Survey Data on Health Insurance Coverage for 2013 and 2014. 2013: Current Population Survey Annual Social and Economic Supplement (CPS-ASEC) and American Community Survey (ACS)

10/31/2014

The CPS-ASEC and ACS estimates released on September 16, 2014 cover CY 2013.20 These data thus provide a baseline for future analyses of changes in health insurance coverage under the Affordable Care Act.

The new CPS-ASEC data were the first collected using a new battery of health insurance questions, long under development, that aim to provide more accurate estimates of the uninsured and sources of coverage.21 The Census Bureau regards these changes as a break-in-series, meaning that this year’s CPS-ASEC estimates are not comparable to past years’ estimates.22

The new CPS-ASEC estimates suggest that 42 million Americans (13.4 percent of the population) were uninsured for all of CY 2013 and 271.4 million Americans had coverage for all or at least part of the year.23 The likelihood of being uninsured varies according to age, race/ethnicity, employment status, and household income. Although the break-in-series in the CPS-ASEC precludes direct comparison of these data with data for earlier years, the new data and methodology suggest conclusions about who is uninsured and who is insured that are similar to those based on last year’s CPS-ASEC data and methodology.24 Table 3, for example, suggests that, in 2013, as in 2012, young adults were more likely to be uninsured than children or seniors.

Table 3. Profile of the Uninsured vs. Total Population by Age, 2013

Age Uninsured (N = 42.0 million) (%) Total Population (N = 313.4 million) (%)
Total 100.0 100.0
0-18 14.1 24.9
19-25 16.4 9.7
26-34 21.3 12.1
35-44 18.0 12.7
45-64 28.6 26.3
65 and older 1.7 14.2

Source: ASPE calculations from Jessica C. Smith and Carla Medalia, U.S. Census Bureau, Current Population Reports, P60-250, Health Insurance Coverage in the United States: 2013, U.S. Government Printing Office, Washington, DC, 2014 (http://www.census.gov/content/dam/Census/library/publications/2014/demo/..., accessed October 27, 2014).


The ACS began to measure health insurance coverage in 2008, and due to its large sample size (approximately 3 million), the Census Bureau has recommended that it be used for state- and local-level analyses. The point-in-time ACS estimate for all age groups is that 45.2 million people (14.5 percent) were uninsured in Calendar Year 2013.25

With the break in the CPS-ASEC time series due to the introduction of the new methodology, the Census Bureau recommends use of the ACS for trend analysis as well. O’Hara and Medalia found that the two Census surveys suggested similar trends between 2009 and 2012.26


20 Jessica C. Smith and Carla Medalia, U.S. Census Bureau, Current Population Reports, P60-250, Health Insurance Coverage in the United States: 2013, U.S. Government Printing Office, Washington, DC, 2014 (http://www.census.gov/content/dam/Census/library/publications/2014/demo/..., accessed October 27, 2014). Additional ACS estimates were released on September 18, 2014.
21 The NHIS data described in the last section also underwent changes in data processing to permit them to reliably identify different types of private coverage, particularly new Marketplace coverage. These changes do not affect overall coverage trends, nor does NCHS believe that they have generated a break-in-series for the share of individuals with different types of coverage.
22 Jessica C. Smith and Carla Medalia, U.S. Census Bureau, Current Population Reports, P60-250, Health Insurance Coverage in the United States: 2013, U.S. Government Printing Office, Washington, DC, 2014 (http://www.census.gov/content/dam/Census/library/publications/2014/demo/..., accessed October 27, 2014); Brett O’Hara and Carla Medalia, CPS and ACS Health Insurance Estimates: Consistent Trends from 2009-2012 , U.S. Census Bureau, SEHSD Working Paper 2014, September 15, 2014 (http://www.census.gov/hhes/www/hlthins/data/incpovhlth/2013/CPS_ACS_Tren..., accessed October 27, 2014).
23 Jessica C. Smith and Carla Medalia, U.S. Census Bureau, Current Population Reports, P60-250, Health Insurance Coverage in the United States: 2013, U.S. Government Printing Office, Washington, DC, 2014 (http://www.census.gov/content/dam/Census/library/publications/2014/demo/..., accessed October 27, 2014).
24 Carmen DeNavas-Walt, Bernadette D. Proctor, and Jessica C. Smith, U.S. Census Bureau, Current Population Reports, P60-245, Income, Poverty, and Health Insurance Coverage in the United States: 2012, U.S. Government Printing Office, Washington, DC, 2013 (http://www.census.gov/prod/2013pubs/p60-245.pdf, accessed October 27, 2014); Kenneth Finegold, New Census Estimates Show 3 Million More Americans Had Health Insurance Coverage in 2012, ASPE Issue Brief, November 23, 2013 (http://aspe.hhs.gov/health/reports/2013/CPSIssueBrief/ib_cps.pdf, accessed October 27, 2014).
25 Jessica C. Smith and Carla Medalia, U.S. Census Bureau, Current Population Reports, P60-250, Health Insurance Coverage in the United States: 2013, U.S. Government Printing Office, Washington, DC, 2014 (http://www.census.gov/content/dam/Census/library/publications/2014/demo/..., accessed October 27, 2014).
26 Brett O’Hara and Carla Medalia, CPS and ACS Health Insurance Estimates: Consistent Trends from 2009-2012, U.S. Census Bureau, SEHSD Working Paper 2014, September 15, 2014 (http://www.census.gov/hhes/www/hlthins/data/incpovhlth/2013/CPS_ACS_Tren..., accessed October 27, 2014).

 

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