Health Insurance Coverage in Colorado: Differing Estimates

Spoiler alert: this blog is about data. Nonetheless, I hope you keep reading. I don’t think anyone would dispute the necessity of data; the information enables us to paint and interpret the landscape of reality. For example, how many Coloradans do not have health insurance? We don’t know precisely, but we can use data from surveys to make an educated guess.

When I first started at CHI in 2005, the only annual data source with detailed data about uninsured Coloradans was the U.S. Census Bureau’s Current Population Survey (CPS). Last week, my colleague Deb Goeken blogged about the newest uninsured estimates from the CPS. A summary of the CPS estimates is available here on the CHI website. Myung Oak Kim of the Colorado Health Benefit Exchange then blogged about Dr. Jonathan Gruber’s recent estimates, based upon the 2008-09 Colorado Household Survey (COHS). Her blog is here, and his presentation is here.

Today we have a third.

The U.S. Census Bureau on Thursday released the results from the 2010 American Community Survey (ACS), an annual survey that replaced the traditional “long form” on the decennial Census. CHI has developed a summary of the findings from today’s release here.

After viewing the results of multiple surveys, colleagues typically ask me, “So which one should I use?” or “Which one do you recommend?” The answer – and it might be unsatisfying – is “it depends.” All of the surveys have strengths, weaknesses and different methods, and which one is used depends on the questions that are being asked and answered. The scope, sample size, geographic granularity and frequency vary between the surveys. For example, a major benefit of the COHS (which will have a new name when The Colorado Trust releases the 2011 survey findings later this year) is that it lets us not only look at insurance status, but how many emergency room visits an uninsured Coloradan reported, what her family’s out-of-pocket medical expenditures were, and whether she reported having a usual place where she receives care.

With the release of the ACS figures, my advice is to keep the following considerations in mind:

• All of the figures are estimates with a margin of error;
• An important factor is whether insurance is being measured consistently over time; and
• Regardless of the specific number, all of the surveys indicate that hundreds of thousands of Coloradans report having no health insurance.

The Colorado Health Institute will continue to sift through the details and findings of these surveys. Our team is committed to providing guidance, interpretation and the most accurate and timely information available on coverage in Colorado.