A change to the Census Bureau survey could affect how they measure the uninsured — and that could impact, and complicate, how the effects of the Patient Protection and Affordable Care Act (PPACA) are measured.
The new questionnaire — being conducted this month — includes a “total revision” to questions about health insurance, just as analysts are trying to get solid data on how well the Patient Protection and Affordable Care Act is working.
The New York Times reported the change to the annual survey Tuesday, saying the changes are intended to improve the survey’s accuracy. However, officials say the new questions are so different that the findings “will not be comparable,” leaving many worried about not giving an apples-to-apples comparison to pre and post-reform effects in the uninsured population.
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Officials said the change could lead to lower attributed numbers of the uninsured.
“We are expecting much lower numbers just because of the questions and how they are asked,” Brett J. O’Hara, chief of the health statistics branch at the Census Bureau, told the Times.
Previously the Census asked people if they had coverage at any point in the prior year, according to the Times. The new questions ask if they have insurance “at the time of the interview,” which in this case took place in February, March and April. Officials use that and other data to try to determine coverage over the last 15 months.
The Times reported that when both questionnaires were used last year, the number of Americans without insurance came in around 2 percent lower under the new questions.
Changes to the Census questionnaire were announced in the Federal Register in September.
The annual Census report measures the number of people with various kinds of health insurance and the number of uninsured for the nation and for each state.
The timing of the changes leaves some questioning the motives behind the change, though it’s being downplayed by officials who say it is merely “coincidental” and “unfortunate.”
“The timing is messy, and there will be significant changes in the data,” said Jenna Stento, senior manager at Avalere Health, noting she’s not surprised about the backlash and “noise” already heard in the both the health industry and in the political arena from the news.
See also: PPACA chips away at uninsured rate
The Census changes will be difficult for “trend analysis” and in analyzing how PPACA is affecting the insured/uninsured population in the next year or two, Stento said. However she said it should “work itself out” in the coming years.