U.S. Census Bureau Data Explained: Breaking Down 2023 Health �Insurance Coverage Estimates �from the ACS and CPS

Featuring a Q&A with a Census Expert

�Thursday, September 26, 2024 | 1:00 PM Central Time�

Speaker

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Elizabeth�Lukanen

Sharon �Stern

Andrea �Stewart

Moderator

Speaker

Robert Hest

Census Expert

Webinar Agenda

• Survey Data Season Overview

Summary and Resources

• 2023 Health Insurance Coverage Estimates

Health insurance coverage rates in 2023, and notable changes from 2022 from two important federal surveys:

Current Population Survey (CPS)

National-level estimates of uninsurance and public and private coverage

American Community Survey (ACS)

State-level estimates of uninsurance and public and private coverage

• 2023 CPS and ACS Data for Research

Accessing the Estimates

Example Research Uses: MN Uninsured Profile; State Outreach; Comparing Federal Surveys Brief

• Question and Answer Session

Special Guest: U.S. Census Bureau Expert Sharon Stern

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Survey Data Season

What Is Survey Data Season?

Each year, SHADAC covers the data releases of multiple federal surveys from a variety of agencies, beginning with the National Health Interview Survey (NHIS) in June continuing through the release of American Community Survey (ACS) and Current Population Survey (CPS) data products in September through January.

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What Survey Data Are Part of this Coverage?

• National Health Interview Survey (NHIS)
• Medical Expenditure Panel Survey – Insurance Component (MEPS-IC)
• Behavior Risk Factor Surveillance System (BRFSS)
• Current Population Survey (CPS)
• American Community Survey (ACS)

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Survey Data Season Resources

What Survey Data Season Resources Does SHADAC Have?

2023 NHIS Full-Year Health Insurance Estimates Early Release:

Decreasing Uninsured Rates Overall and for Certain Groups of Nonelderly Adults

• National Health Interview Survey (NHIS)

A Post-Pandemic Look at the Cost of Employer-Sponsored Insurance (ESI) Coverage: Data from the 2023 Medical Expenditure Panel Survey (MEPS)

• Medical Expenditure Panel Survey – Insurance Component (MEPS-IC)

Survey Data Season Essentials: What Is the BRFSS and How Can Researchers Use It?

• Behavior Risk Factor Surveillance System (BRFSS)

CPS ASEC: 2023 National Health Insurance Coverage Estimates Remain Steady for Adults but Rise for Children

• Current Population Survey (CPS)

2023 ACS: After Two Years of Decline, Uninsured Rates Increased for Children; Public and Private Coverage Rates See Variations Across the States

• American Community Survey (ACS)

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Find more at https://www.shadac.org/survey-data-season-2024

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Survey Data Season: U.S. Census Bureau Data Release Key Dates

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Current Population Survey (CPS)

• 2023 estimates released September 10, 2024
• Find data: Health Insurance Coverage

in the United States: 2023

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American Community Survey (ACS)

• 2023 1-Year data products released September 12, 2024
• Find data: data.census.gov
• Find data: State Health Insurance Coverage: 2013, 2019, 2023
• 2023 1-Year Public Use Microdata Sample (PUMS) File and supplemental materials to be released October 17, 2024
• 2023 5-Year (2019-2023) data products to be released December 12, 2024

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2023 Health Insurance Coverage Estimates

Current Population Survey (CPS)

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2023 Health Insurance Coverage Estimates: CPS Data Release

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Current Population Survey (CPS)

Health insurance coverage in the Current Population

Survey Annual Social and Economic Supplement (CPS

ASEC) refers to comprehensive coverage at any time

during the calendar year for the civilian noninstitutionalized

population of the United States.

Uninsured

People are only considered uninsured if they did not have health insurance coverage for the entire calendar year.

Additionally, people are considered uninsured if they only had coverage through the Indian Health Service (IHS), as IHS coverage is not considered comprehensive.

This also excludes single service plans such as accident, disability, dental, vision, or prescription medicine plans.

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2023 Health Insurance Coverage Estimates: CPS Data Release

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Current Population Survey (CPS)

Private Coverage

• Employment-based: Plan provided through an employer or union.

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• Direct-purchase: Coverage purchased directly from an insurance

company, or through a federal or state Marketplace (e.g.,

healthcare.gov).

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• TRICARE: Coverage through TRICARE, formerly known as

Civilian Health and Medical Program of the Uniformed Services.

