Databases for Estimating Health Insurance Coverage for Children A Workshop Summary (2010) / Chapter Skim
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10 Income and Poverty Measurement in Surveys of Health Insurance Coverage--John L. Czajka
10 Income and Poverty Measurement in Surveys of Health Insurance Coverage--John L. Czajka
Pages 109-140
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From page 109... ...
Each year the Census Bureau produces a set of state-level estimates of children under age 19 in families with incomes at or below 200 percent of the federal poverty level and the subset of these who are without health insurance coverage. The estimates, which are derived from the Annual Social and Economic Supplement (ASEC)
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From page 110... ...
Given these potential limitations, do the ACS income data measure up to the CPS sufficiently well to warrant their use in producing the mandated annual estimates of low-income children and low-income uninsured children? Policy analysts also have reason to be interested in the ACS as a potential data source for a wide variety of analyses of state and local variation in health insurance coverage, and income is likely to play a key role in many such analyses.
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From page 111... ...
This research was conducted by Mathematica Policy Research, Inc., and its subcontractor, Denmead Services & Consulting, under a con tract with the Office of the Assistant Secretary for Planning and Evalua tion in the U.S. Department of Health and Human Services.1 The second set of findings, which is restricted to the CPS and the ACS, was prepared to examine specific issues related to the use of income data in the analysis of health insurance coverage.2 The paper closes with a brief assessment of the implications of these findings for applications of income and health insurance data from the three surveys.
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From page 112... ...
The reported incomes of individual family members at the time of the interview are summed to obtain a measure of total family income for the preceding calendar year. By contrast, the ACS collects income for up to eight sources for each sample person age 15 and older, combining many sources for which the CPS collects separate reports.
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From page 113... ...
Thus, the income data collected from ACS households during a given calendar year span a 23-month period centered on December of the prior year.3 To convert the ACS income to a common reference period -- specifically, the calendar year in which the data were collected -- the Census Bureau applies an inflation adjustment, defined as the ratio of the average monthly price index for the survey year to the average index for the reference period. These monthly adjustment factors are used internally and are applied to published estimates, but the ACS public-use file contains only an average adjustment factor for the 12 survey months, because the Census Bureau has elected not to reveal the survey month.
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From page 114... ...
The NHIS family definition is more expansive, including unmarried partners (and any relatives living with them) and foster children in the same family.
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From page 115... ...
Under the heading Adjustments to Enhance Comparability, the adjustments that were applied to the surveys included in this paper are described. Total Income compares survey estimates of total income, both in the aggregate and by quintile of family income.
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From page 116... ...
In presenting estimates of aggregate income, I include a breakdown by quintile of family income, which makes it possible to compare the surveys with respect to their collection of income from different segments of the income distribution. Table 10-1 presents estimates of aggregate income for the whole population and by quintile of family income for the three surveys.6 It also shows these amounts as a percentage of the corresponding amounts for the CPS.
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From page 117... ...
By this measure, the ACS captures 99.8 percent as much total income as the CPS, and the NHIS, which is weighted to slightly larger population totals than the CPS, declines to 94.2 percent of the CPS total. ACS per capita income equals or exceeds CPS per capita income through the first three quintiles and is within 0.4 percentage points in the fourth quintile and within 1.6 percentage points in the top quintile.
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From page 118... ...
The NHIS does not collect unearned income, but the difference between total income and earned income collected in the NHIS implies unearned income that is 77 percent 7 Recall that total family income and earnings by individual family members are measured independently in the NHIS and not reconciled.
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From page 119... ...
8 In the 2002 NHIS, more than a fifth of individuals were in families with more reported total earnings than total family income. Each of these families would have implied negative unearned income.
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From page 120... ...
With its unearned income mea sured as a residual rather than a reported amount, the NHIS is erratic. The difference between aggregate total and aggregate earned income is as low as 60 percent of the CPS aggregate in one quintile and as high as 88 percent (in the adjacent quintile)
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From page 121... ...
While all three surveys show the expected steep decline in receipt with rising family income, it is likely that both the ACS and the NHIS have far too many high-income families with food stamps or welfare. Without further study, however, it is not clear that the problem necessarily lies with the survey data on receipt as opposed to family income.
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From page 122... ...
Estimates of the number of poor and near-poor (defined as those between 100 and 200 percent of the poverty threshold) are important measures for policy analysis.9 Marked differences across surveys in estimates of the poor and near-poor would be a source of concern among policy analysts and other data users.
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From page 123... ...
SOURCES: Mathematica Policy Research, Inc., from tabulations of poverty status in calendar year 2002 from the 2003 CPS ASEC supplement and the 2003 NHIS, and poverty status in the prior 12 months, inflation-adjusted to calendar year 2002, from the 2002 ACS. is an outlier with an estimate of 41.6 million poor and a poverty rate of 14.7 percent.
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From page 124... ...
Broadening the family concept relative to the CPS family produces major changes in family income and poverty rates. In developing the NHIS estimates of income for comparison with the other surveys, I separated unmarried partners and foster children from
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From page 125... ...
