“past year” but no additional information on what expenditures are covered. It also collects basic work and activity limitations and general health status—potentially useful in defining risk groups and matching to MEPS.
MEPS, in contrast, collects very extensive data on health conditions, health status, the use of medical services, charges and payments, access to care, and health insurance coverage over time. What it lacks is information on what is actually covered by each sample member’s health insurance. Nevertheless, MEPS can support both prospective and retrospective measures of medical care risk.
Limited information on data quality for these various components suggests some areas in which improvements would be desirable.
With respect to income, CPS is the official measure and comparisons show that it does collect more total income than the other major surveys. Despite its overall strength, CPS ASEC income data have notable weaknesses. Reporting of all components of retirement income other than Social Security is well below SIPP, which falls short of the CPS ASEC on most other income sources. This suggests that a data area on which one would rely heavily in evaluating the MCER of the elderly is one in which the CPS would need to be improved.
Supplemental Nutrition Assistance Program (SNAP, formerly the Food Stamp Program) benefits are currently received by 15 percent of the population. The latest estimates comparing what CPS captures with what is actually paid out suggest that the CPS is missing nearly half of total SNAP benefits. Because SNAP benefits are part of what gets added to disposable income to create the SPM, the new measure will not reflect the status of low-income persons as accurately as it would if SNAP benefits were measured more effectively.
Nonresponse to income questions is high; 30 percent of total income is imputed to respondents. A note of caution with the imputation methods is that the medical care risk index is a new measure, and the CPS imputation procedures may not take account of a lot of the components that may be part of this new measure and that may introduce certain kinds of error into the resulting index. If imputation procedures do not account for covariates of medical care risk, the index is weakened. Finally, limitations of CPS ASEC health insurance measures are well known.
Data collected in MEPS on measures of medical service use and medical out-of-pocket expenditures are unique in their detail. MEPS data set the standard, but there is little out there to compare to them. Because of the MEPS panel design, attrition may be the principal concern. The first MEPS interview is actually the second interview with the MEPS sample, because