Public Coverage

• Medicare: Federal program that helps to pay health care costs for people aged 65 and older and for certain people under the age of 65 with long-term disabilities.
• Medicaid: This report uses the term Medicaid to include the specific Medicaid government program and other programs for low-income individuals administered by the states such as the Children’s Health Insurance Program (CHIP) and Basic Health Programs.
• VA and CHAMPVA: Care provided by the Department of Veterans Affairs, the military, and the Civilian Health and Medical Program of the Department of Veterans Affairs.

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2023 Health Insurance Coverage Estimates: �CPS Changes by Type of Coverage

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¹ Includes CHAMPVA (Civilian Health and Medical Program of the Department of Veterans Affairs), as well as care provided by the Department of Veterans Affairs (VA) and the military.

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Note: The estimates by type of coverage are not mutually exclusive; people can be covered by more than one type of health insurance during the year.

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Source: U.S. Census Bureau, Current Population Survey, 2023 and 2024 Annual Social and Economic Supplements (CPS ASEC).

2023 Health Insurance Coverage Estimates: CPS Changes by Age

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† Because of rounding, the percentage point change and the difference between the published estimates do not match.

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All changes are tested at the 90% confidence level.

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Source: U.S. Census Bureau, Current Population Survey, 2023 and 2024 Annual Social and Economic Supplements (CPS ASEC).

2023 Health Insurance Coverage Estimates: CPS Changes by Age (Children 0-18)

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Source: U.S. Census Bureau, Current Population Survey, 2023 and 2024 Annual Social and Economic Supplements (CPS ASEC).

2023 Health Insurance Coverage Estimates: CPS Changes by Age (Nonelderly Adults 19-64)

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Source: U.S. Census Bureau, Current Population Survey, 2023 and 2024 Annual Social and Economic Supplements (CPS ASEC).

2023 Health Insurance Coverage Estimates: CPS Changes by Medicaid Expansion & Poverty Level

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Source: U.S. Census Bureau, Current Population Survey, 2023 and 2024 Annual Social and Economic Supplements (CPS ASEC).

2023 Health Insurance Coverage Estimates

American Community Survey (ACS)

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2023 Health Insurance Coverage Estimates: ACS Data Release

American Community Survey (ACS)

Health Insurance Coverage - Uninsured

While in the CPS ASEC, someone is considered uninsured if they did not have health insurance coverage at any time in 2023, the ACS uses a point-in-time measure, meaning they are not covered at the time of the interview.

Overall Findings

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16.4%

2.6%

2023 Health Insurance Coverage Estimates: ACS Changes by Type of Coverage and Age

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Source: U.S. Census Bureau, Current Population Survey, 2023 and 2024 Annual Social and Economic Supplements (CPS ASEC).

Uninsurance for Nonelderly Adults (19-64)

The uninsured rate in for nonelderly adults was 11.0% in 2023, a decline from 11.3% in 2022. 

2023 Health Insurance Coverage Estimates: ACS Changes by Type of Coverage and Age

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Source: U.S. Census Bureau, Current Population Survey, 2023 and 2024 Annual Social and Economic Supplements (CPS ASEC).

Uninsurance for Children (0-18)

Uninsurance among children rose significantly between 2022 (5.1%) and 2023 (5.4%).

2023 Health Insurance Coverage Estimates: ACS Changes by Type of Coverage and Age

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Source: U.S. Census Bureau, Current Population Survey, 2023 and 2024 Annual Social and Economic Supplements (CPS ASEC).

Private Coverage for Nonelderly Adults (19-64)

The rate of private coverage among nonelderly adults was unchanged at 73.5% in 2023 (73.4% in 2022).

2023 Health Insurance Coverage Estimates: ACS Changes by Type of Coverage and Age

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Source: U.S. Census Bureau, Current Population Survey, 2023 and 2024 Annual Social and Economic Supplements (CPS ASEC).

Private Coverage for Children (0-18)

The rate of private coverage among children in 2023 was 60.6%, unchanged from the same recorded rate in 2022. 

2023 Health Insurance Coverage Estimates: ACS Changes by Type of Coverage and Age

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Source: U.S. Census Bureau, Current Population Survey, 2023 and 2024 Annual Social and Economic Supplements (CPS ASEC).

Public Coverage for Nonelderly Adults (19-64)

The rate of public coverage among nonelderly adults was statistically unchanged in 2023, holding steady at 19.5%, from 19.4% in 2022. 

2023 Health Insurance Coverage Estimates: ACS Changes by Type of Coverage and Age

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Source: U.S. Census Bureau, Current Population Survey, 2023 and 2024 Annual Social and Economic Supplements (CPS ASEC).

