Pres acs workshop_june14_call


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Pres acs workshop_june14_call

  1. 1. Monitoring Health Access using the American Community Survey Kathleen Thiede Call Workshop on the Benefits (and Burdens) of the American Community Survey June 14, 2012 Washington, DCFunded by the Robert Wood Johnson Foundation and Federal and State Agencies
  2. 2. About SHADAC• We help states collect and analyze data to inform state health policy decisions relating to health insurance coverage and access to care.• Our goal: To help states bridge the gap between health data and the policy-making process.• Based at the University of Minnesota 2
  3. 3. States’ needs for monitoring coverage• Consistent estimates• Trends over time – Monitor impacts of health reform• Comparisons across states• Subpopulation analysis – Race/ethnicity, poverty, age – Counties/sub-state areas• Access to microdata 3
  4. 4. Key federal survey data sources• General household survey – ACS: American Community Survey• Employment/Income survey – CPS: Current Population Survey (ASEC)• Health surveys – NHIS: National Health Interview Survey – MEPS-HC: Medical Expenditure Panel Survey-Household Component – BRFSS: Behavioral Risk Factor Surveillance System 4
  5. 5. CPS: the good, the bad and the uglyGood• Historic trends• State-level estimates• Several control variables available Bad• State-specific public • Low sample in health insurance smaller states program names • 10% of respondents• Timely data release have entire Ugly supplement imputed • Concerns about the coverage questions 5
  6. 6. ACS to the rescue• SAMPLE SIZE!!!!!!!!!!!!!!• Sub-state estimates• Robust subpopulation analysis• Representativeness• Current coverage measured• WISH LIST: – Data updates during the year, like NHIS – Self reported health status 6
  7. 7. Questions we help states answer• How many uninsured are in my state and where do they live? What is their demographic profile?• How many people in my state will be eligible for Medicaid under ACA.• How many kids in each county are eligible for CHIP or Medicaid but not enrolled? 7
  8. 8. Where should we allocate funds forcommunity clinics? West Virginia Sub-State Uninsurance Estimates, Age 0-64 All income levels ≤200% of poverty Source: 2009 American Community Survey 8
  9. 9. How many Minnesotans will be NOT beeligible for Medicaid under ACA?100% Not Eligible, 11% 4.0 Million Not Eligible, 8% 38,00080%60% Eligible, 89% 32.7 Million Eligible, 92% 462,00040%20% 0% United States Minnesota 9
  10. 10. How many uninsured kids in Colorado areeligible for CHIP but not enrolled? Source: Colorado Health Institute Analysis of 2008-2010 American Community Surveys 10
  11. 11. What percent of poor kids are uninsured? Uninsurance Rates, Age 0-18, ≤200% FPG Source: 2010 American Community Survey 11
  12. 12. Unmet needs with American FactFinder• Does not provide all policy-relevant measures – Health insurance unit rather than Census family – Federal poverty guidelines (HHS) rather than thresholds – FPG cuts at ACA policy levels (138%, 200%)• Not user-friendly 12
  13. 13. SHADAC’s technical assistance for states• SHADAC’s Data Center – Online table and chart generator of policy-relevant tables of health insurance coverage estimates from the ACS and CPS.• 12 years of rigorous investigation• Technical assistance to help states use data• Education and capacity building• FPG at 138% and 200%• Health Insurance Unit – Family relationships assigned according to health plan eligibility 13
  14. 14. SHADAC’s Data Center 14
  15. 15. SHADAC’s Health Insurance Unit (HIU) Married couple Grandparents, marriedwith two children child, and grandchild Grandparents Married Child Spouse Kids Grandchild• Census family has 1 unit • Census family has 1 unit• HIU family has 1 unit • HIU family has 2 units 15
  16. 16. Conclusions• The ACS fills a gap in state-level data to inform policy decisions – Statewide and locally – Subpopulations; small minority, age or income groups• The ACS is widely accessible – Don’t need to be a data programmer to access this information• The ACS is a great tool for modeling/linking with other data to develop state-level estimates• Benchmarking and sub-population analysis will be compromised if ACS becomes voluntary 16
  17. 17. Sign up to receive ournewsletter and updates at @shadac