Improving Health Insurance Estimates: Using the American Community Survey to Estimate Health Insurance Coverage for Counties in the United States

Bethany DeSalvo, U.S. Census Bureau
Mark Bauder, U.S. Census Bureau
Sam Szelepka, U.S. Census Bureau

This paper investigates the health insurance estimates released by the U.S. Census Bureau's Small Area Health Insurance Estimates (SAHIE) program. These model-based estimates provide data on the number of people with and without health insurance coverage for every county in the United States by age, sex, and income group. The program recently changed from using the Current Population Survey measures of health insurance coverage to using measures from the American Community Survey (ACS). This change substantially lowered the margins of error for the estimates. This paper examines these policy-relevant estimates using demographic and spatial methods, including the new income-to-poverty ratio categories pertinent to the Patient Protection and Affordable Care Act.