Codes and Frequencies
Description
HIPUBCOVE is a recoded variable created by the IPUMS NHIS staff, which indicates, for all persons, whether the individual had health insurance coverage through Medicaid, any other state or other local government program that pays for health care, or, for 1999 forward, the Children's Health Insurance Program.
For all years, the period of coverage refers to at the time of the survey. The component variables used to construct it are: HIMCAIDE,HISTATEE, HICHIPE, and HIOTHGOVE. HIPUBCOV excludes military coverage (HIMILITE), Medicare (HIMCAREE), and Indian Health Service coverage (HIHSE).
Data Collection
For 1997 forward, HIPUBCOVE is based on a direct question about what kind of insurance the person had. Respondents were shown a flashcard listing insurance types and told to pick which one(s) they (and their family members) had.
For 1997 forward, interviewers began by asking whether each family member had any kind of health insurance coverage. For 1997 to 1999, only persons with an affirmative response to this initial question have responses to follow-up questions about the kind of health insurance and details of coverage
For 1997 to 1999, those who did not answer the initial question affirmatively 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 "no insurance").
Various definitions of Medicaid were provided to respondents, but the changes in the definition were not substantial.
In essence, for 1976 to 1996, Medicaid was defined as a health insurance program that provides medical assistance to persons in need. The Field Representative's Manuals for 1997 forward defined Medicaid as "a medical assistance program that provides health care coverage to low income and disabled persons. The Medicaid program is a joint federal-state program which is administered by the States."
The order and wording of NHIS questions on health insurance coverage changed over time to reflect the availability of different types of coverage and issues of interest. From 1976 to 1996, respondents were asked a series of questions on whether family members had each of several types of coverage. Starting in 1997, respondents selected the relevant types of coverage from a list on a flashcard. The contents of the flashcard list reflected the types of public programs available at the time. Users are encouraged to read the User Note on "Changes in the Insurance Data Collection Process" for further information.
The survey questions used to collect the information included in HIPUBCOV changed over time.
1997 forwardInterviewers first asked, "Are you covered by health insurance or some other kind of health care plan?" For individuals who had an affirmative response, the interviewer asked, "What kind of health insurance or health care coverage do you have?" Respondents selected the appropriate response from a flashcard listing various types of insurance coverage, including Medicaid. The options on the card were as follows:
- 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 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 forward)
- 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.
Comparability
The component variables used to create HIPUBCOVE reflect variables that have been edited by the NCHS for accuracy. Beginning in 1997, plan names were used to back-edit responses to verify the accuracy of insurance type. The NCHS strongly advises analysts to use the back-edited insurance variables as a more reliable source of information about the types of insurance coverage than is provided by respondents' 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 categories on a flashcard. Most researchers studying only the period from 1997 forward should use the back-edited variables such as HIPUBCOVE to analyze public insurance coverage. HIPUBCOV, which reflects respondents' original replies without back-editing, is more suitable for studying public coverage both before and after 1997.
Additionally, changes to the universe affect the comparability of this variable between 1999 and 2000; please see the Universe Tab for detailed descriptions of who is in universe for this variable in each sample.
Universe
- 1997; 1998; 1999: All persons with any kind of insurance.
- 2000-2018: All persons.
Availability
- 1997-2018
Weights
- 1997-2018 : PERWEIGHT
