When researchers, policymakers, and analysts reference the number or percentage of Americans who do not have health insurance coverage – often referred to as the “uninsured” – where do they get their data? Oftentimes, the answer comes from data gathered in large federal surveys, such as the American Community Survey (ACS) or the National Health Interview Survey (NHIS), that estimate uninsurance for the nation and, in some cases, across the states and U.S. territories.
To help data users and other interested persons understand the ways that these surveys work to measure the number of uninsured in the nation, SHADAC produces an annual brief entitled “Comparing Federal Government Surveys that Count the Uninsured,” which we have recently updated following the release of 2023 insurance coverage estimates.
Accurate estimates of uninsured rates (the percentage of people that do not have insurance coverage, also referred to as uninsurance) are important in understanding trends and the impacts of actions (policy changes), events (like public health emergencies), or shifts in the economic landscape (like periods of recession) that may affect health insurance coverage.
Within the brief are up-to-date and past national uninsurance estimates, as well as the latest state-level estimates (where feasible), from five federal surveys:
- The American Community Survey (ACS), managed by the U.S. Census Bureau
- The Current Population Survey (CPS), managed by the U.S. Census Bureau
- The Medical Expenditure Panel Survey - Household Component (MEPS-HC), managed by the Agency for Healthcare Research and Quality (AHRQ)
- The National Health Interview Survey (NHIS), managed by the National Center for Health Statistics (NCHS)
- The Behavioral Risk Factor Surveillance System (BRFSS), managed by the Centers for Disease Control and Prevention (CDC)
We also analyze the primary factors contributing to variations in these estimates among surveys both within the surveys’ design and data collection processes, as well as exploring the impacts of recent events external to the surveys, such as the COVID-19 pandemic and the Medicaid continuous coverage requirement unwinding.
View and download the Comparing Federal Government Surveys 2024 Brief to learn more about our findings and analysis.
Interested in insurance coverage trends? Learn more with the following SHADAC products:
- Comparing Federal Surveys That Count the Uninsured 2023 (last year’s version of this brief)
- 15 Years of the Affordable Care Act: More Americans Than Ever Have Health Insurance Coverage (a blog exploring the foundations and definitions of the Affordable Care Act [ACA], how it has changed America’s insurance coverage rates, and the impact of the ACA on uninsured populations)
- Who’s Left Out? Exploring Minnesota’s Uninsured Population with Interactive Maps (an update to an interactive tool created by SHADAC researchers in partnership with the Blue Cross Blue Shield of Minnesota Foundation that provides detailed information on Minnesota uninsured population characteristics including age, sex, race/ethnicity, geographical location, and more across the state – and could be designed for any state!)