State Estimates of Health Insurance Coverage Data from the National Health Interview Survey Eve Powell-Griner SHADAC State Survey Workshop Washington, DC, January 13, 2009 U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention National Center for Health Statistics Current products Early Release Program full year report (June) 20 largest states (population) age groups: under 65; under 18; 18-64 at time of interview percentage uninsured; public coverage; private coverage 1
Periodic product (National Health Statistics Report (NHSR) Number 1, June 19, 2008) State, Regional and National Estimates 41 states with at least 1,000 NHIS respondents (AK, DE, DC, MT, NH, ND, RI, SD, CT, WY excluded) d) 3 years of data combined (2004-06) age groups: under 65; under 18; 18-64 NHSR continued Coverage status: at time of interview: no coverage, private coverage, Medicaid or SCHIP Uninsured at time of interview: uninsured for part of past year, uninsured for more than a year 2
NHSR continued Coverage status and type of coverage by poverty level State-specific estimates compared with national average on all tables and maps Illustrations 3
Children under age 18 with private coverage at the time of interview, by state, 2004-2006 WA ME MT MN OR ND VT NH ID SD MI NY WI MA RI WY CT` NV UT CO NE IA IL IN OH PA NJ MD DE DC CA MO WV KS KY VA AZ NM OK AR TN NC MS AL SC GA TX LA FL AK HI Percentage significantly lower than U.S. overall (61.5%) Percentage not significantly different than U.S. overall Not shown due to small sample size Source: CDC/NCHS, National Health Interview Survey. Chart from NCHS, National Health Statistics Reports, No. 1. Children under age 18 uninsured at time of interview, by state, 2004-2006 WA MT ND *ME OR MN VT NH ID WY SD WI MI NY MA *CT RI NV NE *IA OH PA NJ UT IL IN MD DE CA CO KS MO KY *WV VA DC TN NC AZ NM OK AR SC MS AL GA TX LA FL AK *HI Percentage significantly lower than U.S. overall (9.3%) Percentage not significantly different than U.S. overall Source: CDC/NCHS, National Health Interview Survey. Chart from NCHS, National Health Statistics Reports, No.1. Not shown due to small sample size Estimates for states noted with an * have a relative standard error greater than 30% but less than or equal to 50% and should be interpreted with caution. 4
Children under age 18 with Medicaid / SCHIP coverage at time of interview, by state, 2004-2006 WA MT ND MN ME OR ID WY SD WI MI NY VT NH MA CT NJ RI NV NE IA PA NJ CA UT CO KS MO IL IN OH KY WV MD VA DE DC AZ NM TX OK AR LA MS TN AL SC GA NC FL AK HI Percentage significantly lower than U.S. overall (27.9%) Percentage not significantly different from U.S. overall Not shown due to small sample size Source: CDC/NCHS, National Health Interview Survey. Chart from NCHS, National Health Statistics Reports, No. 1. NHSR continued CPS and NHIS estimates compared in appendix table uninsured for full year uninsured at time of interview uninsured for more than 1 year Differences consistent with previously published comparisons CPS estimates of uninsured full year similar to NHIS estimates of uninsured at time of interview 5
NIS State Health insurance data Other uses Regional estimates High Deductible Health Plans - comparisons of BEA regions and national percentages for persons under 65 years of age, 2007 Far West Rocky Mountain Plains Great Lakes Mideast New England ga Southwest Southeast Percentage significantly lower than U.S. overall Percentage not significantly different from U.S. overall DATA SOURCE: National Health Interview Survey, 2007. NOTE: U.S. overall rate is 17.3%. 6
Limitations in NHIS direct state estimates Excludes smaller states Limits disaggregation into smaller subpopulations (race, etc) Geographic codes not available on public use files due to confidentiality issues Future possibilities for producing state estimates Use modeling techniques Create statistical noise to enable release of geographic identifiers on public use files Expand state access in larger states California UCLA uses NHIS data to calibrate with the CHIS Use geocoded data to capture area characteristics 7