SHADAC Webinar on 2012 CPS and ACS Health Insurance Coverage Estimates: Recording Available
The U.S. Census Bureau released 2012 insurance coverage estimates from theAmerican Community Survey (ACS) and the Current Population Survey (CPS) this month. SHADAC hosted a webinar on September 23rd featuring these estimates and Census staff who were available to answer questions about the estimates. Also discussed were the 2011 county estimates from the Small Area Health Insurance Estimates (SAHIE) program, which were released in late August. Click here to view the webinar recording and access presentation slides and resources.
SHADAC Tables Compare State and County ACS Coverage Estimates from 2011 to 2012
SHADAC created a series of tables containing 2012 state and county health insurance coverage estimates from the American Community Survey (ACS) for all states and the District of Columbia. For each state, the tables provide estimates by age, race/ethnicity, citizenship status, education, work experience, household income, and poverty level, with 2011 estimates provided as reference. County estimates are provided for all counties with populations greater than 65,000, with estimates available for the county population overall and by age. Also available are six 50-state comparison tables: These tables examine changes from 2011 to 2012 for coverage overall, private coverage, public coverage, and children’s coverage, and they look at changes from 2009 to 2012 for coverage overall and children’s coverage.
Kathleen Call Briefs U.S. House of Representatives Staff on the ACS
SHADAC Investigator Kathleen Call briefed Congressional staff on the use and value of the American Community Survey (ACS) for monitoring health access during a luncheon sponsored by the Population Association of America (PAA) on September 23rd in Washington, D.C. Dr. Call discussed the specific benefits of the ACS for states, including its large sample size (which makes the survey state representative each year and facilitates sub-state and subpopulation analyses), its point-in-time measurement of insurance coverage, its accessibility, and its capabilities for linking/modeling with other data sets. View Dr. Call’s presentation slides.
SHADAC in HealthAffairs: High-Risk Pool Enrollees Need Targeted ACA Outreach
A SHADAC study published in the September 9th issue of HealthAffairs found that the majority of surveyed enrollees in Minnesota’s high-risk pool (the Minnesota Comprehensive Health Association, or MCHA) were satisfied with their current coverage; unfamiliar with health care reform and its impact on their current coverage; and worried about the impact of health reform on the cost and affordability of coverage. These findings, which come from a 2012 mail survey of 2,600 adult MCHA enrollees, point to the need for immediate and targeted education and outreach to high-risk pool enrollees in order to ensure their successful transition into new coverage options in 2014. The HealthAffairs paper was led by SHADAC Director Lynn Blewett and co-authored by Elizabeth Lukanen, Kathleen Call, and Heather Dahlen.
SHADAC in Pediatrics: Children of Same-Sex Couples Less Likely to Have Private Health Insurance
An analysis by SHADAC doctoral student Gilbert Gonzales and Director Lynn Blewett found that children of same-sex parents are less likely to have private insurance than children of opposite-sex parents, but this disparity declines in states with legal same-sex marriage or civil unions and in states that allow second-parent adoptions. The analysis, published in Pediatrics on September 16th, used data from the 2008-2010 American Community Survey (ACS) to estimate the relationship between family type and type of insurance coverage for children.
News from the States
Maryland: American Indian/Alaska Native and Asian American Health Access
The Maryland Office of Minority Health and Health Disparities at the state’s Department of Health and Mental Hygiene (MDHMH) released two reports on the health of minorities in Maryland.
The first report presents health data and resources about the state’s American Indian and Alaska Native (AI/AN) population. Using the 2009-2011 American Community Survey, the authors found that the state’s AI/AN population had both lower rates of private insurance coverage than the state’s population overall and higher rates of public coverage and uninsurance.
The second report looks at Maryland’s population of Asians and Pacific Islanders (API). The authors used data from the 2006-2010 Behavior Risk Factor Surveillance System (BRFSS) to analyze insurance coverage for the state’s API population and found that non-Hispanic Asians in Maryland were 1.4 times more likely to be without insurance compared to Whites and also 1.4 times more likely to not be able to afford to see a doctor.
Michigan: Safety Net Providers and Uncompensated Care in Michigan
A brief from the Center for Healthcare Research & Transformation (CHRT) at the University of Michigan analyzes the increased demand for low- or no-cost services at Federally Qualified Health Centers (FQHCs) and free clinics during and after the economic recession that began in 2007. While the state’s uninsured rate began to fall with the economic recovery in 2010, the Medicaid population grew, placing increased demands on the state’s safety net system. The report’s estimates of insurance coverage are based on the SHADAC-Enhanced Current Population Survey (CPS), accessible at theSHADAC Data Center.
