People covered by medicaid above 138 fpl using offtotval, offcutoff, and HIMCAID in ASEC?

My crosstabulations of people covered by medicaid and % FPL show upwards of 39% of those covered by medicaid are above 138% of the FPL. I calculated %FPL as a ratio of OFFTOTVAL and OFFCUTOFF, and subset my population to those who have a positive response in HIMCAID and negative response in HIMCARE. I am working in R using the survey package to incorporate the wtsupp weighting scheme in my tables.

There are a number of complexities around medicaid eligibility and how it is measured in the CPS. First of all, the HIMCAIDLY variable is a part of the ASEC supplement, which uses the entire previous year as the reference period. HIMCAIDLY simply identifies if the individual was ever covered by Medicaid in the previous year. Since the income variables are also annual figures, it is possible that the individual was under the income cut off at one or more points during the year, but aggregated over the whole year, the income values exceed the limit. Furthermore, while the variable is primarily based on self-report, as noted in the HIMCAIDLY variable description, “The data in HIMCAIDLY were edited by the Census Bureau and assign Medicaid coverage to some persons who did not report such health insurance during questioning.” The CPS technical documentation gives the full definition used for identifying Medicaid coverage on page 9-8 (pdf page 112) and also mentions the final complicating factor, that Medicaid eligibility can be different between states.

I hope this helps.

Quick follow up on this: The link to the CPS technical documentation on identifying Medicaid coverage is broken. Could someone post an updated link? Thanks a lot!

I just updated Joe’s post with the correct link. Note there’s also an update of the documentation released in 2019, called Technical Paper 77:

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Many thanks @Matthew_Bombyk !

Unfortunately, I cannot find any reference to Medicaid and the variable HIMCAID in the document at the updated link. (It doesn’t have page 9-8 and pdf page 112 is about variance estimation.)

Can you help with this? Thanks a lot!

The original link was to Technical Paper 66, but I think Joe actually meant to link to the ASEC codebook for 2016. The right material is in the right place in that document. I’ve updated the original post appropriately. Note also that the variable name has changed for HIMCAID - it is now HIMCAIDLY.