Note to Reviewer

NOTE TO REVIEWER

The January 2006 displaced worker supplement to the Current Population Survey (CPS) was approved with the following terms of clearance:

BLS has agreed to examine the items on health insurance coverage and consider changes for the next supplement scheduled for 2008.

With the terms, OMB suggested that BLS review the two questions on health insurance that were tested in the 2006 American Community Survey (ACS) content test for possible inclusion in the supplement.

BLS has reviewed the goals of the health insurance questions in the displaced worker supplement as well as the results of the ACS content test. The displaced worker supplement is designed, in part, to compare a person’s situation before and after a job displacement. With respect to health insurance, the supplement seeks to determine the impact of displacement from a job on health insurance coverage. The supplement was never designed to identify the detailed source of health insurance coverage workers had before or after a job displacement.

Thus, Q17 (Did (name/you) have health insurance at that job?) asks if the worker had health insurance coverage at the job he or she lost. Whether the worker had health insurance coverage from other sources has not been an item requested by the supplement sponsors (other sources of insurance are much less likely to be affected by job displacement). To ensure clarity in the intention of the question for interviewers and respondents, interviewer instructions indicate that coverage by group plans sponsored by an employer or union is the information desired.

To determine whether a displaced worker who had health insurance coverage through the job they lost no longer has coverage, Question SD27, (Other than Medicare or Medicaid, (does/do)(name/you) now have health insurance) is asked of individuals who reported that they had lost or left a job in the past three years (most of whom are then designated as displaced workers based on the reason for the job loss). Interviewer instructions clarify that this refers to coverage by any group plan; it may be partially or fully paid by an employer or by the insured. People who are covered by a family member’s group plan are considered to have insurance. Data gathered through the existing questions appear to meet the goals of the displaced worker supplement.

In addition, replacing the existing questions with those from the ACS content test would not meet the goals of the supplement for the reasons below.

• The ACS questions would have to be adapted for use in the (CATI/CAPI) CPS. They are very long by comparison and are primarily designed for use in a paper-based instrument. In the case of CPS, they would have to be read to respondents over the telephone in the large majority of CPS interviews. This could reduce comprehension and would definitely increase respondent burden.

• Users of the displaced worker supplement have not expressed dissatisfaction with the current questions nor requested additional information on health insurance from the supplement. Thus, it is not clear who we would be serving; in addition, changes to the existing questions would break the time series, which goes back to 1984.

• The additional information on sources of health insurance coverage is not needed for BLS analyses and has not been requested by the supplement sponsors, the Department of Labor’s Employment Training Administration. Thus no funding has been provided to implement them.

• The questions have not been tested in the context of the CPS, and no funding has been provided to do so.

In summary, the existing questions most likely collect the data they are intended to collect, users seem to be satisfied with the data, and the supplement sponsors have not expressed a desire for more detailed questions. Were a better set of questions to be desired, it is not clear that the ACS questions modified for the CPS would provide superior results. Finally, no set of resources has been identified for developing such a set of questions.

Thus, we recommend that the questions should remain in the supplement without modification. Should that not be a sufficient outcome, the questions could be dropped. However, this could be unpopular in the user community, as data from these questions do get a fair amount of use.

CPS Displaced Worker Health Insurance Questions

SD17 Did (name/you) have health insurance at that job?

(1) Yes

(2) No

SD27 Other than Medicare or Medicaid, (does/do)(name/you) now have health insurance?

(1) Yes

(2) No

ACS Content test questions

Version 1

a. Is this person CURRENTLY covered by any type of health insurance or health coverage plan?

Include insurance obtained through a job or purchased directly from an insurance company, and government health coverage such as Medicare, Medicaid, VA and military programs.

􀂆 Yes

􀂆 No – SKIP to question 16

b. What type of health insurance or health coverage does this person have? Mark (X) all that apply.

􀂆 Insurance through a current or former employer or union (of this person or another family member)

􀂆 Insurance purchased directly from an insurance company (by this person or another family member)

􀂆 Medicare, for people age 65 and older, or people with certain disabilities

􀂆 Medicaid, Medical Assistance, or any kind of government-assistance plan for those with low incomes or a disability

􀂆 TRICARE or other military health care

􀂆 VA (including those who have ever enrolled for or used VA health care)

􀂆 Indian Health Service

􀂆 Other – Specify

ACS Content test questions

Version 2

Is this person CURRENTLY covered by any of the following types of health insurance or health coverage plans? Mark “Yes” or “No” for EACH type of coverage in items a-h.

a. Insurance through a current

or former employer or

union (of this person or

another family member)

b. Insurance purchased directly

from an insurance company

(of this person or another

family member)

c. Medicare, for people age 65

and over, or people with

certain disabilities

d. Medicaid, Medical Assistance,

or any kind of government-

assistance plan for those with

low incomes or a disability

e. TRICARE or other military

health care

f. VA (including those who have

ever enrolled for or used VA

health care)

g. Indian Health Service

h. Any other type of health

insurance or health coverage

plan - please specify