Codes and Frequencies
For sample adults with military health care coverage (HIMILITE), HIVA indicates whether the person had military health care other than CHAMP, CHAMPUS or TRICARE, through the Department of Veterans Affairs (VA). Prior to 2019, HIVA was asked of all persons with military health care coverage, as identified in HIMILITE.
Interviewers handed respondents a flashcard listing various types of insurance and asked them to pick the kind(s) of insurance they had. For 2004 forward, the flashcard included the category "Military health care (TRICARE/VA/CHAMP-VA)." Respondents who chose this category were asked a follow-up question about whether their plan was in the form of (1) TRICARE, (2) VA, (3) CHAMP-VA, or (4) other military coverage. HIVA indicates whether an individual had VA coverage. Beginning in 2018, NCHS added another question to address the undercount of individuals with VA coverage. People who initially answered "no" to HIVA, but later indicated VA coverage through the new question, had their answer to HIVA recoded to reflect that they have VA coverage. HIVAE contains the data edited on the basis of the additional question. Their answer to HIMILITE was also recoded to indicate they are covered by military health care. Please see the "Data Editing and Recoding" section on the Description tab of HIMILITE for more information.
From 2018 forward, NCHS recommends using HIVA only to study survey methodology. HIVAE should be used for estimates of the population with VA coverage.
In the course of investigating this variable for integration, IPUMS NHIS staff observed inconsistencies in the universe (the set of survey participants eligible to provide information for a particular variable) for HIVA, but these issues are resolved with the addition of the recoded data in HIVAE. The 2018 person file layout documentation notes that all individuals who indicate they have military health care coverage in HIMILITE are in universe for HIVA. However, there are a number of people who have a "yes" on HIMILITE who are out of universe for HIVA. The start of the inconsistencies coincides with the introduction of a new question in 2018 intended to address the undercount of individuals with VA coverage. There were no inconsistencies in the universes for these variables in earlier years.
HIMILITE is a constructed variable that was recoded on the basis of several questions. First, individuals were asked a question about what kind of health insurance or health care coverage they have. Those who selected "Military health care (TRICARE/VA/CHAMP-VA)" were coded to "yes" on HIMILITE. The respondents were subsequently asked questions about the name of their health insurance plans. If an individual named a military health care plan in one of these verbatim fields, but did not initially select that they had military health care coverage in the first question, their response to HIMILITE was recoded to "yes." Then, those who indicated military health care coverage were asked a question ascertaining the specific type of coverage with the following options: TRICARE, VA, CHAMP-VA, or other military coverage (specify). The individual's answer to this question provided the information for HITRICARE, HIVA, HICHAMPVA, and HIMILITOTH, respectively.
Beginning in 2018, NCHS added a question intended to address the undercount of individuals with VA coverage in NHIS. After ascertaining the specific type of military coverage from people who indicated they are covered by military health care, this question asked persons aged 18 and older who have ever served in the U.S. Armed Forces if they have ever enrolled in or used VA health care. Those who indicated "yes" to this new question had their value for HIMILITE recoded to "yes" and their value for HIVA recoded to "mentioned" (the edited data is contained in the variable HIVAE). Beginning in 2019, responses to HIVA were also recoded on responses to the question "During the past 12 months, did you receive any care at a Veteran's Health Administration facility or receive any other health care paid for by the VA?" However, because this recode of HIMILITE occurred after the question about the specific type of military health care, there are individuals who were coded as "out of universe" for HIVA despite having a value of "yes" on HIMILITE. The recoded data contained in HIVAE rectifies this issue. In 2018, there are 852 people who indicated "yes" on HIMILITE but were "out of universe" for HIVA.
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.