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Why coverage stopped: Cost is too high

Codes and Frequencies

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For persons without health insurance coverage, and, in 1997, persons without health insurance coverage for less than 3 years, HISTOP11 indicates if a reason for not having coverage was the cost was too high. Respondents were handed a card listing possible reasons for no insurance and were asked to specify the reason(s) or could specify 'other' (respondents were limited to five reasons for 1997 forward). For all years, individuals with single service plans were asked for reasons for no insurance, since single service plans were not considered to be insurance plans.

Apart from 1997, response categories listed on the card remained the same. For 1997, the response category "insurance plan raised premium" (HISTOP10A) is also available. See the comparability tab for more details.

For related variables, please use the IPUMS NHIS search function and drop-down menus.

Users are also strongly encouraged to review the user notes Insurance Data Collection.


Changes in the universe and in response categories reduce comparability of 1997 with 1998 forward. Users should also not compare HISTOP11 with variables from before 1997. In 1997, the universe includes only those without insurance for less than 3 years and the response categories are slightly different from all other years. Although mostly comparable, the survey response categories for 1997 distinguished between whether the cost was too high (HISTOP11) or the insurance company raised its premium. (HISTOP10A). For 1998 forward, only HISTOP11 is available. Users who want to compare HISTOP11 with variables from before and after 1997 should see the recoded variable HINOCOSTR.


This variable is not directly comparable with variables from before 1997 indicating no insurance coverage due to high cost, such as HINOREXPEN (1976, 1980, 1982-1984, 1986, 1989, 1993-1996). Prior to 1997, persons who did not have insurance due to high cost may have been covered through other public programs or may have somehow misreported their coverage status. For 1997 forward, the NCHS began editing responses regarding insurance coverage status (based on the plan name given by the respondent) to improve accuracy. The variables from before 1997 have not undergone this editing to improve accuracy and are therefore less comparable with those after 1997.


  • 1997: All persons without health insurance coverage for less than 3 years
  • 1998-1999: Persons without health insurance coverage or for whom it is unknown whether they were without health insurance.
  • 2000-2018: Persons without health insurance coverage or whose only health insurance coverage is a single service plan.


  • 1997-2018