SHADAC Expertise

Coordinated State Coverage Survey (CSCS)

The Coordinated State Coverage Survey (CSCS) is a survey instrument developed by SHADAC to measure state-level health insurance coverage rates.

About the CSCS

The Coordinated State Coverage Survey (CSCS) is:

• A household telephone survey instrument developed by SHADAC researchers
• Specially designed to monitor the uninsured and provide reliable state-level insurance coverage estimates to inform state health policies, unlike national survey instruments

To date, nearly 20 states have used, or are using, the CSCS to collect state-specific data on the uninsured.

Components of the CSCS

The CSCS consists of two main components: the core and the state-added questions.

• The core includes questions on health insurance coverage and demographics. Optional items in the core are designed to assess potential access to health insurance coverage through family members or employers

• State-added questions reflect changes to the CSCS per the informational needs of the states. States have included questions on topics such as willingness to pay (Indiana 2003), concerns about loss of coverage (Alabama 2003; Oklahoma 2004), dental coverage (Alabama 2003), attitudes toward and awareness of state reforms (Massachusetts, 2008) and Medicare supplemental policies (Minnesota 2004, 2007)

Using the CSCS

The survey is available for public use, and SHADAC researchers are available to assist states in customizing the study design. You may download a sample questionnaire (Minnesota 2011 in Word or PDF). Any questions on the content can be directed to Kathleen Call at SHADAC (612-625-2932 or

CSCS Content

The CSCS is designed to achieve concise estimates of health insurance coverage by:

• Targeting primary residences using county identifiers

• Establishing contact with the person in the household most knowledgeable about health insurance

• Enumerating who is in the household

• Selecting one "target" person at random

• Establishing the relationship of the target to all other household members

• Determining the target's current and prior year (annual) health insurance coverage

• Obtaining current health insurance coverage info of all other household members (optional but recommended)

Based on annual insurance status, target respondents are sorted into the following groups:

1. Employer-based insurance all year

2. Individual coverage all year

3. Uninsured all year

4. Period of no insurance during the past 12 months

5. All others

The CSCS also includes additional questions specifically designed for these groups.

CSCS Description

CSCS Flowchart

States Using the CSCS

State Year(s)
Alabama 2003
Colorado 2001, 2008
Connecticut 2001, 2004
Georgia 2002
Indiana 2003
Maine 2002
Minnesota 2001, 2004, 2007, 2009
Massachusetts 2008
Missouri 2004
Montana 2003
North Dakota 2004
Nebraska 2004
Oklahoma 2004, 2008
Pennsylvania 2004
South Carolina 2003
Tennessee 2005
Virgin Islands 2003, 2009
Virginia 2004
West Virginia 2001
Wyoming 2002