Modeling a Bridge When Survey Questions Change: Evidence from the Current Population Survey Health Insurance Redesign

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Most research on health insurance in the United States uses the Current Population Survey Annual Social and Economic Supplement. However, a recent redesign of the health insurance questions disrupted the historical time trend in 2013. Using data from the American Community Survey, which has a parallel trend in the uninsured rate, we model a bridge estimate of the uninsured rate using the traditional questions. Also, we estimate the effect of changing the questionnaire. We show that the impact of redesigning the survey varies substantially by subgroup. This approach can be used to produce bridge estimates when other questionnaires are redesigned.

Bailey, J. and A. Chorniy. 2016. “Employer-Provided Health Insurance and Job Mobility: Did the Affordable Care Act Reduce Job Lock?” Contemporary Economic Policy 34(1): 173–183. Doi:

Blewett, L.A. and M.E. Davern. 2006. “Meeting the Need for State-Level Estimates of Health Insurance Coverage: Use of State and Federal Survey Data.” Health Services Research 41(3): 946–975. Doi:

Bradley, C.J., D. Neumark, and M. Motika. 2012. “The effects of health shocks on employment and health insurance: the role of employer-provided health insurance.” International Journal of Health Care Finance and Economics 253–267. Doi:

Call, K.T., G. Davidson, M. Davern, E.R. Brown, J. Kincheloe, and J.G. Nelson. 2008. “Accuracy in self-reported health insurance coverage among Medicaid enrollees.” INQUIRY: The Journal of Health Care Organization, Provision, and Financing 45(4): 438–456. Doi:

Centers for Medicare and Medicaid Services. 2014. National Health Expenditure Accounts: Methodology Paper, 2013. Centers for Medicare and Medicaid Services. Available at: (accessed March 2018).

Davern, M., H. Rodin, L.A. Blewett, and K.T. Call. 2007. “Are the Current Population Survey Uninsurance Estimates Too High? An Examination of the Imputation Process.” Health Services Research 42(5): 2038–2055. Doi:

Day, J. 2013. “Medicare and Medicaid, Age and Income.” Random Samplings. U.S. Census Bureau. Available at: (accessed March 2018).

Fay, R.E. and G.F. Train. 1995. “Aspects of Survey and Model-Based Postcensal Estimation of Income and Poverty Characteristics for States and Counties.” Proceedings of the American Statistical Association Conference. Orlando, August 13–17, 1995. Available at: (Accessed March 2018).

Kaestner, R. and D. Lubotsky. 2016. “Health Insurance and Income Inequality.” The Journal of Economic Perspectives 30(2): 53–77. Doi:

Kenney, G. and V. Lynch. 2010. “Monitoring Children’s Health Insurance Coverage Under CHIPRA Using Federal Surveys.” Chapter. 8, In Databases for Estimating Health Insurance Coverage for Children: A Workshop Summary, edited by Thomas Plewes, 65–82. Washington, DC: National Academies Press. Doi:

Kish, L. 1965. Survey Sampling. New York: John Wiey & Sons, Inc.

McGeary, K.A. 2009. “How Do Health Shocks Influence Retirement Decisions?” Review of Economics of the Household 7(3): 307–321. Doi:

O’Hara, B. and K. Caswell. 2013. Health Status, Health Insurance, and Medical Services Utilization: 2010. Current Population Reports, P70-133RV. Washington: U.S. Census Bureau.

Pascale, J. 2016. “Modernizing a Major Federal Government Survey: A Review of the Redesign of the Current Population Survey Health Insurance Questions.” Journal of Official Statistics 32(2): 461–486. Doi:

Pascale, J., M.I. Roemer, and D. Resnick. 2009. “Medicaid Underreporting in the CPS: Results from a Record Check Study.” Public Opinion Quarterly 73(3): 497–520. Doi:

Pascale, J., M. Boudreaux, and R. King. 2016. “Understanding the New Current Population Survey Health Insurance Questions.” Health Services Research 51(1): 240–261. Doi:

Smith, J.C. and C. Medalia. 2014. Health Insurance Coverage in the United States: 2013. Current Population Reports, P60-250, U.S. Census Bureau. Washington, DC: U.S. Government Printing Office.

Smith, J.C. and C. Medalia. 2015. Health Insurance Coverage in the United States: 2014, Current Population Reports, P60-253, U.S. Census Bureau, Washington, DC: U.S. Government Printing Office.

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