Driven by the Fierce Urgency of Now, the Administration has decided to revamp the Census Bureau survey of health care coverage, The new approach will be different enough that time series data won't be comparable; the timing is hardly ideal for those curious as to the impact of ObamaCare, prompting a freak-out by Megan McArdle.
But round up the usual apologists! Sarah Kliff, nee of the WaPo Wonkblog and now with Ezra Klein's Vox, is here to reassure us. However, I can't get on the same page with her on this (my emphasis):
Census officials told the Times that the changes will make the survey a more accurate measure of who actually has health insurance coverage. The new survey questions are expected to show a higher uninsured rate. In a test last year, they found that 10.6 percent of Americans said they did not have health insurance when using the new questions – compared to 12.5 percent when people were surveyed with the old ones.
Maybe I am just stuck on dumb, but if the new survey method yields a 10.6 percent uninsured rate and the old method produced a 12.5 percent rate, isn't the new method producing a lower uninsured rate?
Let's flash to the NY Times passage Ms. Kliff is summarizing:
The questionnaire traditionally used by the Census Bureau provides an “inflated estimate of the uninsured” and is prone to “measurement errors,” said a working paper by statisticians and demographers at the agency.
In the test last year, the percentage of people without health insurance was 10.6 percent when interviewers used the new questionnaire, compared with 12.5 percent using the old version. Researchers said that they had found a similar pattern in the data for different age, race and ethnic groups.
Hmm, if the old method produced an “inflated estimate of the uninsured”, that suggests the new method will produce a lower estimate of the uninsured, yes?
The Times explains that the uninsured rate comes down because the new survey is more detailed as to the timing of coverage:
The old questionnaire asked consumers if they had various types of coverage at any time in the prior year. The new survey asks if they have insurance at the time of the interview — in February, March or April — then uses follow-up questions to find out when that coverage began and what months it was in effect. Using this technique, census officials believe they will be able to reconstruct the history of coverage month by month, over a period of about 15 months, for each person in a household.
The new survey was conceived, in part, to reduce a kind of bias or confusion in the old survey. When asked about their insurance arrangements in the prior year, people tended to give answers about their coverage at the time of the interview — forgetting, for example, if they had Medicaid for a few months early in the prior year.
If I am reading that correctly, the survey being undertaken now (early 2014) will attempt to recreate the respondents' actual coverage month by month for 2013. That ties in to Ms. Kliff's reassurance, straight from a "senior administration official":
It might not be time to freak out quite yet: What's being missed here is that the Obama administration will use the new survey questions to collect data for 2013, the year prior to Obamacare's health insurance expansion, a senior administration official says.
The Census Bureau reports the health insurance rate with a one-year delay; in September 2013, for example, the agency reported the percent of Americans without coverage in 2012. It will most likely report the uninsured rate for 2013 sometime this coming fall.
In other words: The survey will make it difficult to compare the uninsured rate for 2012, the last year for the old questions, and 2013, the first year for the new questions. But making the change now means that 2013 and 2014 – the year before and after Obamacare's big programs started – are using the same question set.
Hmmph. In principle, the Census Bureau might report the 2013 numbers early this fall, just before the election. But then again, maybe not - back to the Times:
However, Mr. O’Hara of the Census Bureau said the agency was not planning to release coverage data from early this year in its next report. Agency officials want to assess the reliability of the monthly data, being collected this year for the first time.
I imagine they will still be assessing the data on Election Day.