The 2010 Patient Protection and Affordable Care Act (ACA), which represents the most significant change to the health care system since the introduction of Medicaid and Medicare, has brought a host of new analysts and researchers into the realm of health services research. While this offers many benefits to the design, implementation, and evaluation of health reform initiatives at the state and national level, it will also no doubt lead to conflicting estimates and assessments, both across data sources and for work based on the same data source. It is our experience that many of those conflicts will reflect differences in definitions and assumptions, in some cases explicit and in some cases implicit, as when researchers rely on existing measures of family composition or family income in national surveys. In this brief we describe an important decision that should be considered in analyses of health insurance coverage using survey data: Defining the "family unit" for examining insurance coverage, often called the health insurance unit. We propose a general definition of the health insurance unit and provide Stata and SAS code to facilitate implementing that definition.
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