SEPTEMBER2016

Announcements
EmployerCoveragewasStablein45StatesandNationally,2013to2014
ThenewestversionofSHADACsannualreport,StateLevelTrendsinEmployer
SponsoredHealthInsurance(ESI)examinesnationalandstateleveltrendsinESI
aswellasthefactorsthatinfluenceESI.Thereport,whichuses2013and2014data
fromtheCurrentPopulationSurvey(CPS)and2010to2014datafromthe
InsuranceComponentoftheMedicalExpenditurePanelSurvey(MEPS),provides
statelevelsummarytablesofESIcharacteristics,alongwithindividualstateprofilepages.SHADACs
analysisfindsthatESIcoverageoverallamongpolicyholdersanddependentsdidnotchange
significantlyatthenationallevelfrom2013to2014onlyfourstatessawsignificantincreasesinESI
coverage,andonestatesawasignificantdecrease.

ThePotentialofSection1115WaiversforAffordableCareAct(ACA)Medicaid
Expansions
AspartofaprojectsponsoredbytheFoundationforaHealthyKentucky,SHADAC
releasedabriefexaminingpoliciesandevidencefromfivestatesontheuseofSection
1115waiversasamechanismforACAMedicaidexpansions.Thebrief,whichwas
createdtoinformthepolicydiscussioninKentucky,foundmixedresultsonthepotential
ofthewaiveractivitiesintheselectedstudystatestoimpacteitheraccesstocoverage
andservicesorcostsfornewlyeligibleMedicaidbeneficiaries.
Related:ClickheretoaccessanindepthSHADACreportabouttheimpactoftheACAinKentucky.

CensusReport:AssessingPrevalenceandTrendsinObesity
SHADACPrincipalInvestigatorLynnBlewettrecentlyservedasamemberoftheCommitteeon
EvaluatingApproachestoAssessingPrevalenceandTrendsinObesity.TheHealthandMedicine
DivisionoftheNationalAcademiesofScience,Engineering,andMedicineconvenedthiscommitteeon
behalfoftheRobertWoodJohnsonFoundationtoexamineapproachestodatacollectionandanalysis
thathavebeenusedinpreviousreportsonobesityprevalenceandtrendsatnational,state,andlocal
levels.TheresultingCensusReportdescribesthescopeandnatureofexistingliteratureonthetopic,
providesaframeworkforassessingpublishedreports,andmakesrecommendationsforimproving
futuredatacollectionefforts.

SHADACatthe2016AcademyHealthAnnualResearchMeeting
SHADACfaculty,staff,andstudentsattendedandpresentedatthe2016AcademyHealthAnnual

ResearchMeeting(ARM)fromJune26toJune28,2016,inBoston.ResearchersfromSHADAC
presentedonarangeoftopicsincludingpostreformchangesinhealthcareaccessinMinnesotathe
impactoftheACAonmisreportingofMedicaidcoveragethechangingdemographicsoftheuninsured
stateMedicaiddeliverysystemreformsandstatetrendsinchildrenshealthinsurancecoverage.View

presentationmaterialsandconferencephotosfromSHADAC.

Webcast:Overviewofthe2014SmallAreaHealthInsuranceEstimates
(SAHIE)
AnewSHADACwebinarpodcastprovidesanoverviewofrecentlyreleased2014CensusSAHIE
providinghealthinsurancecoverageratesbycounty.ThewebcastfeaturesCensusBureauexperts
LaurenBowersandDavidPowerspresentinghighlightsfromthedatarelease,providingguidelineson
howresearcherscanaccessthenewdata,anddiscussingtheupdatedMedicaidfiles.Thenew2014
SAHIEincorporatesmorecurrentMedicaiddatatocapturetheimpactoftheACAMedicaidexpansions.

MinnesotaAccountableHealthModel
SHADACresearchersauthoredthefirstannualreportonMinnesotasAccountableHealthModelfor
theMinnesotaDepartmentofHumanServices(DHS)aspartofacontractunderthefederalState
InnovationModels(SIM)Initiative.Thereportdescribestheactivitiesconductedduringandtheresults
fromthefirstyearofMinnesotasSIMinitiative.

