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Historical Context

Health insurance data have been collected periodically by the National Health Interview Survey (NHIS) since 1959. From 1959-1968, insurance coverage data were collected in 3 years (1959, fiscal year 1963 and 1968); during 1968-1989, data were generally collected every 2 years; and since 1989, data were collected every year. The NHIS health insurance questions have changed and expanded over time reflecting changes in health insurance coverage and programs as well as questionnaire design.

Prior to 1997, health insurance questions were asked on supplements to the basic questionnaire. However, beginning in 1997, collection of information about health insurance was incorporated into the family core questionnaire of the survey. Since 1997, the content and flow of the core health insurance section has remained relatively stable, incorporating new programs where necessary. For example, a State Children’s Health Insurance Program (CHIP) category was added to the list of coverage types on the questionnaire following the passing of The Balanced Budget Act of 1997 that established CHIP (BBA 97) (P.L. 105-33). More recently, since 2011, questions on relationships to policyholders, coverage of individuals outside of the household and changes in coverage have been added to the NHIS instruments in take into account the passage of the Affordable Care Act of 2010 (P.L. 111-148, P.L. 111-152) (ACA). New questions added in 2014 obtain information about whether coverage was obtained through the Federal Health Insurance Marketplace and state-based exchanges.

A more complete discussion of the history of health insurance data collection on the NHIS prior to 2007 can be found in Health Insurance Coverage Trends, 1959-2007: Estimates from the National Health Interview Survey.