EPPN Census Series: Healthcare
Healthcare is one of the primary industries that rely on U.S. census data, and federal programs are an important way that many Americans access health care services. Medicaid and Medicare are the two largest – these programs provide health coverage for low-income Americans and Americans over 65. Together these two programs spent more than $425 billion in 2019. Census data also direct resources to other federal health programs that support vulnerable communities and populations, including the Children’s Health Insurance Program and Health Center Program.
In addition to federal government support for health care programs, census data provide information to the private sector, working in conjunction with the American Community Survey (ACS), to gain a better understanding of population trends and to be able to provide services as they are needed. While the primary 2020 Census form asks for basic demographic information, the American Community Survey (ACS) asks questions about employment, education, infrastructure and transportation access, and more. This survey occurs on a regular basis. When it is tied together with the census during census years, the survey is called the Combined, and together, the surveys help ensure an accurate count and a sample of more detailed information that guides much of these federal decisions on issues like healthcare. It is required to fill out both the ACS and the 2020 Census form if you receive both.
In addition to ACS data, the census combines administrative and survey data acquired from other federal agencies, state, and local governments. Without the census, the health of millions of Americans would be at risk.
The census uses the ACS to assist in determining the funding required for Medicaid and Medicare. The formula used to determine Medicaid reimbursement levels relies heavily on the average income per person of each state, while the formula for Medicare determines reimbursement rates based on how expensive it is to practice within a certain area. The ACS is also used to provide detailed data on factors that affect health, level of insurance coverage, service provided by hospitals, and fertility rates. As such, the ACS is the only available source of reliable community-level data and helps to determine where new local health facilities should be constructed and if a community is in a Health Professional Shortage Area.
In addition to Medicare and Medicaid, other federal health programs that provide vital health care for at-risk populations rely on census data. The Children’s Health Insurance Program (CHIP) provides low-cost healthcare to 9.6 million children in families that earn too much money to qualify for Medicaid. Likewise, the Supplemental Nutrition Program for Women, Infants, and Children (WIC) uses the census to provide monthly food voucher prices to safeguard the health of low-income women, infants, and children who are at a nutrition risk. Finally, the Health Center Program uses census information to recognize underserviced areas and have created 12,000 service delivery sites across the U.S. and its territories, serving over 28 million Americans. The census has played a critical role in these smaller-scale federal programs that ensure the health and wellbeing of low-income Americans.
The census and ACS have faced a number of challenges in their attempts to obtain a fair count and accurate demographic data, which would, in turn, jeopardize the accuracy of data used to support America’s healthcare system, leading to inefficiencies and misaligned resources. Estimates show significant undercounting in the 2010 Census, missing millions of people and in particular non-white populations, including 4.9% American Indians and Alaska Natives, 2.1% of the black population, 1.5% Latinos, 1.3% Native Hawaiians and other Pacific Islanders, and 0.1% Asians.
Members of Congress should be encouraged to support the census and ensure that the information it will collect is accurate. In addition, advocates can share how the census benefits the health of all Americans. As Episcopalians, we advocate on many of these programs on a regular basis, grounded in our Church’s policies on healthcare. We can go a step beyond advocacy and help to get an accurate census count this year. Be sure to check out our toolkit and additional information on our civic engagement webpage.
Work on this 2020 Census Series was led by Blair Hood, policy intern, Office of Government Relations