Timely and accurate estimates of the number of people who do not have health insurance coverage are important for understanding trends in health insurance coverage and the impacts of policy changes that affect health insurance. Estimates of the number of people who are uninsured are available from several different sources. This brief provides an annual update to comparisons of uninsurance estimates from five federal surveys. It presents trends in national estimates of uninsurance, presents the most recent available state-level estimates from these surveys, and describes the main reasons for variation in the estimates across the different surveys. This brief compares five federal surveys that are used to estimate the level of uninsurance in the United States. These include: The American Community Survey (ACS): Conducted by the U.S. Census Bureau, the ACS is an annual household survey that replaced the decennial census long form questionnaire. A question on health insurance coverage was added to the ACS in 2008. The Behavioral Risk Factor Surveillance System (BRFSS): Sponsored by the U.S. Centers for Disease Control and Prevention, the BRFSS is a state-based survey of adults focusing on population health, risk factors, and health behaviors. Since 1991, it has included a question that asks whether respondents are uninsured or have some form of health insurance. The Current Population Survey (CPS): The CPS is conducted by the U.S. Census Bureau for the Bureau of Labor Statistics, and the survey's Annual Social and Economic Supplement (ASEC) collects data on health insurance coverage. The CPS estimates of health insurance coverage are among the most commonly cited estimates, and they are used to monitor both state and national trends in health insurance coverage. The estimates date back to 1987. The Medical Expenditure Panel Survey--Household Component (MEPS-HC): The MEPS-HC is sponsored by the Agency for Healthcare Research and Quality, and consists of several interviews with the same respondents over two full calendar years. Conducted since 1996, the MEPS-HC collects data on health status and health conditions, health insurance coverage, access to and utilization of health care services, medical expenditures, and various demographic and socioeconomic characteristics. The National Health Interview Survey (NHIS): Sponsored by the National Center for HealthStatistics, the NHIS includes questions about health insurance coverage, health care utilization and access, health conditions and behaviors, and general health status, in addition to demographic and socioeconomic characteristics. The NHIS has been conducted annually since 1957; annual health insurance coverage estimates are available beginning with 1998. Each of these surveys was designed to collect information for different research and policy purposes. Table 1 summarizes key information from each of these surveys, such as who is included in the survey, when and how the survey is conducted, response rates, and the availability of state-level health insurance estimates. In addition to collecting data on uninsurance, most of these surveys also have undergone revisions to help them measure effects of the Patient Protection and Affordable Care Act.
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