Can we trust population surveys to count Medicaid enrollees and the uninsured?

Abstract

Health foundations, such as the Robert Wood Johnson Foundation (RWJF), make multimillion-dollar investments in programs to expand insurance coverage. These efforts are driven largely by estimates of the number of uninsured people derived from population surveys, which might overestimate the number of uninsured people if they under-count people enrolled in Medicaid. This paper reports the results of the RWJF-funded California Medicaid Undercount Experiment (CMUE) to estimate the extent of underreporting of Medicaid in the California Health Interview Survey (CHIS) and its effect on estimates of uninsurance. Although some over- and underreporting occurs, overall CHIS Medicaid estimates match administrative counts for adults.