Codes and Frequencies
Description
HIPBUYOWNR is a recoded variable created by the IPUMS NHIS staff, which indicates, for all persons who had at least one private health insurance health plan (except for 1997 to 1999), whether they had a plan that was purchased directly, rather than through an employer or union. For 1997 to 1999, the universe includes those who mentioned they had some form of health insurance.
Number of Private Plans Considered
There were changes over time in the number of insurance plans considered when collecting information about private health insurance purchased directly.
Information was collected on "any plan" for 1976 and 1980; on to up to five plans in 1982; on up to six plans in 1983; on up to five plans for 1984-1989; on "any plan" for 1990 and 1991; and on up to four plans per family for 1992 forward. Beginning in 2004, the NHIS public use files reported data only for plans one and two.
The recoded HIPBUYOWNR variable is based on responses to questions on coverage under plans one through five for 1982-1989, plans one through four for 1992-2003, and plans one and two for 2004 forward.
Changes in the number of insurance plans considered should have relatively little effect on the results for HIPBUYOWNR.
Persons with three or more plans have a "yes" response in HIPRIVGT2 (available for 2004 forward). Analysis by IHIS staff indicates that a very small number of persons (less than 0.2 percent of the total number of individuals with private health insurance per year for 2004 to 2009) had three or more private insurance plans. For 2004 forward, information on third and fourth insurance plans is available only through the restricted access files available through Research Data Centers.
Users are strongly encouraged to review the user notes Insurance Data Collection and Private Insurance Definitions.
Data Collection Process
For all years, interviewers first asked whether each family member was covered by any kind of health insurance or some other kind of health care plan. (Proxy reporting was allowed, so one person might provide this information for all family members.) Persons without an affirmative response to this opening query were treated differently beginning in 2000.
For 1997 to 1999, only people with affirmative responses to this initial question were included in follow-up questions about the kind of health insurance and the details of coverage; for 1997 to 1999, those without an affirmative response to the initial question are coded NIU (not in universe) for follow-up questions on insurance characteristics. Beginning in 2000, the response "no insurance" was included as a valid response to the initial question. Thus, for 2000 forward, the universe for follow-up questions on insurance coverage type and details was "all persons" (including those with an affirmative response to HINONE or reporting "no insurance").
For 1976 to 1996, HIPBUYOWNR reflects a negative response indicating the plan was not obtained through an employer or union.
For these survey years, respondents were only asked a yes/no question about whether their private plan was obtained through an employer or union. Respondents who answered "no" were considered to have plans purchased directly. For 1995 forward, self-employed persons with insurance obtained through professional associations are included as having insurance through the workplace, not purchased directly.
For 1997 forward, respondents were handed a flashcard listing various types of health insurance and asked to pick which one(s) they had (or how the insurance was obtained, for 2004 forward). HIPBUYOWNR reflects the response category "purchased directly."
Survey Questions
The wording of questions used to ascertain whether private insurance was purchased directly changed over time.
1976, 1980
- Is anyone in the family covered by hospital insurance, that is, a health insurance plan which pays any part of a hospital bill?
- Is anyone in the family now covered by a health insurance plan which pays any part of a hospital, doctor or surgeon's bill?
- Was this plan obtained through an employer or union?
- (Not counting Medicare) is anyone in the family now covered by a health insurance plan which pays any part of hospital, doctor or surgeon's bill?
- Was this plan originally obtained through the workplace, that is, through present or former employer or union?
- Health insurance can also be obtained privately or through a current or former employer or union. Was anyone in the family covered by private health insurance or by membership in a health maintenance organization in (month)?
- Was any of [name] health insurance obtained through an employer or union?
- (Not counting the government health programs we just mentioned,) In (month) was anyone in the family covered by a private health insurance plan? Do NOT include plans that pay for ONLY ONE type of service, such as nursing home care or accidents.
- Was this plan obtained through an employer or union?
- (Not counting the government health programs we just mentioned,) In (month) was anyone in the family covered by a private health insurance plan?
- Was this plan originally obtained through the workplace, that is, through a present or former employer or union?
- What kind of health insurance or health care coverage {do/does} {you/subject name} have? INCLUDE those that pay for only one type of service (nursing home care, accidents, or dental care), exclude private plans that only provide extra cash while hospitalized. Response category: Private health insurance plan purchased directly
- Which one of these categories best describes how this plan was obtained?
- Response category: Purchased directly
During the course of data editing, the NCHS staff discovered many errors in the responses to questions about insurance coverage. Such errors became apparent, for example, through mismatches between the verbatim names of insurance plans and the type of insurance coverage people selected from categories on a flashcard. Users should be aware that the responses for HIPBUYOWNR prior to 1997 have not been edited for accuracy, and respondents may have mistakenly reported their insurance information.
Comparability
HIPBUYOWNR is completely comparable for 2004 forward. The variable is also completely comparable within the two sets of grouped years 1997-2003 and 1993-1996. The reduction in the number of plans for which data are publicly available would seem to reduce comparability before and after 2004; however, analysis by IHIS staff found very few individuals (less that 0.2 percent of persons with private health insurance in 2004-2009) had more than 2 private insurance plans.
The responses about what kind of insurance coverage the person had have been back-edited for accuracy only in the data for 1997 forward. (See the variable description for HINOTCOVE for a description of this back-editing process.) As noted in the variable description for HIPBUYOWNR, the unedited responses about insurance type were found to contain many errors. For example, analysis of the unedited version of the data by IHIS staff indicates that for each year from 2004 to 2009, around 1.6 percent of respondents who reported having private insurance did not have private insurance. Researchers should thus exercise caution when comparing results for HIPBUYOWNR before and after 1997.
Universe
- 1976; 1980; 1982; 1984; 1986; 1989; 1992: Persons who are covered by a private health insurance plan (excludes single service plans).
- 1983; 1993: Persons in quarters 3 and 4 covered by a general health insurance plan (excludes single service plans).
- 1994-1996: Persons who are covered by a private health insurance plan (excludes single service plans).
- 1997-1999: Persons who are covered by some type of health insurance plan.
- 2000-2003: All persons
- 2004-2018: Persons who are covered by a private health insurance plan (excludes single service plans).
Availability
- 1976, 1980, 1982-1984, 1986, 1989, 1992-2018
Weights
- 1976, 1980, 1982, 1984, 1986, 1989, 1992, 1994-2018 : PERWEIGHT
- 1983, 1993 : SAMPWEIGHT