NewsfromtheStates
Colorado:AnalysisofUniversalCoverageAmendment
AfinancialanalysisfromtheColoradoHealthInstitute(CHI)examinedtheviabilityofa
proposedconstitutionalamendmenttocreateasystemofuniversalstatehealthcare
coveragecalledColoradoCare.TheanalysisprojectsthatColoradoCarewouldbreak
eveninitsfirstyear(2019)whileextendingcoveragetoallColoradans(6.7percentof
whomremainuninsured).Theprogramwouldslideintodeficitsinfutureyearsdueto
insufficienttaxrevenueandfederalfunds.

Colorado:2015ZipCodeLevelCoverageEstimates
TheColoradoHealthInstitutereleasednewzipcodelevelestimatesofhealthinsurancecoveragefrom
the2015ColoradoHealthAccessSurvey(CHAS),abiennialhouseholdtelephonesurveyofmorethan
10,000randomlyselectedhouseholdsinthestate.TheanalysisfoundthatmostZIPcodesshoweda
declineintheprobabilityofbeinguninsuredsince2013,withanaverageprobabilityofuninsuranceby
ZIPcodedroppingbyslightlymorethanhalf.

Kentucky:QuarterlySnapshot
AspartofaprojectsponsoredbyFoundationforaHealthyKentucky,SHADAC
producesquarterlysnapshotstoprovidethelatestdataonhealthreformtopicsof
interesttothestate.Thenewlyreleasedsnapshotfocusesondatafromthefirstquarter
of2016.Amongotherfirstquarterhighlights:KYhadthesecondlargeststateincrease
inchildrensMedicaid/CHIPparticipationratesfrom20132014,with94percent
participationin2014Medicaidcoveredabout6,660birthsandthousandsofprevention
screeningservicesandMedicaidcoveredalmost611,000adultsofages1964inthefirstquarterof
2016.

Louisiana:CoverageIncreasedforKids,FellSlightlyforAdultsin2015
TheLouisianaDepartmentofHealthandHospitalsreleasedresultsfromthe2015
LouisianaHealthInsuranceSurvey(LHIS),abiennialhouseholdtelephonesurveyof
8,600adultsexaminedcharacteristicsoftheinsuredanduninsured.Between2013and
2015,theuninsuredrateforchildrendroppedto3.8percentin2015from4.4percentin
2013,andforadults,theuninsuredrateroseslightlyto22.7percentin2015from22
percentin2013.

Massachusetts:InsuranceCoverageStableSince2008,butEmployer
CoverageDown
TheBlueCrossBlueShieldofMassachusettsFoundationreleasedresultsfromthe2015

MassachusettsHealthReformSurvey(MHRS),ahouseholdtelephonesurveyfieldedsince2006by
SocialScienceResearchSolutions(SSRS)inconjunctionwiththeUrbanInstitutetoassesstheimpact
oftheACA.Thesurveyresults,whichinclude2,014householdsin2015,indicatethatMassachusetts
sustainedhealthinsurancegainsachievedafterthestates2006healthreforms,withabout95percent
ofnonelderlyadultshavinghadhealthinsurancecoveragesince2008.

Resources
GeographicConcentrationoftheUninsuredin2013and2014
SHADACresearchersdevelopedadatasummaryofthegeographicconcentration
oftheuninsuredacrossU.S.countiesin2013and2014usingthemostrecent2016
SmallAreaHealthInsuranceEstimates(SAHIE).Thissummaryincludestabular
informationonthe100countieswiththehighestestimatednumbersofuninsuredfor
thesummaryyears,anditintroducesaninteractivemapillustratingthechangesinuninsured
populationsfrom2013to2014forallcounties(includingchangesinthenumberofuninsured,the
uninsuredrate,andthepercentofthepopulationthatisuninsured).Theinformationinthesummary
caninformtargetedoutreachandenrollmentinitiativesaimedattheremaininguninsured.

