Methodology of the RAND Health Reform Opinion Study

Methodology of the RAND Health Reform Opinion Study

Katherine Grace Carman
Christine Eibner
Copyright Date: 2015
Published by: RAND Corporation
Pages: 24
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  • Book Info
    Methodology of the RAND Health Reform Opinion Study
    Book Description:

    Understanding insurance transitions is critical to evaluating the success of the Affordable Care Act and to identifying opportunities for improvement. This report describes a methodology to track transitions in health insurance enrollment between November 2014 and December 2015.

    eISBN: 978-0-8330-9137-6
    Subjects: Health Sciences, Business

Table of Contents

  1. Front Matter
    (pp. i-ii)
  2. Preface
    (pp. iii-iii)
  3. Abstract
    (pp. iv-iv)
  4. Table of Contents
    (pp. v-v)
  5. Tables
    (pp. vi-vi)
  6. Abbreviations
    (pp. vii-vii)
  7. Introduction
    (pp. 1-2)

    The Affordable Care Act (ACA), signed into law on March 23, 2010, greatly expanded access to health insurance in the United States. The law’s major health insurance coverage provisions took effect beginning in 2014, including expansions to the Medicaid program, rating reforms in the individual market, federal subsidies for Marketplace enrollees, and an individual mandate requiring most Americans to obtain coverage or pay a tax penalty. Many of the law’s provisions will be phased in over time; for example, the individual mandate penalties reach their maximum level in 2016, and a mandate requiring employers to offer coverage is scheduled to...

  8. Sample
    (pp. 3-4)

    Survey participants for the RHROS are drawn from the ALP. The ALP began surveying respondents in January 2006; since that time, more than 400 surveys have been fielded. The ALP is a nationally representative Internet panel that includes both a probability and a conveniencebased sample. Participants in the probability sample were recruited via probability-based mail and random-digit-dial sampling methods. The convenience sample includes a “snowball” sample in which participants were given the opportunity to invite friends and acquaintances to participate and a respondent-driven cohort that sampled enrollees through social networks. Unlike opt-in Internet surveys, Internet access is not required to...

  9. Survey Timing and Items
    (pp. 5-7)

    Between November 2014 and December 2015 we will conduct four surveys asking respondents about their health insurance coverage. The first survey took place at the beginning of the 2015 open enrollment period; it was in the field from November 11, 2014, until December 1, 2014. The second survey was fielded at the end of the open enrollment period, between February 16, 2015, and March 2, 2015. The third survey will be fielded after the April 15, 2015, tax filing deadline. The final survey will be fielded in late summer or early fall of 2015. We have left the precise...

  10. Weighting
    (pp. 8-9)

    Because surveys cannot reach all members of the population, we create weights so that results are representative of the population overall. Weights are widely used in survey research. We apply a two-step approach. In the first step, we use a raking algorithm, following Deming (1943) and Deville et al. (1993), to match the distribution of characteristics in our sample as of September 2013 to the estimates of the distribution of characteristics of the population aged 18 to 64 from the 2013 Current Population Survey (CPS). We aimed to match population proportions on interactions of gender and race/ethnicity, gender and education,...

  11. Analyses
    (pp. 10-13)

    After each survey we will produce several key pieces of output. When reporting the newest results for each of our four surveys, we will examine changes in coverage from September 2013 to the current date, as well as from November 2014 to the current date. This will allow us to observe transitions since the rollout of most provisions of the ACA (from before the first open enrollment period to the present date) as well as transitions during the second open enrollment period. We calculate the weighted share of respondents with each source of current and past insurance. We then multiply...

  12. Appendix: Survey Text
    (pp. 14-16)
  13. References
    (pp. 17-17)