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Census survey adjustments could skew health insurance data

While there are many studies emerging on how many Americans signed up for health insurance benefits through the federal and state-run marketplaces, past research into health insurance demographics and prevalence are important aspects of understanding the healthcare reform law’s impact. The Census Bureau recently implemented changes to the health insurance questions in its Current Population Survey, and some experts are concerned this could cause issues with measuring the performance of the Affordable Care Act.

The new questions are supposed to increase the decades-old survey’s accuracy, but it could end up making it difficult to see how health insurance coverage affordability and availability have changed since the ACA came into effect. 

Health insurance comparisons could change under new revisions

According to the Census Bureau, the new health insurance questions were included in the survey beginning in February 2014, and they were developed after 14 years of research and two nationwide tests in 2010 and 2013. The newly designed questions are meant to make it easier for the government to establish an accurate baseline for measuring changes in health coverage under the healthcare reform law. 

While the Census Bureau stated the questions were created to better measure the ACA’s impact, critics of the changes have emerged with their concerns. The New York Times reported the questions have been altered to the point that it will be difficult to compare coverage under the ACA with health insurance before the healthcare reform law. In fact, these alterations may not showcase which changes in health coverage are actually due to the ACA. The new questionnaire has been found to achieve different results than the past survey, according to The New York Times, which is one of the primary concerns regarding the changes.

The Fiscal Times reported officials both in favor of and opposed to the ACA are concerned about changing how the government measures health insurance data. 

John H. Thompson, director of the Census Bureau, told The Washington Post the agency made these changes in full knowledge of how they would impact the ACA.

“This has been a scientific process, and that’s the way we operate,” Thomason said. “I don’t understand where all these concerns come from suddenly. We pride ourselves on being a statistical agency that produces objective, nonpartisan and high-quality information. That’s our mission.”

The agency’s method of questioning Americans on the new survey is supposed to help reconstruct their insurance history, The New York Times explained. The previously used questionnaire asked people whether they had health coverage in the prior year, while the new survey starts by asking Americans if they have health insurance at the time of the survey and then works backward with follow-up questions to try to determine the person’s coverage history. This ability to recreate coverage history is exciting to some, despite the opposition to the new survey. 

There may be concerns about the new survey, but The New York Times reported the questionnaire does ask whether people received their coverage through the health insurance exchanges. Being able to determine enrollment figures through the survey is one positive of the changes, as the bureau will now be able to examine the prevalence of subsidized private insurance compared to coverage through the government.

Reengineering the health insurance questions in the Current Population Survey may make it difficult to see just how much the ACA has affected coverage, but it will end up creating a baseline for health insurance under the law and enrollment through the exchanges. Overhauling the survey now may not have been the best choice, according to some experts, but it may have been necessary to understand the extent of the ACA.

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Erin Woulfe
Erin Woulfe
Erin Woulfe likes to write about things that matter. Keeping her finger on the pulse of what’s happening in the public sector world, she blogs about the latest legislative news and employee benefit trends that affect our school, city and county clients. She’s been with NIS since 2002. “I love connecting to our clients and providing them with the tools they need in order to administrate their plan,” says Erin. “Whether that be materials to educate their employees on certain benefits, how to effectively communicate change within an organization or just providing tips and how-to’s to help them make their job easier.”

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