Codes and Frequencies
For sample adults and sample children (and, prior to 2019, all persons) (or persons covered by some kind of health care plan for 1997-1999), HINDIAN reports whether the respondent had Indian Health Insurance coverage at the time of the interview. The Indian Health Service (IHS) provides medical assistance to eligible American Indians at IHS facilities and helps pay the cost of selected health care services from other facilities. The Field Representative's Manual for 1997 forward defined the Indian Health Service as "the Federal health care program for Native Americans."
Persons with only Indian Health Service coverage are considered to be uninsured, and included in the frequencies in the variable HINOTCOVE.
1997 forward interviewers first asked, "Are you covered by health insurance or some other kind of health care plan?" and individuals who had an affirmative responses were asked, "What kind of health insurance or health care coverage do you have?" Respondents selected the appropriate response from a card listing various types of insurance coverage:
- Private health insurance (2004 forward)
- Private health insurance plan from employer or workplace (1997-2003)
- Private health insurance plan purchased directly (1997-2003)
- Private health insurance plan through a state or local government program or community program (1998-2003)
- Medicare (1997 forward)
- Medi-Gap (1997 forward)
- Medicaid (1997 forward)
- CHIP (Children's Health Insurance Program) (1999 forward)
- Military Health Care/VA (1997-2003)
- Military Health Care (CHAMPUS/TRICARE/CHAMP-VA) (1997-2018)
- Military related health care: TRICARE (CHAMPUS)/VA health care/CHAMP-VA (2019 forward)
- Indian Health Service (1997 forward)
- State-sponsored health plan (1997 forward)
- Other government program (1997 forward)
- Single Service Plan (e.g., dental, vision, prescriptions) (1999-2018)
- No coverage of any type (2000 forward)
Respondents could pick more than one type of insurance and interviewers were instructed to mark all that applied.
HINDIAN is mostly comparable over time. Response categories changed over time to reflect the changing availability of public programs and different measures of private insurance plans. Additionally, substantial questionnaire changes introduced in 2019 may affect comparability with earlier years.
HINDIAN is not comparable with the recoded variable HIHSE, which reflects responses edited for accuracy by the NCHS. The NCHS strongly advises analysts to use recoded insurance variables as a more reliable source of information about the types of insurance coverage than is provided by respondents' original and unedited answers about their insurance type. During the course of data editing, the NCHS discovered many errors in the responses to questions about insurance coverage. This might be shown, for example, by a mismatch between the verbatim name of an insurance plan and the type of insurance coverage the person selected from the categories on the card. The NCHS corrected misreported insurance coverage by reassigning individuals to the correct category in recoded variables.
The NHIS questionnaire was substantially redesigned in 2019 to introduce a different data collection structure and new content. For more information on changes in terminology, universes, and data collection methods beginning in 2019, please see the user note.
- 1997-1999: Persons covered by some type of health care plan.
- 2000-2018: All persons.
- 2019-2020: Sample adults age 18+ and sample children age 0-17.