NewCurrentPopulationSurvey(CPS)HealthInsuranceContent
SHADACresearcherJoannaTurnerauthoredabriefprovidingdetailedquestiontextfor
thenewhealthinsurancecontentintheAnnualSocialandEconomicSupplementtothe
CurrentPopulationSurvey(CPSASEC),alongwithatimelineontheavailability
estimatesbasedonthenewsurveycontent.ThisbriefisacompanionpiecetoSHADAC
Brief#39,whichgivesanoverviewoftheCensusBureausmodifiedcontentandsurvey
designfortheAnnualSocialandEconomicSupplementtotheCurrentPopulation
Survey(CPSASEC).

NCHSReleases2015MEPSICData
TheNationalCenterforHealthStatistics(NCHS)recentlyreleasedastatisticalbriefonthenational
resultsfromthe2015MedicalExpenditurePanelSurveyInsuranceComponent(MEPSIC),anannual
surveyofprivateemployersandStateandlocalgovernmentsthatisdesignedtoberepresentativeofall
50statesandtheDistrictofColumbia.Thebriefdescribestrendsfrom2008to2015inemployer
sponsoredinsurance(ESI),withemphasison20142015changes.From2014to2015:thenumberof
ESIenrolleesdeclinedfrom55.8to57.3milliontheoverallpercentageofemployeesworkingat
establishmentsthatofferinsuranceincreasedfrom83.2to83.8percenttheofferrateatlargefirms(i.e.,
thosewith100ormoreemployees)increasedfrom97.3to98.8percent,theofferrateatfirmswith
fewerthan50employeesdecreasedfrom49.8to47.6percentandtheoveralltakeupratedecreased
from76.7to75.0percent.

2015NHISDataRelease
TheNationalCenterforHealthStatistics(NCHS)releaseddatafromthe2015NationalHealth
InterviewSurvey(NHIS).Datauserscanaccesseightdatafiles,eachofwhichcontainsASCIIandCSV
data,alongwithsamplestatementsforSAS,SPSS,andStata.Earlyreleaseestimates(i.e.,those
releasedpriortofinaldataeditingandfinalweighting)for2015areavailablehere.Thefirstavailable
reportusingthefinal2015NHISdataisonstatelevelwirelesssubstitutionestimates.

FederalSurveyDataReleaseScheduleonSHADAC.org
SHADACmonitorsandcontinuouslyupdatestheFederalSurveyDataReleaseScheduleonour
website.WeprovideinformationonupcomingdatareleasesfromtheAmericanCommunitySurvey
(ACS),theCurrentPopulationSurvey(CPS),theMedicalExpenditurePanelSurvey(MEPS),the
NationalHealthInterviewSurvey(NHIS),andtheBehavioralRiskFactorSurveillanceSystem(BRFSS).
ThesoonestupcomingdatareleasesaretheACSs1Year2015datareleaseonAmericanFactFinder
(comingonSeptember15,2016)theBRFSSsAnnualDataSurveyfor2015(cominginSeptember
2016)andtheCPSs2015NationalIncome,Poverty,andHealthInsuranceStatisticsdatarelease

(cominginSeptember2016).BookmarkourFederalSurveyDataReleasepagetostayuptodateon
thedatareleasecalendar.

HighlightsfromtheSHADACBlog
CaliforniaEmployersContinuetoOfferInsurance,butFewerWorkersEnroll
LaceyHartman,August16,2016CrossPostfromACA411InsightsBlog
OnPoint:TrackingtheACAinKentucky
LynnBlewett,August10,2016
CalifornianswithIndividualHealthInsuranceSpendAlmost$2,500LessonCareinYearOneofHealth
Reform
AmyAdamsandSamePatnoe,July4,2016CrossPostfromACA411InsightsBlog
EarlyReleaseof2015FullYearNHIS:NationalUninsuredRateDropsto9.1%(Infographic)
SHADACStaff,May27,2016
ValidatingSelfReportedHealthInsuranceCoverage:PreliminaryResultsonCPSandACS
JoannePascale,KathleenCall,AngelaFertig,andDonOellerich,May20,2016
CrossPostfromU.S.CensusBureau

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