The University of Michigan
How Many Are Uninsured? Different Data Offer Different Dimensions
The number and composition of the uninsured changes dramatically if you look at the uninsured during a particular month rather than over an entire year. Getting accurate and timely estimates of how many people experience what kinds of spells of uninsurance is important in order to craft effective policies for the uninsured. Further, those uninsured all year differ from those individuals who lose coverage for only part of the year.
A team of researchers
at the University of Michigan’s Economic Research Initiative on
the Uninsured (ERIU) has assembled Fast Facts on the Uninsured, a set
of statistics highlighting important differences contained in three key
data sources: the Current Population Survey (CPS), an annual data source
that interviews individuals about their health insurance once a year;
the Survey of Income and Program Participation (SIPP); and the Medical
Expenditure Panel Survey (MEPS). The latter two surveys interview people
about their coverage multiple times during a year.
Mary Harrington, a Research Investigator with ERIU and formerly with Mathematica Policy Research, Inc., has spent 14 years investigating different issues involving health insurance coverage for low-income populations. Harrington talks about the importance of researchers and policymakers looking at other data sources on the uninsured and not over-relying on the Current Population Survey (CPS).
Q: What is the purpose of ERIU compiling Fast Facts?
A: We’re trying to make health policymakers and researchers with an interest in the uninsured aware of how much difference it can make when you look at statistics about the uninsured from different data sources and at different points in time or reference periods. Researchers and policymakers can use the Fast Facts data to answer numerous questions about the magnitude, characteristics, and distribution of the uninsured over different time frames and data sources.
Q: Why is this important?
A: People who are uninsured for an entire year, the chronically uninsured, are distinct from those uninsured for some portion of the year. And the part-year uninsured includes people who cycle in and out of coverage as well as those who begin or end a spell without coverage during that year. Policies targeted to the chronically uninsured are likely to differ from the kinds of policies needed for those who change from one status to another and experience a brief period without insurance.
Q: What specifically can MEPS and SIPP tell us that CPS can’t?
A: For some populations it doesn’t seem to matter which data source you use, as you’re able to tell a very similar story. But for certain groups, including children, the self-employed, Hispanics, and immigrants, it really does seem to make a difference when you look at the all-year vs. part-year distinctions. When looking at MEPS and SIPP we see children are less likely than average to experience a lack of coverage throughout the entire year. Children are more likely to be covered under public programs, and turnover is greater in public programs than it is in employment-based and other private coverage. Those are the kinds of things you can tease out.
Q: How could policies be more specifically targeted to address the different types of uninsured?
A: A person who lacks insurance throughout the year may very well benefit from policies that would expand public coverage or make affordable employer-based coverage available to them. Whereas the people who are cycling in and out of coverage during a year, and who are experiencing periods of being uninsured, are going to benefit from policies that would allow them to keep insurance once they get it.
Q: What do we need to keep in mind when we read about 43.6 million uninsured Americans?
A: We need to realize
the number of people who are uninsured is much larger than 43 million.
More than 60 million are uninsured at some time
during the year, and the number can be as
high as 80 million if you expand your view to
a period of two years. Uninsurance touches an awful lot of
people’s lives. This is not a uniformly
unemployed, low-income group of people. It’s
a very diverse population that includes working
families who are
middle-income and upper-income, as well as very
vulnerable families and adults. This is a dynamic
population and we can’t lose sight of that.
We need to start thinking about being uninsured
of uninsurance that people experience.
Funded by The Robert Wood Johnson Foundation, ERIU is a five-year program shedding new light on the causes and consequences of lack of coverage, and the crucial role that health insurance plays in shaping the U.S. labor market. The Foundation does not endorse the findings of this or other independent research projects.