have faced challenges. It is difficult to maintain funding over time, which means, for example, that it was necessary to make decisions on survey design with little research on survey methods because of shortage of funds to support that basic research. In the end, Massachusetts obtained useful information, but it was in isolation. Analysts need comparisons with other states for context and to support stronger evaluation designs.

Despite the relatively successful experience with state surveys in Massachusetts, Long contended that federal surveys are still needed. She made several recommendations of ways to make federal survey data more useful: (a) provide much larger state and local area samples, both overall and for key population groups (including children); (b) make state identifiers available outside of research data center settings; (c) add more geocoding of state and local areas; (d) for the ACS, add state program names to health insurance questions; (e) expand survey content to include questions on access, use, and costs of care, along with other issues of relevance to national health reform; and (f) make data files available more quickly and in user-friendly formats to facilitate their use by state analysts.



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