Missouri: Data Book on Health and Health Care
The Missouri Hospital Association released a data book providing information about the state’s Medicaid Program (MO HealthNet). The data book considers coverage, participation, expenditures, financing, delivery models, and utilization. State-level insurance coverage is calculated using the 2011 American Community Survey (ACS) and county-level coverage is calculated using the Census Bureau’s 2010 Small Area Health Insurance Estimates (SAHIE). The report calculates an overall uninsurance rate of 16 percent for the state, a rate that rises to 25 percent for Missourians below 138 percent of the Federal Poverty Level (FPL) and drops to 11 percent for Missourians above 138 percent FPL. Childless adults are currently ineligible for Medicaid in Missouri, and working parents and jobless parents are eligible up to 18 percent FPL. Under an ACA Medicaid expansion, all three groups would be eligible up to 138 percent FPL.
Wisconsin: Findings from the 2011 Family Health Survey
The Wisconsin Department of Health Services (DHS) released results from the 2011 Wisconsin Family Health Survey (FHS), which includes information about health insurance coverage in the state. According to the survey, an estimated 5.1 Wisconsin residents were insured at any point in time during 2011, while about 445,000 people were uninsured. The state’s percentage of uninsured (as a point-in-time measure) was statistically stable from 2010 to 2011, at seven percent and eight percent, respectively. The FHS also looks at duration of coverage and coverage by age, gender, race/ethnicity, and income. The FHS is a telephone survey of Wisconsin households with a sampling frame that includes all households with a working landline telephone. In 2011, the sampling frame was stratified by geography and included an oversampling of the state’s black residents. The final overall response rate for the survey was 47 percent.
ASPE Brief Examines 2012 CPS Coverage Estimates
In a brief from the U.S. Office of the Assistant Secretary for Planning and Evaluation (ASPE), researcher Kenneth Feingold examines the recently-released 2012 Current Population Survey (CPS) estimates of health insurance coverage. The brief highlights the overall increase in the number of Americans with insurance coverage, which grew from 260.2 million in 2011 to 263.2 million in 2012. This increase correlates with a statistically significant drop in the percentage of uninsured, from 15.7 percent in 2011 to 15.4 percent in 2012. The brief also examines coverage by age, race/ethnicity, household income, and source of coverage. For details on CPS estimates of coverage by state, see the SHADAC blog on this topic.
Medicaid/CHIP Child Participation Rates
An Urban Institute report from researchers Genevieve Kenney, Nathaniel Anderson, and Victoria Lynch examines state Medicaid/CHIP participation rates among children, updating previous estimates to include 2011 American Community Survey (ACS) data from the Integrated Public Use Microdata Series (IPUMS) produced by the Minnesota Population Center at the University of Minnesota. Nationwide, Medicaid/CHIP participation rates have risen by 5.5 percentage points since 2008, reaching 87.2 percent in 2011. Nineteen states and the District of Columbia had participation rates at or above 90 percent in 2011. At the low end, only four states had rates below 80 percent.
Medicaid and CHIP Enrollment Trends
Two issue briefs prepared by Health Management Associates for the Kaiser Commission on Medicaid and the Uninsured (KCMU) examine enrollment trends in Medicaid and CHIP across all 50 states and DC based on State Medicaid enrollment reports collected each June since 2002.
Medicaid enrollment reached a high of 54.1 million in June 2012, increasing by 1.3 million from June 2011. Over half of this enrollment increase is attributable to growth in five states: California, Florida, New Jersey, New York, and North Carolina. Colorado saw the largest percentage change from June 2011 to June 2012, with a 10.6 percent increase.
CHIP enrollment reached 5.5 million in June 2012, with an additional 206,000 children enrolling across the country since June 2011. Enrollment grew in 35 states during this time, with six states (California, Colorado, Georgia, Indiana, New York, and Texas) seeing over 10,000 additional children enroll.
MEPS Early Data Release: Uninsurance in First Half of 2012
A new brief from the Agency for Healthcare Research and Quality (AHRQ) considers data on the uninsured from the Medical Expenditure Panel–Household Component (MEPS-HC) for the first half of 2012. An estimated 21.6 percent of the U.S. nonelderly population were uninsured during the first six months of 2012—a figure that does not differ significantly from the same time period in 2011. The data show a strong association between age and insurance coverage, with more than one-third of adults ages 19 to 29 lacking insurance. Geography was also strongly associated with insurance coverage, with people in the South accounting for 37.3 percent of the nonelderly population but 44.1 percent of the nonelderly uninsured.
Lynn Blewett and Julie Sonier of SHADAC will both be at the conference and look forward to seeing everyone. Also attending the conference will be SHARE grantee Lindsey Leininger, Assistant Professor at the University of Illinois at Chicago, who will be presenting findings from her SHARE-funded research on an October 11th panel, "The State Buzz from AcademyHealth's Annual Research Meeting."
The State Health Access Data Assistance Center (SHADAC) is a program of the Robert Wood Johnson Foundation and a part of the Health Policy and Management Division of the School of Public Health at the University of Minnesota.