Marriage and Health Care Coverage Among Families with Children. Study Methods

This brief is based on secondary data tables provided to Mathematica Policy Research, Inc. (MPR) by the Office of the Assistant Secretary for Planning and Evaluation (ASPE). The tables are based on survey data from the 2004 Annual Social and Economic Supplement (ASEC) to the Current Population Survey (CPS), a nationally representative survey of the non-institutionalized U.S. population conducted annually by the U.S. Census Bureau. The data were collected from February through April of 2004 but assess rates of health care coverage for the calendar year 2003. For this analysis, we focused on families with children under age 18 who were living with their biological parents, adoptive parents, or stepparents.

In comparing differences in rates of health care coverage between married-parent and single-parent families, we excluded data for the approximately 5 percent of households headed by cohabiting parents, because rates of health care coverage are very different for families headed by cohabiting parents than for other families with children. For similar reasons, we also excluded data for the less than 4 percent of families headed by parents who were married but separated. The estimates for single-parent families include parents who were widowed, divorced, or had never been married.

Because families can have more than one source of health care coverage, the estimates for source of coverage (Figures 1 and 2) are not mutually exclusive and therefore do not sum to the totals for overall rates of health care coverage (Tables 1 and 2). For the estimates of health care coverage among low-income families, the sample is limited to families with incomes below 200 percent of the federal poverty level. For the estimates of racial/ethnic differences in coverage rates, the figures for African-Americans and whites are limited to non-Hispanics in these groups. For African-Americans, the figures exclude people who reported their race as African-American in combination with some other group. The estimates of racial/ethnic differences for married-parent families include only same-race couples.

In the data tables provided to MPR, the estimates of coverage rates through public health care programs including Medicaid and the State Children's Health Insurance Program (SCHIP) were adjusted for underreporting of public health care coverage in the CPS (DeNavas-Walt et al. 2007, p. 18) using the TRIM3 microsimulation model. The purpose of the adjustment is to align the survey estimates of public coverage with program statistics on persons who were enrolled in Medicaid or SCHIP at any time during the calendar year. The adjustment increases the survey estimates of the percentage of families with public health care coverage and reduces the estimates of families who were without health care coverage for the entire year. Alternative adjustment procedures may yield different estimates (Dubay et al. 2006), so readers should interpret these results accordingly. For more details on the TRIM3 simulation model, see http//



The brief was written by Brian Goesling and Heather Koball, Mathematica Policy Research, Inc.(MPR) for the Office of the Assistant Secretary for Planning and Evaluation (ASPE), Office of Human Services Policy in the U.S. Department of Health and Human Services (HHS).

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