Vital and Health Statistics Advance Data From Vital and Health Statistics: Numbers 71-80 Series 16: Compilations of Advance Data From Vital and Health Statistics No, 8 Data in this report from health and demographic surveys present statistics by age and other variables on health care coverage, family planning services, blood carbon monoxide levels, blood lead levels, and ambulatory medical care, Estimates are based on the civilian noninstitutionalized population of the United States, These reports were originally published in 1981 and 1982, U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Public Health Service Centers for Disease Control and Prevention Notional Center for Health Statistics Hyaitsville, Maryland December 1993 DHHS Publication No, [PHS] 94-1867 Trade name disclaimer The use of trade names is for identification only and does not Imply endorsement by the Public health Service, U.S. Department of Health and Human Services. Copyright information All material appearing in this report is in the public domain and may be reproduced or copied without permission: citation as to source, however, is appreciated. Suggested citation National Center for Health Statistics. Advance data from vital and health !;tatistics: numbers 71–80. National Center for Health Statistics. Vital Health Stat 16(8). 1993. National Center for Health Statistics Manning Feinleib, M.D., Dr,P.H., Director Jack R. Anderson, Deputy Director Jacob J. Feldman, Ph.D., Associate Director for AnaZysis and Epidemwlogy Gail F. Fisher, Ph.D., Associate Director fir Planning and Extramural Programs Peter L. Hurley, Associate Director for Vital and Health Statistics Systems Robert A. Israel, Associate Director for International Statistics Stephen E. Nieberding, Associate Director for Management Charles J. Rothwell, Associate Director for Data Processing and Services Monroe G. Sirken, Ph.D., Associate Director for Research and Methodology David L. Larson, Assistant DirectoL Atlanta Health Care Coverage Under Private Health Insurance, Medicare, Medicaid, and Military or Veterans Administration Health Benefits: United States, 1978 . No. 71 Visits to Family Planning Service Sites: United States, 1978 . No. 72 Patient Profile, NationalReporting System for Family Planning Sefices: United States, l978 . No. 73 Visits to Family Planning Clinics: United States, 1979 . No. 74 Expected Principal Sources ofPayment for Hospital Discharges: United States, 1979 . No. 75 Blood Carbon Monoxide Levelsin Persons 3–74Years ofAge: United States, 1976-80a . No. 76 1980 Summary National Ambulatory Medical Care Survey . No. 77 Drugs Most Frequently Used in Office-Based Practice: National Ambulatory Medical Care Survey, 1980 . No. 78 Blood Lead Levels for Persons 6 Months–74 Years of Age: United States, 1976-80 . No. 79 Medication Therapy in Office Visits for Hypertension: National Ambulatory Medical Care Survey, 1980 . No. 80 ... III m~~‘&~’ ~‘~~” n Vital and Health Statistics of the National Center for Health Statistics Number 71 ● June 29, 1981 Health Care Coverage Under Private Health Insurance, Medicare, Medicaid, and Military or Veterans Administration Health Benefits: United States, 1978 Division of Health interview Statistics The National Center for Health Statistics included civiIian noninstitutionzdized population. They are a special supplement on health care coverage under “point prevalence” estimates because they represent private health insurance and Medicare as a part of the a person’s health care coverage status only at the 1978 National Health Interview Survey questionnaire. time of interview, and for no other period during the While this supplement was not designed to produce year. They are “average annual” estimates because estimates for all types of health care coverage, it did the total annuaI National Health Interview Survey contain a series of items related to eligibility for sample consists of summing the results for 52 weekly Medicaid and for military and Veterans Administration representative samples of the civilian noninstitution- health care benefits.1 By making certain assumptions alized population. about how these items relate to the broader concept Technical qualifications related to the estimates of health care coverage, it is possible to obtain esti- are summarized in the technical notes. For a more mates of the number of persons eligibile for these detailed discussion of these qualifications and for a types of benefits. copy of the questionnaire see the 1978 Current This preliminary report presents estimates of the Estimates (Series 10, No. 130). Additional data on coverage status of persons in the civilian noninstitu- health care coverage will be available in future publi- tionalized population under private health insurance cations from the National Center for Health Services and the three types of public programs mentioned in Research based on the 1977 National Medical Care the title. There are many other forms of at Ieast Expenditure Survey,z and from the National Center partial coverage for health care costs, including for