SPG synthesis report - State Coverage Initiatives

sources of funding for updating the nationally available datasets that are incorporated in
the MSID.
As of 2007, 25 SPG states had received access to the database and several incorporated
their state-specific survey data into the database. These MSID users have incorporated
MSID data in the development of legislative briefs and policy discussions, state fact
books and information tools for stakeholders, as well as there SPG reports to HHS. Ease
of use has enabled states to incorporate the MSID in policy conversations. Access to
MSID has been particularly valuable to states such as Mississippi and Alabama, which
historically have lacked data resources. The MSID has also been invaluable to the
Arkansas SPG project by providing data to inform policy discussions at both the state
legislature and the Arkansas Health Insurance Roundtable.
Value of State Data Collection
Most states used at least a portion of the SPG funds to undertake their own state-specific
surveys. These surveys both enhanced their understanding of the problem and helped
inform policy options related to expanding coverage and access. 10 The data collection
activities proved critical to states, enabling them to develop: (1) a clearer picture of the
uninsured, including their demographics, health care seeking patterns, and barriers to
care; and (2) develop a general framework within which to explore specific policy
options.
Grantees used SPG program funds for state-level data collection and analysis that
provided critical inputs to state policy debates and decisions regarding coverage
strategies. These funds enabled states to undertake in-depth analyses of state-specific
characteristics and circumstances. State-specific surveys conducted by grantees generally
had larger sample sizes than most national surveys, enabling states to develop estimates
of important subpopulations among their uninsured residents. This information enabled
grantees to undertake an informed decision-making process for both new policy options
and expansions to existing coverage.
State surveys also enabled grantees to prepare estimates for specific subpopulations.
SHADAC reports that typical state sampling frames included over-sampling for rural and
other geographic areas, racial and ethnic groups, low-income populations, and children. 11
These estimates enabled states to better understand disparities in health insurance
coverage not only by race, but also by income and geographic area. This data proved very
useful to local communities in their own planning efforts. National surveys are not able to
provide this level of sampling and sub-analyses.
Grantees reported again and again that the state level data provided a unique and valuable
political purpose. 12 First, the state household surveys could be tailored to address unique
local policy interests and options. Second, states had control over the timing of the survey
and the release of findings, especially when tied to the legislative calendar. Third,
analysts were able to respond to detailed questions from legislators and policymakers
because they were armed with sub-analyses. Fourth, states were able to engage local
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