families and other groups. Information about changes in the composition of the American family, from the number of people living alone to the number of children living with only one parent, is essential for planning and carrying out a number of federal programs, such as families in poverty.

The responses to this question were used to determine the relationships of all persons to the householder, as well as household type (married couple family, nonfamily, etc.). From responses to this question, we were able to determine numbers of related children, own children, unmarried partner households, and multigenerational households. We calculated average household and family size. When relationship was not reported, it was imputed using the age difference between the householder and the person, sex, and marital status.

Household
A household includes all the people who occupy a housing unit. (People not living in households are classified as living in group quarters.) A housing unit is a house, an apartment, a mobile home, a group of rooms, or a single room that is occupied (or if vacant, is intended for occupancy) as separate living quarters. Separate living quarters are those in which the occupants live separately from any other people in the building and which have direct access from the outside of the building or through a common hall. The occupants may be a single family, one person living alone, two or more families living together, or any other group of related or unrelated people who share living arrangements.

Average Household Size
A measure obtained by dividing the number of people in households by the number of households. In cases where people in households are cross- classified by race or Hispanic origin, people in the household are classified by the race or Hispanic origin of the householder rather than the race or Hispanic origin of each individual. Average household size is rounded to the nearest hundredth.

Relationship to Householder
Householder
One person in each household is designated as the householder. In most cases, this is the person or one of the people in whose name the home is owned, being bought, or rented and who is listed on line one of the survey questionnaire. If there is no such person in the household, any adult household member 15 years old and over could be designated as the householder.

Households are classified by type according to the sex of the householder and the presence of relatives. Two types of householders are distinguished: a family householder and a non- family householder. A family householder is a householder living with one or more individuals related to him or her by birth, marriage, or adoption. The householder and all people in the household related to him or her are family members. A nonfamily householder is a householder living alone or with non-relatives only.

Spouse
Includes a person married to and living with a householder who is of the opposite sex of the householder. The category "husband or wife" includes people in formal marriages, as well as people in common-law marriages. In tabulations, unless otherwise specified, "Spouse" does not include same-sex married couples even if the marriage was performed in a state issuing marriage certificates for same-sex couples.

Includes a son or daughter by birth, a stepchild, or adopted child of the householder, regardless of the child's age or marital status. The category excludes sons-in-law, daughters-in-law, and foster children.

  • Biological son or daughter
- The son or daughter of the householder by birth.
  • Adopted son or daughter - The son or daughter of the householder by legal adoption. If a stepson or stepdaughter has been legally adopted by the householder, the child is then classified as an adopted child.
  • Stepson or stepdaughter - The son or daughter of the householder through marriage but not by birth, excluding sons-in-law and daughters-in-law. If a stepson or stepdaughter of the householder has been legally adopted by the householder, the child is then classified as an adopted child.


  • Own Child
    A never-married child under 18 years who is a son or daughter by birth, a stepchild, or an adopted child of the householder. In certain tabulations, own children are further classified as living with two parents or with one parent only. Own children of the householder living with two parents are by definition found only in married-couple families. (Note: When used in "EMPLOYMENT STATUS" tabulations, own child refers to a never married child under the age of 18 in a family or a subfamily who is a son or daughter, by birth, marriage, or adoption, of a member of the householder's family, but not necessarily of the householder.)

    Related Child
    Any child under 18 years old who is related to the householder by birth, marriage, or adoption. Related children of the householder include ever-married as well as never-married children. Children, by definition, exclude persons under 18 years who maintain households or are spouses or unmarried partners of householders.

    Other Relatives
    In tabulations, the category "other relatives" includes any household member related to the householder by birth, marriage, or adoption, but not included specifically in another relationship category. In certain detailed tabulations, the following categories may be shown:

    • Grandchild -
    The grandson or granddaughter of the householder.
  • Brother/Sister - The brother or sister of the householder, including stepbrothers, stepsisters, and brothers and sisters by adoption. Brothers-in-law and sisters-in-law are included in the "Other Relative" category on the questionnaire.
  • Parent - The father or mother of the householder, including a stepparent or adoptive parent. Fathers-in-law and mothers-in-law are included in the "Parent-in-law" category on the questionnaire.
  • Parent-in-law - The mother-in-law or father-in-law of the householder.
  • Son-in-law or daughter-in-law - The spouse of the child of the householder.
  • Other Relatives - Anyone not listed in a reported category above who is related to the householder by birth, marriage, or adoption (brother-in-law, grandparent, nephew, aunt, cousin, and so forth).


  • Nonrelatives
    This category includes any household member, including foster children, not related to the householder by birth, marriage, or adoption. The following categories may be presented in more detailed tabulations:

    • Roomer or Boarder -
    A roomer or boarder is a person who lives in a room in the household of the householder. Some sort of cash or noncash payment (e.g., chores) is usually made for their living accommodations.
  • Housemate or Roommate - A housemate or roommate is a person age 15 years old and over, who is not related to the householder, and who shares living quarters primarily in order to share expenses.
  • Unmarried Partner - An unmarried partner is a person age 15 years old and over, who is not related to the householder, who shares living quarters, and who has a close personal relationship with the householder. Same-sex spouses are included in this category for tabulation purposes and for public use data files.
  • Foster Child - A foster child is a person under 21 years old, who is placed by the local government in a household to receive parental care. Foster children may be living in the household for just a brief period or for several years. Foster children are nonrelatives of the householder. If the foster child is also related to the householder, the child is classified as that specific relative.
  • Other Nonrelatives - Anyone who is not related by birth, marriage, or adoption to the householder and who is not described by the categories given above.
  • When relationship is not reported for an individual, it is imputed according to the responses for age, sex, and marital status for that person while maintaining consistency with responses for other individuals in the household.

