Comparing Errors in Medicaid Reporting across Surveys: Evidence to Date

Abstract

Objective To synthesize evidence on the accuracy of Medicaid reporting across state and federal surveys. Data Sources All available validation studies. Study Design Compare results from existing research to understand variation in reporting across surveys. Data Collection Methods Synthesize all available studies validating survey reports of Medicaid coverage. Principal Findings Across all surveys, reporting some type of insurance coverage is better than reporting Medicaid specifically. Therefore, estimates of uninsurance are less biased than estimates of specific sources of coverage. The CPS stands out as being particularly inaccurate. Conclusions Measuring health insurance coverage is prone to some level of error, yet survey overstatements of uninsurance are modest in most surveys. Accounting for all forms of bias is complex. Researchers should consider adjusting estimates of Medicaid and uninsurance in surveys prone to high levels of misreporting.

Medicaid ‘Welcome-Mat’ Effect Of Affordable Care Act Implementation Could Be Substantial

“…The survey tracks Medicaid coverage specifically; however, past literature on survey methods suggests a fair amount of misclassification between Medicaid and other means-tested coverage. 13 The Appendix contains results using a more narrowly defined Medicaid variable in the Current Population Survey data.…”

“…13 As long as misclassification of insurance coverage was uniform across states and time, this should not have biased our results. However, one effect of the Massachusetts reform could have been to educate the population on insurance in general.…”

Can we trust parental reports of child care subsidy receipt?

“…Indeed, as discussed earlier a number of studies investigating the Medicaid undercount have successfully used either an experimental or matching approach to capitalize on both administrative and survey data (e.g., Call et al, 2012). As part of the state subsidy administrative tracking system, states routinely collect a range of information on the sources and amounts of child care assistance a family receives.…”

“…A large segment of work in this area has focused on addressing the so-called “Medicaid undercount”, or the well-validated concern that estimates of Medicaid participation drawn from survey data sources are consistently lower than participation rates drawn from administrative data records (Call, Davidson, Davern, Blewett, & Nyman, 2008; Call, Davern, Klerman, & Lynch, 2012; Davern, Call, Ziegenfuss, Davidson, Beebe, & Blewett, 2008; Davern, Klerman, Baugh, Call, & Greenberg, 2009; Klerman, Ringel, & Roth, 2005). Studies have tended to use either an experimental approach, in which a random sample of survey respondents is drawn from administrative records and then survey respondents’ reports of program take-up are cross-checked with the administrative data, or a matching approach, in which administrative data records are identified and linked with respondents drawn from existing survey data sources and overlap between the two sources is examined (Call et al, 2008; Davern et al, 2008; 2009).…”

The Effect of the 2014 Medicaid Expansion on Insurance Coverage for Newly Eligible Childless Adults

“…Despite the small percentage of seemingly ineligible childless adults reporting Medicaid coverage, the NHIS, like all other household surveys, undercounts participation in Medicaid relative to administrative data (Call, Davern, et al, 2013). The NHIS has several featuresincluding a point-in-time coverage question and the use of state-specific plan names-that should mitigate limitations identified in other surveys (Cantor et al, 2007;Klerman et al, 2009).…”