SOURCES: Mathematica Policy Research, Inc., from tabulations of poverty status in calendar year 2002 from the 2003 CPS ASEC supplement and the 2003 NHIS, and poverty status in the prior 12 months, inflation-adjusted to calendar year 2002, from the 2002 ACS. TABLE 10-10 Estimates of Poor and Near-Poor Elderly: Three Surveys Population Subgroup CPS ACS NHIS Millions of Persons All Persons Aged 65 and Older 34.22 33.56 34.22 Poverty Status Poor 3.58 3.20 3.76 Near-poor 9.58 7.98 9.10 Total Low Income 13.16 11.18 12.86 Percentage of the Population All Persons Aged 65 and Older 100.00 100.00 100.00 Poverty Status Poor 10.50 9.50 11.00 Near-poor 28.00 23.80 26.50 Total Low Income 38.50 33.30 37.60 NOTES: The poor have a family income below the poverty threshold.
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From page 126... ...
By comparing the income and poverty estimates pre pared using the CPS family definition with estimates obtained from the original data, I assessed the impact of using the NHIS versus CPS family definition on groups and individuals for the purposes of estimating family income. Table 10-11 shows estimates of the impact of the broader NHIS family definition.
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From page 127... ...
When the data producers elect to allocate their missing income data, high rates of nonresponse are likely to mean that large fractions of the income data they provide to their users will have been created by the data producers themselves rather than supplied by their respondents. This makes the quality of the income data dependent not only on the completeness and accuracy of the reported amounts, but also on the quality of the methods used to generate allocated amounts.
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From page 128... ...
Another reason to be concerned about rounding is that a high level of rounding suggests inaccuracy or a lack of precision in the reported amounts generally. I examined the extent of rounding in reported incomes below $52,500 for earnings, wages and salaries, Social Security benefits, other retire ment income, total personal income, and total family income in the three
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From page 129... ...
MORE CURRENT COMPARISONS Comparing just a single year of data provides no basis for assessing how the rolling reference period for annual income data in the ACS may affect the measurement of income and poverty in the ACS relative to the CPS. To provide more data on this issue, I constructed simple comparisons using data from the 2007 and 2008 ACS and the 2008 and 2009 CPS ASEC supplements.
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From page 130... ...
by comparing young adults aged 18 to 24 by college enrollment, relative income, and the percentage lacking health insurance coverage. Poor and Near-Poor For 2007 the ACS estimated a slightly higher poverty rate than the CPS, at 13.0 versus 12.5 percent, and a slightly smaller fraction between
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From page 131... ...
The near-poor have a family income at or above the poverty threshold but below twice the poverty threshold. SOURCES: Mathematica Policy Research, Inc., from tabulations of poverty status in calen dar years 2007 and 2008 from the 2008 and 2009 CPS ASEC supplements and the 2007 and 2008 ACS.
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From page 132... ...
Using a very different approach to measuring health insurance coverage, the ACS obtained an uninsured rate of 15.2 percent (see Table 10-18)
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From page 133... ...
SOURCES: Mathematica Policy Research, Inc., from tabulations of poverty status in calen dar years 2007 and 2008 from the 2008 and 2009 CPS ASEC supplements and the 2007 and 2008 ACS. among the near-poor (25.9 versus 24.3 percent)
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From page 134... ...
SOURCES: Mathematica Policy Research, Inc., from tabulations of poverty status in calen dar years 2007 and 2008 from the 2008 and 2009 CPS ASEC supplements and the 2007 and 2008 ACS. TABLE 10-18 Number and Percentage Uninsured by Relative Income: All Persons, CPS and ACS, 2008 Estimate CPS ACS Uninsured Persons (millions)
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From page 135... ...
4.56 4.58 Percentage Uninsured All Children Under Age 18 9.80 9.90 Income Relative to Poverty Under 100% 15.70 15.90 100 to under 200% 14.70 15.90 200 to under 400% 8.60 8.70 400 or more 3.40 2.90 Low Income (under 200%) 15.20 15.90 SOURCE: Mathematica Policy Research, Inc., tabulations of the 2009 CPS ASEC supplement and the 2008 ACS.
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From page 136... ...
20.80 20.05 Percentage Uninsured All Nonelderly Adults 20.40 20.00 Income Relative to Poverty Under 100% 44.00 41.30 100 to under 200% 37.10 38.10 200 to under 400% 20.30 20.40 400 or more 7.50 7.00 Low Income (under 200%) 40.00 39.50 SOURCE: Mathematica Policy Research, Inc., from tabulations of the 2009 CPS ASEC supplement and the 2008 ACS.
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From page 137... ...
I have no explanation for this. Regard less of college enrollment, only 6 to 7 percent of young adults excluded from the ACS poverty universe are reported to be without health insurance coverage.
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From page 138... ...
Such differences are often but certainly not always consistent with differences in the two surveys' approaches to measuring income, including reference period as well as the way that income is defined.
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From page 139... ...
From the perspective of income measurement, the chief issues revolve around the ACS reference period and the ways that the Census Bureau has attempted to annualize the estimates, the residence rules for college students living away from home, the small number of questions
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From page 140... ...
. Income Data for Policy Analysis: A Comparative Assess ment of Eight Surveys.
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