Codes and Frequencies
For persons who did not have health insurance coverage through Medicare, or private insurance coverage, HINOREXPEN indicates whether the person did not have insurance because it was too expensive or he or she could not afford it. Respondents were handed a card which listed reasons or could specify "other," and were asked to pick all that applied.
For 1976 to 1989, persons may have had coverage through other public programs, such as Medicare (1976) Medicaid (1976 and 1980) or military health care (1976-1989). For 1976 to 1996, individuals may have also been covered through the government programs Aid to Families with Dependent Children or received Supplemental Security Income.
This is because coverage through these programs were not asked about until later in the survey. For 1993 to 1996, individuals were asked about coverage through these public programs before being asked for a reason for "not having coverage" and thus are not in the universe. However, for 1993 to 1996, individuals could also indicate they had insurance through "some other health plan." Coverage refers to at the time of the survey, except for 1993 to 1996, when it is in the previous month. See the comparability tab for more details.
The definition of private health insurance remained fairly consistent, except for 1993 to 1996 when single service plans were considered a form of health insurance. Thus individuals with such plans are not in the universe for HINORDISS for these years. Users are strongly encouraged to review the user note on Private Insurance Definitions.
Changes in the universe and the choice of responses available to respondents reduce comparability over time. For 1993 to 1996 those with single service insurance plans are not included in the universe (they were not asked reasons for no insurance). Individuals with such plans were considered to be covered by insurance. Prior to 1989, information on single service plans was not collected and these plans may have been rare.
For the years 1976 to 1989, the universe includes those who may have been covered through other forms of public assistance, such as Medicaid or military health care. This is because the question for "reason for no insurance" occurred before questions about coverage through these other programs in the survey. For example, for 1986 and 1989, some individuals who indicated unemployment as a reason for no insurance were also recorded to have insurance (HICOVR). Users should be careful when comparing with later years.
Because of coverage through other programs, HINOREXPEN is not comparable directly with variables for 1997 forward (such as HISTOP1) which indicates the respondent did not have coverage due to cost but lost his or her job or changed employer. Users who wish to compare HINOREXPEN with the surveys for 1997 forward should see the variable HINOCOSTR, which has been recoded to improve comparability over time.
During the course of data editing, the NCHS discovered many errors in the responses to questions about insurance coverage. Often, respondents misclassified the type of insurance they had. 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 variables for 1997 forward reflect editing that ensured the individual lacked any insurance coverage. Other differences which reduce comparability are changes in the universe. For 1997 the universe includes only those without insurance for less than 3 years and for all years from 1997 forward, those with single service plans are asked about reasons for no insurance.
- 1976: Persons not covered by Medicaid, Medicare, or insurance that paid for any part of hospital, doctor or surgeon's bill (or who only had a health insurance plan that paid for accidents).
- 1980; 1982; 1984: Persons not covered by Medicare or health insurance that paid for any part of hospital, doctor, or surgeon's bill (or who only had a health insurance plan that paid for accidents).
- 1983: Persons in quarters 3 or 4 not covered by Medicare or health insurance that paid for any part of hospital, doctor, or surgeon's bill (or who only had a health insurance plan that paid for accidents).
- 1986: Persons not covered by Medicare or health insurance that paid for any part of hospital, doctor, surgeon or dentist's bill (or who only had a health insurance plan that paid for accidents).
- 1989: Persons not covered by Medicare or any health insurance plans, including single service plans.
- 1993: Persons in quarters 3 or 4 not covered by Medicaid, Medicare, other public assistance, Indian Health insurance, CHAMPUS/CHAMP-VA, other military health care, or any private health insurance plan.
- 1994-1996: Persons not covered by Medicaid, Medicare, other public assistance, Indian Health insurance, CHAMPUS/CHAMP-VA, other military health care, or any private health insurance plan.
- 1976, 1980, 1982-1984, 1986, 1989, 1993-1996