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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.

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.

Availability

Available

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.

1

2

3

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)]].

1

2

3

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

1

2

3

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].

1

2

3

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

1

2

3

f. Indian Health Service.

1

2

3

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

1

2

3

[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]

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

Lifestage

Adult

Participants

Individuals aged 18-64 years.

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, Other languages available at source

Standards
StandardNameIDSource
Logical Observation Identifiers Names and Codes (LOINC) Health ins coverage proto 63066-5 LOINC
caDSR Form PhenX PX011502 - Health Insurance Coverage 6872129 caDSR Form
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)

Protocol Name from Source

Health Reform Monitoring Survey, 2015

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 Name Variable IDVariable DescriptiondbGaP Mapping
PX011502_Health_Insurance_Coverage_From_Employer
PX011502010100 Are you currently covered by any of the more
following types of health insurance or health coverage plans? a. Insurance through a current or former employer or union (of yours or another family member's). This would include COBRA coverage. show less
Variable Mapping
PX011502_Health_Insurance_Coverage_Indian
PX011502010600 Are you currently covered by any of the more
following types of health insurance or health coverage plans? f. Indian Health Service. show less
N/A
PX011502_Health_Insurance_Coverage_Medicaid
PX011502010400 Are you currently covered by any of the more
following types of health insurance or health coverage plans? d. Medicaid, Medical Assistance (MA), the Children's Health Insurance Program (CHIP), or any kind of state or government-sponsored assistance. pla show less
Variable Mapping
PX011502_Health_Insurance_Coverage_Medicare
PX011502010300 Are you currently covered by any of the more
following types of health insurance or health coverage plans? c. Medicare, for people 65 and older, or people with certain disabilities. show less
Variable Mapping
PX011502_Health_Insurance_Coverage_Military
PX011502010500 Are you currently covered by any of the more
following types of health insurance or health coverage plans? e. TRICARE or other military health care, including VA health care. show less
Variable Mapping
PX011502_Health_Insurance_Coverage_NoCoverage
PX011502020100 Does this mean you currently have no health more
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 t show less
Variable Mapping
PX011502_Health_Insurance_Coverage_Other
PX011502010700 Are you currently covered by any of the more
following types of health insurance or health coverage plans? g. Any other type of health insurance. coverage or health coverage plan show less
Variable Mapping
PX011502_Health_Insurance_Coverage_Purchased
PX011502010200 Are you currently covered by any of the more
following types of health insurance or health coverage plans? b. Insurance purchased directly from an insurance company (by you or another family member). This would include coverage purchased through an exchan show less
Variable Mapping
PX011502_Health_Insurance_Coverage_Type
PX011502020200 What type of health insurance do you have? Variable Mapping
Demographics
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, Access to Health Care

Measure Protocols
Protocol ID Protocol Name
11502 Health Insurance Coverage
Publications

Levites Strekalova, Y. A., et al. (2024) Application of the Delphi method to the development of common data elements for social drivers of health: A systematic scoping review. Translational Behavioral Medicine. 2024 June; 14(7): 426-433. doi: 10.1093/tbm/ibae020

Klein, E. G., et al. (2024) A Randomized Clinical Trial of a Quitline Vaping Cessation Intervention: Baseline Characteristics of Young Adult Exclusive E-Cigarette Users Seeking Treatment. International Journal of Environmental Research and Public Health. 2024 June; 21(6): 809. doi: 10.3390/ijerph21060809

Burnett-Bowie, S. A. M., et al. (2024) The American Society for Bone and Mineral Research Task Force on clinical algorithms for fracture risk report. Journal of Bone and Mineral Research. 2024 May; 39(5): 517-530. doi: 10.1093/jbmr/zjae048

Kosyluk, K., et al. (2024) Mental Distress, Label Avoidance, and Use of a Mental Health Chatbot: Results From a US Survey. JMIR Formative Research. 2024 April; 8(17). doi: 10.2196/45959

Hatch, M. A., et al. (2024) PrEP for people who use opioids: A NIDA clinical trials network survey study in Southern US cities where HIV incidence is high. Drug and Alcohol Dependence. 2024 April; 257(9). doi: 10.1016/j.drugalcdep.2024.111133

Bartholomew, T. S., et al. (2024) Project CHARIOT: study protocol for a hybrid type 1 effectiveness-implementation study of comprehensive tele-harm reduction for engagement of people who inject drugs in HIV prevention services Addiction Science & Clinical Practice. 2024 March; 19(1). doi: 10.1186/s13722-024-00447-9

Cleverley, K., et al. (2024) The Toronto Adolescent and Youth Cohort Study: Study Design and Early Data Related to Psychosis Spectrum Symptoms, Functioning, and Suicidality. Biological Psychiatry-Cognitive Neuroscience and Neuroimaging. 2024 March; 9(3): 253-264. doi: 10.1016/j.bpsc.2023.10.011

Trifan, G., et al. (2023) Association of Unfavorable Social Determinants of Health With Stroke/Transient Ischemic Attack and Vascular Risk Factors in Hispanic/Latino Adults: Results From Hispanic Community Health Study/Study of Latinos Journal of Stroke. 2023 September; 25(3): 361-370. doi: 10.5853/jos.2023.00626