    Unrelated Individual
    An unrelated individual is:

    (1) a householder living alone or with nonrelatives only,

    (2) a household member who is not related to the householder, or

    (3) a person living in group quarters who is not an inmate of an institution.

    Family Households
    A family consists of a householder and one or more other people living in the same household who are related to the householder by birth, marriage, or adoption. All people in a household who are related to the householder are regarded as members of his or her family. A family household may contain people not related to the householder, but those people are not included as part of the householder's family in tabulations. Thus, the number of family households is equal to the number of families, but family households may include more members than do families. A household can contain only one family for purposes of tabulations. Not all households contain families since a household may be comprised of a group of unrelated people or of one person living alone - these are called nonfamily households. Families are classified by type as either a "married- couple family" or "other family" according to the sex of the householder and the presence of relatives. The data on family type are based on answers to questions on sex and relationship that were asked of all people.

    • Married-Couple Family -
    A family in which the householder and his or her spouse are listed as members of the same household.
  • Other Family:

    - Male Householder, No Wife Present -A family with a male householder and no spouse of householder present.

    - Female Householder, No Husband Present - A family with a female householder and no spouse of householder present.

    Family households and married-couple families do not include same-sex married couples even if the marriage was performed in a state issuing marriage certificates for same-sex couples. Same-sex couple households are included in the family households category if there is at least one additional person related to the householder by birth or adoption.

  • Average Family Size
    A measure obtained by dividing the number of people in families by the total number of families (or family householders). In cases where the measures, "people in family" or "people per family" are cross-tabulated by race or Hispanic origin, the race or Hispanic origin refers to the householder rather than the race or Hispanic origin of each individual. Average family size is rounded to the nearest hundredth.

    Subfamily
    A subfamily is a married couple (husband and wife interviewed as members of the same household) with or without never-married children under 18 years old, or one parent with one or more never-married children under 18 years old. A subfamily does not maintain its own household, but lives in a household where the householder or householder's spouse is a relative. The number of subfamilies is not included in the count of families, since subfamily members are counted as part of the householder's family. Subfamilies are defined during processing of data.

    In selected tabulations, subfamilies are further classified by type: married-couple subfamilies, with or without own children; mother-child subfamilies; and father-child subfamilies.

    In some labor force tabulations, children in both one-parent families and one-parent subfamilies are included in the total number of children living with one parent, while children in both married-couple families and married-couple subfamilies are included in the total number of children living with two parents.

    Nonfamily Household
    A householder living alone or with nonrelatives only. Same-sex couple households with no relatives of the householder present are tabulated in nonfamily households.

    Unmarried-Partner Household
    An unmarried-partner household is a household other than a "married-couple household" that includes a householder and an "unmarried partner." An "unmarried partner" can be of the same sex or of the opposite sex as the householder. An "unmarried partner" in an "unmarried-partner household" is an adult who is unrelated to the householder, but shares living quarters and has a close personal relationship with the householder. An unmarried-partner household also may be a family household or a nonfamily household, depending on the presence or absence of another person in the household who is related to the householder. There may be only one unmarried partner per household, and an unmarried partner may not be included in a married-couple household, as the householder cannot have both a spouse and an unmarried partner. Same-sex married couples are included in the count of unmarried-partner households for tabulations purposes and for public use data files.

    Question/Concept History

    Between 1996 and 2007, the question response categories remained the same. In 2008, the "Son or daughter" category was expanded to "Biological son or daughter," "Adopted son or daughter," and "Stepson or stepdaughter." Also "In-law" was expanded to "Parent-in-law" and "Son-in-law or daughter-in-law."

    Limitation of the Data

    Unlike the Current Population Survey (CPS) and the Survey of Income and Program Participation (SIPP), the ACS relationship question does not have a parent pointer to identify whether both parents are present. For example, if a child lives with unmarried parents, we only know the relationship of the child to the householder, not to the other parent. So a count of children living with two biological parents is not precise.

    Comparability

    The relationship categories for the most part can be compared to previous ACS years and to similar data collected in the decennial census, CPS, and SIPP. With the change in 2008 from "In-law" to the two categories of "Parent-in-law" and "Son-in-law or daughter-in-law," caution should be exercised when comparing data on in-laws from previous years. "In-law" encompassed any type of in-law such as sister-in-law. Combining "Parent-in-law" and "son-in-law or daughter-in-law" does not represent all "in-laws" in 2008. The same can be said of comparing the three categories of "biological" "step," and "adopted" child in 2008 to "Child" in previous years. Before 2008, respondents may have considered anyone under 18 as "child" and chosen that category. The ACS includes "foster child" as a category. However, the 2010 census did not contain this category, and "foster children" were included in the "Other nonrelative" category. Therefore, comparison of "foster child" cannot be made to the 2010 Census.