most serious implications for measurement.4 It has been shown that the measured poverty rate declines over the life of a SIPP panel independently of the true trend, and there is an especially steep decline over the first two to three waves (Anderson and Fields, 2010; Czajka, Mabli, and Cody, 2008; Weinberg, 2003). When the 1995 National Research Council panel recommended a new poverty measure that would be produced from SIPP (National Research Council, 1995), the Census Bureau developed plans to restore the overlapping panel design, whereby a new panel was started each year; however, this was not done (Weinberg, 1999). Overlapping panels ensure a uniform bias for cross-sectional, annual estimates, which is why MEPS does not have the same problem as SIPP.
In considering surveys that meet the requirements for production outlined earlier, we restrict our attention to surveys conducted by the federal government. If a measure of MCER is to be produced by the federal government on an annual basis, closely tied to the release of the SPM, the data used to construct that measure must be obtained from a federal survey or surveys. The data collection schedule and the quality and consistency of the data that are collected are critical elements in the production of an annual measure that can be used to track changes in medical care financial risk over time. Although there are serious limitations to the relevant data being collected in federal surveys at the present time, full federal authority over all of the processes that contribute to the production of a measure of MCER is essential to ensuring the integrity and viability of the measure. In addition to MEPS, then, we consider the CPS ASEC (see http://www.census.gov/hhes/www/hlthins/data/index.html), the National Health Interview Survey (NHIS) (see http://www.cdc.gov/NCHS//NHIS.htm), the American Community Survey (ACS), and the Consumer Expenditure (CE) series quarterly survey (see http://www.bls.gov/cex). The responsible agencies for these surveys are the U.S. Census Bureau for the CPS ASEC, SIPP, and ACS, the National Center for Health Statistics for NHIS, the Agency for Healthcare Research and Quality (AHRQ) for MEPS, and the Bureau of Labor Statistics for the CE.
The CPS ASEC provides a standard for statistical precision because of its role as the official source of monthly unemployment estimates and annual poverty rates and its widespread use for estimating the percentage of the population without health insurance coverage. The CPS ASEC collects interviews from about 80,000 households each year. MEPS and NHIS samples vary in size over time. The largest recent MEPS sample, for calen-
4 With the abutted panel design, which was introduced in 1996, successive panels are end to end—that is, the start of one panel coincides with the completion of the preceding panel. Previously, a new panel was started each year, as is the case with MEPS.