The New York Times is
reporting a change in how the census is going to count the uninsured, asserting that the bureau "is changing its annual survey so thoroughly that it will be difficult to measure the effects of President Obama’s health care law in the next report, due this fall, census officials said." This story has all the potential to give ammunition to the law's opponents with more "cooking the books" allegations.
An internal Census Bureau document said that the new questionnaire included a “total revision to health insurance questions” and, in a test last year, produced lower estimates of the uninsured. Thus, officials said, it will be difficult to say how much of any change is attributable to the Affordable Care Act and how much to the use of a new survey instrument.
The indispensable Sarah Kliff has the
whole story, a story that really clarifies this change in the survey instrument and what it could mean for estimating the numbers of uninsured.
What's being missed here is that the Obama administration will use the new survey questions to collect data for 2013, the year prior to Obamacare's health insurance expansion, a senior administration official says.
The Census Bureau reports the health insurance rate with a one-year delay; in September 2013, for example, the agency reported the percent of Americans without coverage in 2012. It will most likely report the uninsured rate for 2013 sometime this coming fall.
In other words: The survey will make it difficult to compare the uninsured rate for 2012, the last year for the old questions, and 2013, the first year for the new questions. But making the change now means that 2013 and 2014–the year before and after Obamacare's big programs started–are using the same question set.
The new survey questions are designed to give a more accurate picture of people's insurance status throughout the year. Instead of asking if they'd been insured at any point in the past year, it will ask if they currently have insurance, and include follow-up questions to determine when that coverage was obtained and how many months it's been in effective. Census officials say that this will give about a 15-month, month-to-month history of coverage that will be more accurate than the previous count.
As Kliff points out, there are other established and reliable measures of how many Americans are uninsured, like Gallup's (which, by the way, found the lowest rate of uninsured since 2008 in its most recent survey). The Gallup survey, for one, will provide continuity of data to provide a point of comparison with census data.
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