This brief explores whether the relatively high estimates of direct purchase coverage in the American Community Survey (ACS) are caused by people misreporting their Medicaid coverage.  The authors examine this question using a unique version of the ACS that has been linked to Medicaid enrollment data. They find that a relatively small number of people with direct purchase in the ACS are enrolled in Medicaid on their interview date and conclude that misclassifcation of Medicaid coverage is not the main driver of high direct purchase estimates in the ACS.