Current Population Survey (CPS) Health Insurance Definitions
The Census Bureau collects data about different types of health insurance coverage and broadly classifies the types into either Private (non-government) coverage or Government-sponsored coverage.
Private Health Insurance
Private health insurance is coverage by a health plan provided through an employer or union and coverage purchased directly by an individual from an insurance company or through an exchange.
- Employment-based health insurance is coverage offered through one's own employment or a relative's. It may be offered by an employer or by a union.
- Own Employment-based health insurance is coverage offered through one's own employment and only the policyholder is covered by the plan.
- Direct-purchase health insurance is coverage through a plan purchased by an individual from a private company or through an exchange. Exchange plans include coverage purchased through the federal Health Insurance Marketplace as well as other state-based marketplaces and include both subsidized and unsubsidized plans.
Government Health Insurance
Government health insurance includes plans funded by governments at the federal, state, or local level. The major categories of government health insurance are Medicare, Medicaid, the Children's Health Insurance Program (CHIP), individual state health plans, TRICARE, CHAMPVA (Civilian Health and Medical Program of the Department of Veterans Affairs), as well as care provided by the Health and Medical Program of the Department of Veterans Affairs, military health care (VA Care), and the Indian Health Service.*
- Medicare is the Federal program which helps pay health care costs for people 65 and older and for certain people under 65 with long-term disabilities.
- Medicaid is a program administered at the state level, which provides medical assistance to the needy. Families with dependent children, the aged, blind, and disabled who are in financial need may be eligible for Medicaid. It may be known by different names in different states.
- CHIP, the Children's Health Insurance Program, is a program administered at the state level, providing health care to low-income children who do not qualify for Medicaid. CHIP may be known by different names in different states. The CHIP program may also be known by its former name, the State Children's Health Insurance Program (SCHIP).
- Military health care includes TRICARE and CHAMPVA (Civilian Health and Medical Program of the Department of Veterans Affairs), as well as care provided by the Department of Veterans Affairs (VA Care).
- TRICARE is a military health care program for active duty and retired members of the uniformed services, their families, and survivors.
- CHAMPVA is a medical program through which the Department of Veterans Affairs helps pay the cost of medical services for eligible veterans, veteran's dependents, and survivors of veterans.
- The Department of Veterans Affairs provides medical assistance to eligible veterans of the Armed Forces.
- State-specific plans: Some states have their own health insurance programs for low-income uninsured individuals. These health plans may be known by different names in different states.
- Indian Health Service (IHS)* is a health care program through which the Department of Health and Human Services provides medical assistance to eligible American Indians at IHS facilities. In addition, the IHS helps pay the cost of selected health care services provided at non-IHS facilities. If someone only reports having IHS coverage and no other type of health insurance, they are considered uninsured.
The CPS categorizes TRICARE, CHAMPVA and VA Health Care into a single "military health care" variable. The data do not distinguish between coverage for active-duty, retired and Veteran members. In addition, the CPS does not sample the active-duty military population, which reduces TRICARE's significance as a form of military, employer-based health insurance coverage (except for active-duty military spouses and dependents).
The American Community Survey (ACS), however, contains separate variables for TRICARE (coverage primarily for active-duty military and retirees) and VA Health Care (for eligible Veterans), and thus can categorize TRICARE as employment-based health insurance coverage. In addition, unlike the CPS, the ACS collects data on the active-duty military population. It is for these reasons the ACS considers TRICARE employer-based (private) health insurance, and the CPS categorizes TRICARE as government (public) coverage.
*After consulting with health insurance experts, the Census Bureau modified the definition of the population without health insurance in the Supplement to the March 1998 Current Population Survey, which collected data about coverage in 1997. Previously, people with no coverage other than access to the Indian Health Service were counted as part of the insured population. Subsequently, the Census Bureau has counted these people as uninsured. The effect of this change on the overall estimates of health insurance coverage was negligible.