Public Coverage for Children (0-18)

The rate of public coverage among children in 2023 was 39.4%, statistically unchanged from the previous year at 39.6%.

2023 CPS and ACS Data for Research

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2023 CPS and ACS Data for Research: Accessing the Estimates

Current Population Survey (CPS) Main Report

American Community Survey (ACS) Main Report

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2023 CPS and ACS Data for Research: Accessing the Estimates

America Counts Stories

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2023 CPS and ACS Data for Research: Accessing the Estimates

Primary web access: data.census.gov

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2023 CPS and ACS Data for Research: Accessing the Estimates

CPS Detailed and Historical Tables

ACS Detailed and Historical Tables

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2023 CPS and ACS Data for Research: Accessing the Estimates (Visualizations)

Interactive Data Visualizations

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2023 CPS and ACS Data for Research: Accessing the Estimates

2023 Public-use CPS ASEC available https://www.census.gov/data/datasets/time-series/demo/cps/cps-asec.html

• Public-use dictionary also posted
• Available in ASCII, SAS, and CSV formats

2023 1-Year ACS Public-use Microdata Sample (PUMS) will be released on October 17, 2024

• 1% public use microdata sample (1% of population)
• The smallest identifiable geographic unit is the Public Use Microdata Area (PUMA) containing at least 100,000 persons
• PUMAs are generally groups of counties or parts of counties, and do not cross state boundaries

Institute for Social Research and Data Innovation - http://www.ipums.org

• SHADAC Health Insurance Unit (HIU) and Federal Poverty Guidelines (FPG) variables for CPS and ACS are available through IPUMS

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2023 CPS and ACS Data for Research: Accessing the Estimates

ACCESS health policy relevant estimates at the U.S. and state level

DOWNLOAD customized reports and select data as an Excel file

GENERATE detailed graphics, trend lines, maps, bar charts, and data tables

MARGINS of error in addition to point estimates allows for significance testing

SUBSCRIBE to SHADAC’s newsletter for updates on new resources and data releases

2023 CPS and ACS Data for Research: Example Uses in Projects

MN Community and Uninsured Profile

• Using the latest estimates from the U.S. Census Bureau's American Community Survey (ACS), the profile provides rates and counts of Minnesotans at numerous geographic levels: the ZIP code (i.e., Census-defined ZIP code), county, economic development region, MNSure rating area, legislative district (senate and house), and state.
• The profile features characteristics of the total population and uninsured population within a select community.

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2023 CPS and ACS Data for Research: Example Uses in Projects

MN Community and Uninsured Profile: Local Case Studies (Duluth)

• Using the ZIP Code Uninsured Rates from the MN Profile (populated using ACS data) can be a useful tool for navigator and assister organizations to focus and tailor outreach & enrollment activities and communications to specific communities that are more likely to be uninsured or who need help connecting to health care resources.
• SHADAC used the Duluth area of MN to identify uninsurance hotspots by ZIP code, and then cross-referenced characteristics of these populations (age, race and ethnicity, ratio of income to poverty level, sex, and disability status) to provide a better understanding of the make-up of the community and assist these kinds of efforts.

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2023 CPS and ACS Data for Research: Example Uses in Technical Assistance

• Identify the geographic distribution of remaining eligible but uninsured populations by income level�
• Identify populations that may have an affordable offer of employer-sponsored coverage or other characteristics that would make them ineligible or unlikely to enroll in coverage�
• Estimate the size, characteristics, and geographic locations of populations eligible for coverage expansions

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2023 CPS and ACS Data for Research: Further Resources – SHADAC

• National Health Interview Survey (NHIS)
• Medical Expenditure Panel Survey – Insurance Component (MEPS-IC)
• Behavior Risk Factor Surveillance System (BRFSS)
• Current Population Survey (CPS)
• American Community Survey (ACS)

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Question & Answer

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Question & Answer

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Please submit question using the Q&A feature

Andrea �Stewart

Sharon Stern

Robert �Hest

Thank you!

Andrea Stewart

astewart@umn.edu

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2023 CPS and ACS Data for Research: Further Resources – U.S. Census Bureau

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Information on data.census.gov:

https://census.gov/data/what-is-data-census-gov.html

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Census Academy:

https://census.gov/data/academy/webinars/upcoming.html

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Webinars: Exploring Census Data Webinar Series�https://www.census.gov/data/academy/webinars/series/exploring-census-data.html

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Data Gems: A series of short “How-To” videos census.gov/data/academy/data-gems.html

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Feedback: Email comments to cedsci.feedback@census.gov