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Protocol - Health Insurance Coverage

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Description:

The respondent is asked about health insurance coverage. A number of possible types of health care coverage are included, not simply health insurance.

Protocol:

The next question asks about your health insurance or health coverage plans. In answering this question, please exclude plans that pay for only one type of service (such as nursing home care, accidents, family planning, or dental care) and plans that only provide extra cash when hospitalized.

1. Are you currently covered by any of the following types of health insurance or health coverage plans?

Covered

Not Covered

Not Sure

a. Insurance through a current or former employer or union (of yours or another family member’s). This would include COBRA coverage.

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b. Insurance purchased directly from an insurance company (by you or another family member). This would include coverage purchased through an exchange or marketplace, such as HealthCare.gov [IF THE RESPONDENT IS IN A STATE WITH STATE-SPECIFIC NAMES, INSERT [or (INSERT PROGRAM NAME)]].

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c. Medicare, for people 65 and older, or people with certain disabilities.

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d. Medicaid, Medical Assistance (MA), the Children’s Health Insurance Program (CHIP), or any kind of state or government-sponsored assistance. plan based on income or a disability. You may know this type of coverage as [IF THE RESPONDENT IS IN A STATE WITH STATE-SPECIFIC NAMES INSERT PROGRAM NAME].

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e. TRICARE or other military health care, including VA health care.

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f. Indian Health Service.

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g. Any other type of health insurance. coverage or health coverage plan

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[IF “COVERED” NOT SELECTED FOR ANY ITEMS IN Q1]

2. Does this mean you currently have no health insurance or health coverage plan?

In answering this question, please exclude plans that pay for only one type of service (such as, nursing home care, accidents, family planning, or dental care) and plans that only provide extra cash when hospitalized.

I do NOT have health insurance 1

I HAVE some kind of health insurance 2

[IF Q1G = 1 OR Q2 = 2]

2.b. What type of health insurance do you have?

[TEXT BOX]

Protocol Name from Source:

Health Reform Monitoring Survey 2015

Availability:

Publicly available

Personnel and Training Required

No specific training is needed if data are collected through a self-administered questionnaire. The interviewer must be trained to conduct personal interviews with individuals from the general population. The interviewer must be trained and found to be competent (i.e., tested by an expert) at the completion of personal interviews. The interviewer should be trained to prompt respondents further if a "don’t know" response is provided.

Equipment Needs

These questions can be administered in a computerized or noncomputerized format (i.e., paper-and-pencil instrument). Computer software is necessary to develop computer-assisted instruments. The interviewer will require a laptop computer/handheld computer to administer or to allow the respondent to self-administer a computer-assisted questionnaire.

Requirements
Requirement CategoryRequired
Major equipment No
Specialized training No
Specialized requirements for biospecimen collection No
Average time of greater than 15 minutes in an unaffected individual No
Mode of Administration

Interviewer-administered questionnaire

Life Stage:

Adult

Participants:

Individuals aged 18-64 years.

Specific Instructions:

The respondent needs to understand that the question addresses private and government-provided health insurance plans. Although Indian Health Service coverage is included as a possible response category in the question about type of coverage, individuals with only this type of coverage are counted as being uninsured in federal health statistics. Note that 1.b indicates that state-specific exchange names should be inserted. Although the Expert Review Panel recommends following the protocol, if possible, the question may be truncated at HealthCare.gov (https://www.healthcare.gov/) if resources are unavailable to program state-specific exchange names.

Selection Rationale

The Health Reform Monitoring Survey (HRMS) protocol was vetted against other health insurance coverage measures and was chosen because it determined if the respondent had health insurance and the type of coverage. The question also acknowledges recent changes to insurance coverage options provided by the Patient Protection and Affordable Care Act. Note that the questions do not address the adequacy of health insurance coverage or the cost for copayments.

Language

English, Spanish

Standards
StandardNameIDSource
Common Data Elements (CDE) Person Health Insurance Type 2518985 CDE Browser
Logical Observation Identifiers Names and Codes (LOINC) Health ins coverage proto 63066-5 LOINC
Derived Variables

None

Process and Review

The Expert Review Panel #2 (ERP 2) reviewed the measures in the Demographics, Social Environments and Environmental Exposures domains.

Guidance from ERP 2 includes:

• Replaced protocol

• New Data Dictionary

Back-compatible: there are changes to the Data Dictionary, previous version of the Data Dictionary and Variable mapping in Toolkit archive (link)

Source

Health Reform Monitoring Survey (HRMS), Quarter 1 2015 Questionnaire, Question numbers Q7, Q8, Q8b. http://hrms.urban.org/survey-instrument/HRMS-Quarter-1-2015-survey.pdf

Urban Institute. (2015). Health Reform Monitoring Survey (HRMS), 2015. Washington, DC: Author.

General References

None

Protocol ID:

11502

Variables:
Export Variables
Variable NameVariable IDVariable DescriptionVersiondbGaP Mapping
Research Domain Information
Measure Name:

Health Insurance Coverage

Release Date:

May 31, 2016

Definition

Question asking whether the respondent is covered by health insurance or some other form of health care coverage at the time of the interview.

Purpose

Individuals who do not have health insurance do not visit health care providers on a regular basis or for preventive testing (e.g., prostate examination) and may be more vulnerable to illness or disease. Usually, individuals who do not have health insurance are those who cannot afford to pay the insurance premiums and are not eligible for government programs (e.g., immigrants).

Keywords

Demographics, health care, health insurance plan, Medicare, Medicaid, medical care, medical bills, Medicare Supplemental Insurance, Medigap, Health Reform Monitoring Survey, HRMS