What the Census Bureau’s New Uninsured Figures Tell Us about Coverage in Colorado and the U.S.

Next week marks the release of the 2017 Colorado Health Access Survey (CHAS) results. The survey is the preeminent source of information on health care coverage and access in Colorado. But it is not the only source of uninsured estimates.

Yesterday, the U.S. Census Bureau released its 2016 findings from two national surveys, the Current Population Survey (CPS) and the American Community Survey (ACS). The big takeaway is that both surveys show significant decreases in the uninsured rate nationally between 2015 and 2016. The ACS — which allows for state-level estimates as well — showed a parallel decrease in Colorado’s uninsured rate.

The Census Bureau’s national findings also highlight continued declines in uninsurance among most demographic groups since 2013, prior to the implementation of the Affordable Care Act (ACA). Declines among some groups appear to have slowed — showing no significant difference — when comparing 2015 to 2016, however.

Among the ACS and CPS highlights:

• According to the CPS, the national uninsured rate fell from 9.1 percent in 2015 to 8.8 percent in 2016. Similarly, the ACS found a decrease in the percentage of people without coverage, from 9.4 percent in 2015 to 8.6 percent in 2016.
• Colorado paralleled the national trend, falling from 8.1 percent to 7.5 percent between the two years.
• In 2016, the number of uninsured Coloradans was an estimated 410,000, down from 433,000 in 2105.
• Colorado’s uninsured rate of 7.5 percent ranks 24^th lowest among all 50 states and D.C., nestled between California’s rate of 7.3 percent and Arkansas’s rate of 7.9 percent.
• Consistent with prior years, Massachusetts had the lowest uninsured rate at 2.5 percent, and Texas had the highest at 16.6 percent.
• Nationally, people with incomes under the poverty line, or $24,600 for a family of four, showed the greatest gains in getting covered since 2013, especially in states that expanded Medicaid.
• Young adults ages 19 to 25, people living in cities, and people working less than full time showed significant decreases in uninsurance between 2015 and 2016.
• While national uninsured rates among African Americans and Latinos have decreased the most since 2013, these two groups continue to have the highest uninsured rates, and showed no statistical change between 2015 and 2016.

With all these numbers, we often get asked, “So which estimate is best?” This was a question we explored in a past brief and will explore again after the release of the 2017 CHAS data.

In short, the answer is, “It depends.”

It depends on what questions you are answering with the data. Each data source has its benefits and drawbacks. Do you want information on why people are uninsured? Look to the CHAS. Want to do cross-state comparisons? The ACS is best. Want to examine how the income sources of the uninsured vary nationally? It’s the CPS.

In addition, we often get asked why estimates differ. For one thing, the years are different. (CHAS will reflect 2017, the Census Bureau surveys cover 2016.) Moreover, we expect estimates to differ based on how insurance coverage is measured in each of these surveys. In the CHAS, for example, we have the ability to customize the question for Colorado, adding in state-specific program names likes “Health First Colorado” or “Child Health Plan Plus.” We also make certain someone is actually uninsured by asking a verification question. In contrast, the ACS has a single multiple-choice item about health insurance on its questionnaire.

The takeaway is that the CHAS, CPS and ACS provide valuable and complementary information to help round out the picture of insurance coverage in the state and in the nation.

So how do the Census Bureau’s results align with the CHAS results?

For that, you’ll have to join us next week. You can still sign up for one of our launch events across the state here.

See you there!