Last year, the U.S. Census Bureau enacted a second and final round of changes in a planned, two-stage redesign process for the agency’s Current Population Survey Annual Social and Economic Supplement (CPS ASEC). The first revision, made in 2014, was a redesign of the CPS ASEC questions regarding health insurance, income, medical expenditure, and poverty data; the second, an implementation of a new data processing system that specifically takes into account the 2014 changes across each category in the questionnaire.[1]

Using the new processing system, the Census Bureau released 2018 estimates on health insurance, income, poverty, and medical expenditures, as well as re-processing collected data for 2017 in a bridge file meant to serve as the transition between the legacy and the new processing systems.

A new brief from SHADAC researchers Brett Fried, MPP, and Lacey Hartman, MPP, takes a look at estimates of medical out-of-pocket spending in both the legacy and new production files, comparing changes in the data between both. In particular, the brief highlights how the number of individuals with high burden medical spending decreased between the two files as a result of the new processing system, rather than from any changes in policy.

The brief also includes a more detailed exploration of the changes made to medical expenditure questions in the CPS, just how the data processing system changed from the legacy system to the new, calculations of the differing estimates of high burden medical spending at the national and state levels, and concludes with a discussion of potential implications for policymakers as well as for researchers in attempting to produce accurate estimates of medical burden.