Census CPS Changes Were Based on Careful Research in Order to Improve Coverage Estimates

April 17, 2014

From the desk of
SHADAC Investigator Kathleen Call

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History of the CPS Redesign

For years, policy analysts have pointed to a variety of weaknesses in the health insurance coverage measures in the Current Population Survey (CPS): recall error, respondent fatigue, etc. In response, the Census Bureau began work that aimed to improve these measures—work that started long before the Affordable Care Act (ACA) was conceived and passed into law.  Changing a federal data system is a lengthy process, and the timeline of the CPS revision process is in itself evidence that the changes were methodologically rather than politically motivated.

The New CPS Will Provide Pre-ACA Coverage Estimates

The redesigned CPS asks about coverage at the time of the survey and looks back to January of the prior calendar year, capturing monthly insurance coverage information up through the month of the survey. Therefore, the 2014 CPS will provide annual coverage estimates for 2013 that we will be able to compare to 2014 estimates from the 2015 CPS.  Certainly, there will be a break in trend for examining coverage with the CPS; however, we will have consistent CPS-based pre- and post-ACA measures of the number and percent of people with and without health insurance.  Moreover, we will still be able to track changes over time using the Census Bureau’s American Community Survey (ACS), which has provided consistent measures of insurance coverage since coverage questions were added to the survey in 2008. We can also obtain trend information from the National Health Interview Survey (conducted by National Center for Health Statistics) and the Medical Expenditure Panel Survey (conducted by the Agency for Healthcare Research and Quality).

The Benefits of the Redesign

What has been overlooked in the recent commotion about changes to the CPS is all the new information that we will gain through the redesign. The revised question series will provide a wealth of new content that can be used to monitor sources of health insurance and changes in coverage month by month over the course of a calendar year and up to as long as 15 months.  This content includes information about the purchase of coverage on health insurance exchanges; the receipt of subsidies; employer coverage offers; and why eligible workers do not take up employer coverage offers. The CPS will also be uniquely capable (among publicly available federal data sources) of producing state-level estimates for all fifty states on exchange participation and out-of-pocket medical spending. 

The Take-Away

All change comes with trade-offs.  The redesign CPS offers numerous benefits:

• More valid measurement of annual insurance coverage and point-in-time coverage;
• The ability to track monthly transitions over a 15-month period;
• Information about marketplace participation; and
• Information about employer coverage offers and worker take-up.

These benefits do come at the cost of a break in a time series dating back to 1986. However, the redesigned CPS will provide pre- and post-ACA estimates that will facilitate reform evaluation.  

SHADAC hopes to partner with the Census Bureau in an effort to “harmonize” the CPS data, updating the “SHADAC-Enhanced CPS” data series—which already accounts for past changes to the CPS--to account for the newest CPS changes. 

We are confident that the CPS will continue to be a valuable resource for monitoring health policy.  Embrace the change.

Recommended Resources

"An Introduction to Redesigned Health Insurance Coverage Questions in the 2014 Current Population Survey’s Annual Social and Economic Supplement" (SHADAC Issue Brief)

"Comparing Health Insurance Estimates from the American Community Survey and the Current Population Survey" (SHADAC Issue Brief)

You can explore estimates using the SHADAC-Enhanced CPS at the redesigned SHADAC Data Center.