Papers Containing Tag(s): 'Centers for Medicare'
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Medicaid Services - 13
American Community Survey - 11
Protected Identification Key - 10
Social Security - 9
Viewing papers 1 through 10 of 15
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Working PaperThe Design of Sampling Strata for the National Household Food Acquisition and Purchase Survey
February 2025
Working Paper Number:
CES-25-13
The National Household Food Acquisition and Purchase Survey (FoodAPS), sponsored by the United States Department of Agriculture's (USDA) Economic Research Service (ERS) and Food and Nutrition Service (FNS), examines the food purchasing behavior of various subgroups of the U.S. population. These subgroups include participants in the Supplemental Nutrition Assistance Program (SNAP) and the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), as well as households who are eligible for but don't participate in these programs. Participants in these social protection programs constitute small proportions of the U.S. population; obtaining an adequate number of such participants in a survey would be challenging absent stratified sampling to target SNAP and WIC participating households. This document describes how the U.S. Census Bureau (which is planning to conduct future versions of the FoodAPS survey on behalf of USDA) created sampling strata to flag the FoodAPS targeted subpopulations using machine learning applications in linked survey and administrative data. We describe the data, modeling techniques, and how well the sampling flags target low-income households and households receiving WIC and SNAP benefits. We additionally situate these efforts in the nascent literature on the use of big data and machine learning for the improvement of survey efficiency.View Full Paper PDF
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Working PaperCitizenship Question Effects on Household Survey Response
June 2024
Working Paper Number:
CES-24-31
Several small-sample studies have predicted that a citizenship question in the 2020 Census would cause a large drop in self-response rates. In contrast, minimal effects were found in Poehler et al.'s (2020) analysis of the 2019 Census Test randomized controlled trial (RCT). We reconcile these findings by analyzing associations between characteristics about the addresses in the 2019 Census Test and their response behavior by linking to independently constructed administrative data. We find significant heterogeneity in sensitivity to the citizenship question among households containing Hispanics, naturalized citizens, and noncitizens. Response drops the most for households containing noncitizens ineligible for a Social Security number (SSN). It falls more for households with Latin American-born immigrants than those with immigrants from other countries. Response drops less for households with U.S.-born Hispanics than households with noncitizens from Latin America. Reductions in responsiveness occur not only through lower unit self-response rates, but also by increased household roster omissions and internet break-offs. The inclusion of a citizenship question increases the undercount of households with noncitizens. Households with noncitizens also have much higher citizenship question item nonresponse rates than those only containing citizens. The use of tract-level characteristics and significant heterogeneity among Hispanics, the foreign-born, and noncitizens help explain why the effects found by Poehler et al. were so small. Linking administrative microdata with the RCT data expands what we can learn from the RCT.View Full Paper PDF
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Working PaperThe Long-Term Effects of Income for At-Risk Infants: Evidence from Supplemental Security Income
March 2024
Working Paper Number:
CES-24-10
This paper examines whether a generous cash intervention early in life can "undo" some of the long-term disadvantage associated with poor health at birth. We use new linkages between several large-scale administrative datasets to examine the short-, medium-, and long-term effects of providing low-income families with low birthweight infants support through the Supplemental Security Income (SSI) program. This program uses a birthweight cutoff at 1200 grams to determine eligibility. We find that families of infants born just below this cutoff experience a large increase in cash benefits totaling about 27%of family income in the first three years of the infant's life. These cash benefits persist at lower amounts through age 10. Eligible infants also experience a small but statistically significant increase in Medicaid enrollment during childhood. We examine whether this support affects health care use and mortality in infancy, educational performance in high school, post-secondary school attendance and college degree attainment, and earnings, public assistance use, and mortality in young adulthood for all infants born in California to low-income families whose birthweight puts them near the cutoff. We also examine whether these payments had spillover effects onto the older siblings of these infants who may have also benefited from the increase in family resources. Despite the comprehensive nature of this early life intervention, we detect no improvements in any of the study outcomes, nor do we find improvements among the older siblings of these infants. These null effects persist across several subgroups and alternative model specifications, and, for some outcomes, our estimates are precise enough to rule out published estimates of the effect of early life cash transfers in other settings.View Full Paper PDF
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Working PaperEstimating the U.S. Citizen Voting-Age Population (CVAP) Using Blended Survey Data, Administrative Record Data, and Modeling: Technical Report
April 2023
Working Paper Number:
CES-23-21
This report develops a method using administrative records (AR) to fill in responses for nonresponding American Community Survey (ACS) housing units rather than adjusting survey weights to account for selection of a subset of nonresponding housing units for follow-up interviews and for nonresponse bias. The method also inserts AR and modeling in place of edits and imputations for ACS survey citizenship item nonresponses. We produce Citizen Voting-Age Population (CVAP) tabulations using this enhanced CVAP method and compare them to published estimates. The enhanced CVAP method produces a 0.74 percentage point lower citizen share, and it is 3.05 percentage points lower for voting-age Hispanics. The latter result can be partly explained by omissions of voting-age Hispanic noncitizens with unknown legal status from ACS household responses. Weight adjustments may be less effective at addressing nonresponse bias under those conditions.View Full Paper PDF
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Working PaperThe Underserved Have Less Access to Employer-Sponsored Telemedicine Coverage
September 2022
Working Paper Number:
CES-22-40
Telemedicine has been proposed as one means of improving health care access for underserved communities, and information about insurance coverage for telemedicine (TMC) is important in understanding its utilization and provision. We use 2018-2019 Medical Expenditure Panel Survey-Insurance Component data on employer-sponsored coverage to examine pre-pandemic TMC relative to employer, worker, and health plan characteristics. We find that the share of employees in private sector establishments offering TMC was lower in the most rural counties, in smaller firms, in establishments without unionized employees, and in establishments where most workers were low wage, part-time and older when compared to other establishments. These findings reflect differences across establishments in insurance offers, as well as differences in TMC conditional on an insurance offer, which suggests that TMC may function as a premium plan feature with limited availability and potential support for improving healthcare access for the underserved.View Full Paper PDF
