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The US health system has come under intense scrutiny in recent years, prompted in part by the steadily increasing uninsured rate. As policymakers struggle with questions about the effectiveness and efficiencies of the current system, accurate measurement of health insurance coverage has come into focus as an important component of reform proposals. While there has been a considerable amount of research examining and comparing the various methods used to estimate coverage, there is one aspect that has been largely overlooked: qualitative testing of the survey questions used to generate the official measure of coverage. These questions are asked within the Current Population Survey (CPS), and major policy and funding decisions are based on its estimates of insurance coverage. This paper presents findings from cognitive testing of the CPS, assesses those findings within the context of related empirical research, and suggests a research agenda for a redesigned set of questions on insurance.
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