Analysis of Children's Health Insurance Patterns: Findings from the SIPP. A. Data

05/12/1999

The findings presented herein are based on an analysis of longitudinal data from the 1992 panel of the SIPP. Starting with an initial sample of about 20,000 households representing the resident, noninstitutionalized population of the United States, except for those living in military barracks, the Census Bureau reinterviewed respondents every four months over a period of three calendar years. Respondents were asked a lengthy set of questions about their labor force participation, sources and amounts of income, family and household composition, and participation in government programs in each of the preceding four months. The interviews were staggered, with one quarter of the sample, constituting a “rotation group,” being interviewed each month. The purpose of this design was, in part, to minimize the impact of recall error and other reporting problems on the quality of the data compiled for calendar months. The estimates for a given calendar month are based on roughly equal proportions of the respondents describing circumstances one month ago, two months ago, three months ago, and four months ago.

Several features of the SIPP make these data especially appealing for the analysis of dynamic behavior in children’s health insurance coverage. The SIPP provides a detailed measure of health insurance coverage for every month of the two to three year duration of a panel. Measures of the duration of new spells of particular types of coverage or lack of coverage can be constructed by aggregating the reports from successive interviews, so that no matter how long the measured duration of a particular spell, no part of a reported spell relies on respondent recall beyond four months. In addition to providing measures of health insurance coverage, SIPP also provides very detailed measures of demographic and economic characteristics--again on a monthly basis. This affords us the opportunity to construct contemporaneous measures of circumstances that may affect eligibility for and enrollment in particular types of coverage. For example, we can construct a reasonably good simulation of Medicaid eligibility on a monthly basis and compare these monthly estimates to reports of Medicaid participation and insurance coverage--or the lack thereof--on a monthly basis as well. Arguably, there are no better data for investigating the dynamics of children’s health insurance coverage in the context of changing circumstances, including Medicaid eligibility.

Despite these strengths, however, the SIPP does possess some notable limitations that will become evident as we proceed through our findings. These include some well-documented but not well understood problems with the quality of retrospective monthly reports of program participation and health insurance coverage.

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