Protocol - Health Insurance Coverage
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
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 Category | Required |
|---|---|
| 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
| Standard | Name | ID | Source |
|---|---|---|---|
| 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 ID | Variable Description | dbGaP Mapping | |
|---|---|---|---|---|
| PX011502_Health_Insurance_Coverage_From_Employer | ||||
| PX011502010100 | Are you currently covered by any of the more | Variable Mapping | ||
| PX011502_Health_Insurance_Coverage_Indian | ||||
| PX011502010600 | Are you currently covered by any of the more | N/A | ||
| PX011502_Health_Insurance_Coverage_Medicaid | ||||
| PX011502010400 | Are you currently covered by any of the more | Variable Mapping | ||
| PX011502_Health_Insurance_Coverage_Medicare | ||||
| PX011502010300 | Are you currently covered by any of the more | Variable Mapping | ||
| PX011502_Health_Insurance_Coverage_Military | ||||
| PX011502010500 | Are you currently covered by any of the more | Variable Mapping | ||
| PX011502_Health_Insurance_Coverage_NoCoverage | ||||
| PX011502020100 | Does this mean you currently have no health more | Variable Mapping | ||
| PX011502_Health_Insurance_Coverage_Other | ||||
| PX011502010700 | Are you currently covered by any of the more | Variable Mapping | ||
| PX011502_Health_Insurance_Coverage_Purchased | ||||
| PX011502010200 | Are you currently covered by any of the more | Variable Mapping | ||
| PX011502_Health_Insurance_Coverage_Type | ||||
| PX011502020200 | What type of health insurance do you have? | Variable Mapping | ||
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
Ba, D. M., et al. (2024) Navigation-Based Telehealth Informed Decision-Making for Prostate Cancer Screening in Black Men. Current Oncology. 2024 June; 31(7): 3698-3712. doi: 10.3390/curroncol31070273
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