Health Statistics and the Health Care Financing neighborhood health clinics and locaJ philanthropic Administration based on the 1980 Medical Care health-service agencies. “Health care coverage” as Utilization and Expenditure Survey. used in this report does not include these forms of coverage or insurance restricted to dread diseases, Coverage status of persons accidents, dental. care, or protection related to in- come maintenance during periods of Mness. Coverage under four types of health restricted to certain groups is also excluded, such as care coverage coverage for Indians whose sole source of care is The concept of “coverage” is relatively unambig- through the Indian Health Service. uous for private health insurance and Medicare, and The focus of this report is on the extent or scope can be approximated for military and/or Veterans of health care coverage in the population rather than Administration (VA) health benefits. The closest on the” question of breadth or depth of that coverage. corresponding concept for Medicaid is that of “eli- Est@ates are shown first by cross-classifying the gibility,” However, because the criteria for Medicaid coverage status for each person to produce an undu- eligibility vary among the States, because many plicated estimate of coverage under the four types persons only become aware of their eligibility after considered together. This is followed by a presenta- seeking medical aid, and finally because of the added tion of estimates for each of the four types of health complexity in defining eligibility associated with care coverage and the procedures foIlowed in “spenddown” provisions there is no generally agreed deriving them. on criteria for estimating the number of persons All of the estimates presented in this report are “covered by” Medicaid. average annual point prevalence estimates for the The Medicaid estimates shown in this report are U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES, Public Health Service, Office of Health Research, Statistics, and Technology 2 operationally defined in terms of responses to three Table 1. Number and percent dktribution of persons by age, covera!y items contained on the 1978 National Health Inter- status under private health insurance, Medicare, and militam’ view Survey (NHIS) questionnaire. Persons are and/or Veterans Administration health benefits, and by Medicaid defined as having “categorical or reported Medicaid coverage status: United States, 1978 coverage” if they (1) had a valid Medicaid card at the Has valid Medicaid card, time of interview, (2) were receiving Aid to Families raceivesA FDC or SS1, and/or reports Medicaid with Dependent Children or Supplementary Security covere~ as reason for no All Income payments, or (3) Medicaid coverage was Age and covera~ status’ health insurance plan persons given as a reason for not being covered by any health — Reposted as Not reported insurance plan. meeting at as meeting Because of the lack of uniformity associated with least one any of ~~ the definitions of Medicaid coverage, the estimates criteria2 criteria for this type of coverage are shown separately in table 1. The data from the 1978 NHIS indicate that about Number of persons in thousands 179.5 million persons (83.9 percent) in the civilian All ages, all coverage statuses . 213,828 14,846 198~82 noninstitutionalized population were covered by Covered . EZJZZ&l 4,0zz 175,451 private health insurance, Medicare, or military and/or Notcovered . 10348 21,295 VA health benefits. Among the estimated 31.6 million Unknown if covered . 2:713 %1 47 2,237 persons (14.8 percent) not covered under any of Under 65 years, all coverage statuses . 191,041 12,762 1782!79 these three and the 2.7 million persons (1.3 percent) Covered . m 2111 155,000 for whom the coverage status could not be deter- Not covered . 0204 21,1147 mined, an estimated 10.8 million persons had cate- Unknown if covered . 2;579 Q 7 2,1133 gorical or reported Medicaid coverage. Combining 65 years and over, all coverage these two groups (represented by the boxed cells in statuses . 22,788 2,084 20,703 table 1) produces estimates of about 190.3 million Covered . q If.!.& 20,451 persons (89 percent) in the civilian noninstitution- Notcovered . 149 Unknown if covered . 133 alized population covered by at least one of the four Ez?l ~~ types of coverage and about 23.5 million persons Percent distribution (11 percent) who were not identified as being covered All ages, all coverage statuses . 100.0 6.9 93.1 under private health insurance or any of the three Covered . Em& 82.1 public prograrns.3 Notcovered . 10.0 1.0 The sum of the estimates in the boxed cells in Unknown if covered . 1:3 m Under 65 years, all coverage table 1 shows that virtually all persons 65 years of age statuses . 100.0 6.7 93.3 and over (about 99 percent) were covered under at Covered . 81.1 least one of the four types of coverage. The corre- Notcovered . 11.1 sponding estimate for persons under 65 years of age Unknown if covered . 1.1 is about 88 percent. 65 years and over, all coverage statuses .