An Interactive Overview of Small Area Health Insurance Estimates (SAHIE) Walter Lee Holmes Jr. U.S. Census Bureau September 20, 2013

Transcription

1 An Interactive Overview of Small Area Health Insurance Estimates (SAHIE) Walter Lee Holmes Jr. U.S. Census Bureau September 20,

2 Presentation Overview About SAHIE Why SAHIE SAHIE Timeline Methodology and Inputs Next Steps Website Features Interactive Tool 2

3 About SAHIE The Small Area Health Insurance Estimates (SAHIE) program produces model-based estimates of health insurance coverage for counties and states. Sister program of Small Area Income and Poverty Estimates (SAIPE) program. 3

4 About SAHIE (cont.) SAHIE 2011 publishes state and county level estimates for the following domains : The full cross classification of: Four age categories: 0-64, 18-64, 40-64, At the state-level only: Four race/ethnicity categories: all races, Hispanic, White not Hispanic, Black not Hispanic Three sex categories: all sexes, male, female Five income groups: all incomes, and IPR categories 0-138%, 0-200%, 0-250% and 0-400% Age category 0-18: in all incomes and in IPR categories 0-138%, 0-200%, 0-250% and 0-400% 4

5 Why SAHIE Only source for single-year health insurance estimates for ALL counties Can look at trends for all counties - ACS is a 5 year moving aggregate Data are recent (2011 SAHIE released August 29, 2013) Overall, it enhances ACS estimates for single year by reducing ACS Margin of Error (MOEs) 5

6 HEALTH INSURANCE COVERAGE ESTIMATES Percent Uninsured, 2011 All Races, At or Below 138% of Poverty, Under Age 65 MODEL-BASED ESTIMATES The data provided are indirect estimates produced by statistical model-based methods using sample survey, decennial census, and administrative data sources. The estimates contain error stemming from model error, sampling error, and nonsampling error. Source: U.S. Census Bureau, Small Area Health Insurance Estimates (SAHIE) Program, Aug Percent Uninsured by County State U.S. Department of Commerce Economic and Statistics Administration U.S. CENSUS BUREAU 6

7 Counties Not Published in the 2011 ACS 1-year Estimates Legend County Not Published County Published State Source: U.S. Census Bureau American Community Surveu Office, 2012 U.S. Department of Commerce Economic and Statistics Administration U.S. CENSUS BUREAU SAIPE

8 SAHIE Timeline Sponsored by Centers for Disease Control and Prevention's (CDC), National Breast and Cervical Cancer Early Detection Program (NBCCEDP). 8

9 SAHIE Timeline Released experimental SAHIE 2000 estimates (released summer 2005) : Under 18, all ages Released experimental SAHIE 2001 estimates (released summer 2007) : Women 18-64, 40-64, Race and Hispanic Origin 9

10 SAHIE Timeline SAHIE 2005 was our first official estimates (released Oct 2008). IPR 200 and 250 for select states For SAHIE 2008 (released Sept 2011), added 138% and 400% IPR for the Affordable Care Act (ACA) Added at county level in

11 Methodology Hierarchical Bayes approach Fitted using Markov Chain Monte Carlo (MCMC) Model consists of two main parts: Income Insurance Fay-Herriot style 11

12 Data Inputs American Community Survey (ACS) Demographic population estimates Federal income tax returns Supplemental Nutrition Assistance Program (SNAP) County Business Patterns Medicaid Children s Health Insurance Program (CHIP) Decennial Census 12

13 American Community Survey ACS added a health insurance question in 2008 Replaced CPS - ASEC in the SAHIE model in 2008 Used to create the Poverty Universe Samples approximately 3.5 million households annually ACS releases 1-year, 3-year, and 5-year estimates 13

14 Demographic Population Estimates Produced by the Population Division of the U.S. Census Bureau Released annually on July 1 Age, Race, Sex, Hispanic Origin (ARSH) 14

15 Federal Income Tax Returns Obtained from IRS 1040 form Aggregated data; no Personally Identifiable Information (PII) Approximately 130 million returns Number of exemptions (Child and Adult) Income to Poverty Ratios (IPR) 15

16 Supplemental Nutrition Assistance Program (SNAP) United States Department of Agriculture, Food and Nutrition Service County and state-level participation Over 41 million households Uniform eligibility (except AK, HI) We adjust for natural disaster spikes 16

17 County Business Patterns Extracted from the Business Register Number of employees by: Firm size Retail sector Non-retail sector Shows employment trends down to the Zip Code level 17

18 Decennial Census ARSH information, housing tenure counts (i.e., owning, renting), and urban/rural population counts from the most recent decennial census 18

19 Medicaid Centers for Medicare and Medicaid Services Participation in Medicaid program Program is geared towards people with low-incomes Age and sex information Medicaid currently covers approximately 52 million people 19

20 Children's Health Insurance Program (CHIP) Combined with Medicaid for SAHIE model CHIP covers approximately 8 million children CHIP covers children with family incomes too high to quality for Medicaid who can t afford traditional insurance 20

21 Next Steps SAHIE 2012: February 2014 Continued collaboration with CDC Additional IPR domains Additional age domain Public vs. Private insurance research 21

22 Contact Information Walter Lee Holmes Jr: Phone: SAHIE Branch Phone: SAHIE Website: 22

23 Disclaimer This presentation is released to inform interested parties of ongoing projects and to encourage discussion of work in progress. Any views expressed on statistical, methodological, technical, or operational issues are those of the author and not necessarily those of the U.S. Census Bureau 23

24 Website Features 24

25 SAHIE Layout 25

26 SAHIE Highlights Document 26

27 Highlights Document Maps 27

28 ACA Highlights Document Map 28

29 SAHIE Publications 29

30 Brochures 30

31 Interactive Tool 31

32 Data Page 32

33 Trend Tool 33

34 County-Level Maps 34

35 Filter Capabilities 35

36 Satellite View 36

37 Street View 37

38 Video Tutorial 38

39 Social Media 39

40 END SLIDE SHOW 40