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Working PaperAge, Sex, and Racial/Ethnic Disparities and Temporal-Spatial Variation in Excess All-Cause Mortality During the COVID-19 Pandemic: Evidence from Linked Administrative and Census Bureau Data
May 2022
Working Paper Number:
CES-22-18
Research on the impact of the COVID-19 pandemic in the United States has highlighted substantial racial/ethnic disparities in excess mortality, but reports often differ in the details with respect to the size of these disparities. We suggest that these inconsistencies stem from differences in the temporal scope and measurement of race/ethnicity in existing data. We address these issues using death records for 2010 through 2021 from the Social Security Administration, covering the universe of individuals ever issued a Social Security Number, linked to race/ethnicity responses from the decennial census and American Community Survey. We use these data to (1) estimate excess all-cause mortality at the national level and for age-, sex-, and race/ethnicity-specific subgroups, (2) examine racial/ethnic variation in excess mortality over the course of the pandemic, and (3) explore whether and how racial/ethnic mortality disparities vary across states.View Full Paper PDF
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Working PaperThe Use of Administrative Records and the American Community Survey to Study the Characteristics of Undercounted Young Children in the 2010 Census
May 2018
Working Paper Number:
carra-2018-05
Children under age five are historically one of the most difficult segments of the population to enumerate in the U.S. decennial census. The persistent undercount of young children is highest among Hispanics and racial minorities. In this study, we link 2010 Census data to administrative records from government and third party data sources, such as Medicaid enrollment data and tenant rental assistance program records from the Department of Housing and Urban Development, to identify differences between children reported and not reported in the 2010 Census. In addition, we link children in administrative records to the American Community Survey to identify various characteristics of households with children under age five who may have been missed in the last census. This research contributes to what is known about the demographic, socioeconomic, and household characteristics of young children undercounted by the census. Our research also informs the potential benefits of using administrative records and surveys to supplement the U.S. Census Bureau child population enumeration efforts in future decennial censuses.View Full Paper PDF
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Working PaperDisclosure Limitation and Confidentiality Protection in Linked Data
January 2018
Working Paper Number:
CES-18-07
Confidentiality protection for linked administrative data is a combination of access modalities and statistical disclosure limitation. We review traditional statistical disclosure limitation methods and newer methods based on synthetic data, input noise infusion and formal privacy. We discuss how these methods are integrated with access modalities by providing three detailed examples. The first example is the linkages in the Health and Retirement Study to Social Security Administration data. The second example is the linkage of the Survey of Income and Program Participation to administrative data from the Internal Revenue Service and the Social Security Administration. The third example is the Longitudinal Employer-Household Dynamics data, which links state unemployment insurance records for workers and firms to a wide variety of censuses and surveys at the U.S. Census Bureau. For examples, we discuss access modalities, disclosure limitation methods, the effectiveness of those methods, and the resulting analytical validity. The final sections discuss recent advances in access modalities for linked administrative data.View Full Paper PDF
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Working PaperLabor Market Effects of the Affordable Care Act: Evidence from a Tax Notch
July 2017
Working Paper Number:
carra-2017-07
States that declined to raise their Medicaid income eligibility cutoffs to 138 percent of the federal poverty level (FPL) under the Affordable Care Act (ACA) created a "coverage gap'' between their existing, often much lower Medicaid eligibility cutoffs and the FPL, the lowest level of income at which the ACA provides refundable, advanceable "premium tax credits'' to subsidize the purchase of private insurance. Lacking access to any form of subsidized health insurance, residents of those states with income in that range face a strong incentive, in the form of a large, discrete increase in post-tax income (i.e. an upward notch) at the FPL, to increase their earnings and obtain the premium tax credit. We investigate the extent to which they respond to that incentive. Using the universe of tax returns, we document excess mass, or bunching, in the income distribution surrounding this notch. Consistent with Saez (2010), we find that bunching occurs only among filers with self-employment income. Specifically, filers without children and married filers with three or fewer children exhibit significant bunching. Analysis of tax data linked to labor supply measures from the American Community Survey, however, suggests that this bunching likely reflects a change in reported income rather than a change in true labor supply. We find no evidence that wage and salary workers adjust their labor supply in response to increased availability of directly purchased health insurance.View Full Paper PDF
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Working PaperWhen Race and Hispanic Origin Reporting are Discrepant Across Administrative Records and Third Party Sources: Exploring Methods to Assign Responses
December 2015
Working Paper Number:
carra-2015-08
The U.S. Census Bureau is researching uses of administrative records and third party data in survey and decennial census operations. One potential use of administrative records is to utilize these data when race and Hispanic origin responses are missing. When federal and third party administrative records are compiled, race and Hispanic origin responses are not always the same for an individual across sources. We explore different methods to assign one race and one Hispanic response when these responses are discrepant. We also describe the characteristics of individuals with matching, non-matching, and missing race and Hispanic origin data by demographic, household, and contextual variables. We find that minorities, especially Hispanics, are more likely to have non-matching Hispanic origin and race responses in administrative records and third party data compared to the 2010 Census. Minority groups and individuals ages 0-17 are more likely to have missing race or Hispanic origin data in administrative records and third party data. Larger households tend to have more missing race data in administrative records and third party data than smaller households.View Full Paper PDF
