Monitoring health reform efforts: Which state-level data to use?

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This study compares estimates of health insurance coverage from the American Community Survey (ACS) to those in twelve state-specific surveys. Uninsurance estimates for the nonelderly are consistently higher in the ACS than in state surveys, as are direct purchase insurance estimates. Estimates for employer-sponsored insurance are similar, but public coverage rates are lower in the ACS. The ACS meets some but not all of the states' data needs; its large sample size and inclusion of all U.S. counties in the sample allow for comparison of insurance coverage within and across states. State-specific surveys provide the flexibility to add policy-relevant questions, including questions needed to examine how health insurance translates into access, use, and affordability of health services.

Original languageEnglish (US)
Pages (from-to)93-105
Number of pages13
JournalInquiry (United States)
Issue number2
StatePublished - May 2014


  • American community survey
  • Policy evaluation
  • State surveys
  • Uninsurance


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