The U.S. Census Bureau produces state-level estimates of the distribution of health insurance coverage on an annual basis. Although the Census Bureau's estimates of coverage are often cited in academic and policy circles, analysts suspect that they overstate rates of all-year uninsurance and understate Medicaid enrollment. For a variety of reasons, many state analysts prefer to collect and make use of their own survey data. Over 40 states have recently conducted their own population surveys to get state-level estimates of health insurance coverage. State survey estimates of uninsurance are typically lower than the estimates produced by the Census Bureau's Current Population Survey, Annual Social and Economic Supplement (CPS). These discrepancies fuel the debate about the number of uninsured and may threaten the validity and usefulness of survey data to inform policy decisions around access to health care and insurance. In this brief we compare state survey and CPS estimates of uninsurance, analyze factors with the greatest potential to explain these differences, and discuss the policy implications of this persistent discrepancy.
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