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Key Resources and 2022 Updates: SHADAC's Health Insurance Unit
October 2022:Updated April 2023
In the years following the passage of the Patient Protection and Affordable Care Act (ACA), SHADAC developed and introduced its Health Insurance Unit, or “HIU,” a tool to aid in defining family interrelationships in federal population surveys for the purpose of analyzing health insurance coverage.
Since the inception of this tool, SHADAC has regularly produced updated HIU variables, including in fall 2022 following the release of the 2021 American Community Survey (ACS) and 2022 Current Population Survey Annual Social and Economic Supplement (CPS ASEC). These variables were recently made available via IPUMS-CPS (October 19, 2022) and IPUMS-USA (March 10, 2023). These HIU variables use the updated HIU methodology introduced in 2020 and incorporate the latest years of survey data and federal poverty guidelines, as relevant.
What is the SHADAC HIU?
First released in 2012, one of the goals of the SHADAC HIU is to establish a common definition of a “family unit” to help ensure consistent and comparative research across major national surveys when analyzing health insurance coverage.
Most federal surveys define a “family” differently from the way it is defined by most private and public insurance programs. For instance, the definition of "family" or "household" in U.S. Census Bureau surveys includes all related members of a household, no matter the degree of relationship, and does not necessarily align with dependent coverage or public program eligibility.
The SHADAC HIU attempts to more closely align with a definition of family used for private and public health insurance coverage eligibility. The SHADAC HIU uses a narrower definition of family that looks at specific interrelationships between individuals within a household and excludes all non-dependent relatives (grandparents, adult siblings, aunts/uncles, etc.) who may be household members but are unlikely to be considered as part of the “family unit” as defined for the purposes of determining eligibility for health insurance.
The SHADAC HIU, then, is defined as an economic unit that consists of those members of a household who would likely be eligible as a group for family health insurance coverage, or whose resources (i.e., income) would be considered in determining eligibility for public coverage.
Related Resources
- Defining Family for Studies of Health Insurance Coverage (August 2021): A brief that outlines the impacts of using the SHADAC HIU in analysis—specifically, analysis showing how the population distribution of family income changes using three different definitions of family: all members in the same household (Census definition), the definition used by the IPUMS (described below), and the SHADAC HIU (described in detail in a companion brief). Researchers can use this brief to assess whether the SHADAC HIU is suitable for their analysis and what the potential impacts of its use might be.
- Stata Code (January 2021): Technical documentation of statistical code in STATA to help researchers to employ the SHADAC HIU in their own analysis using ACS microdata downloaded from IPUMS USA.
