Health Insurance Coverage
In 2008, the American Community Survey began asking about current health insurance coverage. Data on health insurance coverage were derived from answers to Question 15, 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 15a to 15h).
a. Insurance through a current or former employer or union (of this person or another family member)
b. Insurance purchased directly from an insurance company (by this person or another family member)
c. Medicare, for people 65 and older, or people with certain disabilities
d. Medicaid, Medical Assistance, or any kind of government-assistance plan for those with low incomes or a disability
e. TRICARE or other military health care
f. VA (including those who have ever used or enrolled for VA health care)
g. Indian Health Service
h. Any other type of health insurance or health coverage plan
During the editing process, write-in answers describing or naming the type of other health insurance or health coverage plan in part h were classified into one of the first seven categories. Hence, only the first seven types of health coverage are part of the microdata file. All write-in responses were classified using an automated computer system. This automated procedure compared write-in responses with a master computer code list and then assigned a code to each write-in response. The computerized matching assured that identical alphabetic entries received the same code. Clerical coding categorized any write-in responses that did not match the computer dictionary. The computer dictionary was then updated with the results of the clerical coding. A computer edit was used for the following types of write-in responses: the type of coverage could not be determined, but coverage by a family member was indicated; coverage was indicated, but a determination between private and public could not be made; and responses of "no coverage." If the write-in could not be coded to one of the coverage types or assigned with the computer edit, or was determined to not be coverage (i.e. dental or vision), the write-in was treated as blank.
People were considered insured if they were reported to have at least one "yes" to Questions 15a to 15f. 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 coverage 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 the Department of Veterans Affairs (VA); the State Childrens Health Insurance Program (SCHIP); and individual state health plans. Respondents reporting a "yes" to the types listed in c, d, or f were considered to have public health coverage. The types of health insurance are not mutually exclusive; people may be covered by more than one at the same time.
Health insurance coverage is a new question on the 2008 American Community Survey. Hence the limitations are not fully known. However, the 2006 Content Test of the American Community Survey provides useful information. The evaluation of that test data demonstrated the viability of asking questions on health insurance coverage in the ACS. See "2006 American Community Survey Content Test Report P.8: Evaluation Report Covering Health Insurance" (www.census.gov/acs/www/AdvMeth/content_test/P8_Health_Insurance.pdf
). For consistency with other surveys describing the health insurance status of the population, the universe for most health insurance data tabulations is the civilian noninstitutionalized population. Because some types of group quarters populations may have health insurance coverage distributions that are different from the household population, the distributions in the published tables may differ slightly from how they would look if the total population were represented.