DOI: 10.3886/icpsr38526.v1
title: Health Reform Monitoring Survey, United States, April 2021
title: Version 1

description: In January 2013, the Urban Institute launched the Health Reform Monitoring Survey (HRMS), a survey of the nonelderly population, to explore the value of cutting-edge, Internet-based survey methods to monitor the Affordable Care Act (ACA) before data from federal government surveys are available. Topics covered by the 20th round of the survey (April 2021) include self-reported health status, health insurance coverage, access to health care, awareness of Marketplace and Medicaid coverage options, use of public benefits, telehealth, COVID-19 vaccine attitudes, forgone care because of the COVID-19 pandemic, and unfair treatment in health care settings. Additional information collected by the survey includes age, gender, sexual orientation, marital status, education, race and ethnicity, United States citizenship, housing type, home ownership, internet access, income, and employment status.
description: This study was conducted to provide information on health insurance coverage, access to and use of health care, health care affordability, and self-reported health status, as well as timely data on important implementation issues under the Affordable Care Act (ACA).
description: The Health Reform Monitoring Survey (HRMS) provides data on health insurance coverage, access to and use of health care, health care affordability, and self-reported health status. Beginning in the second quarter of 2013, each round of the HRMS also contains topical questions focusing on timely ACA policy issues. In the first quarter of 2015, the HRMS shifted from a quarterly fielding schedule to a semiannual schedule.
description: The variables include original survey questions, household demographic profile data, and constructed variables which can be used to link panel members who participated in multiple rounds.
description: The Health Reform Monitoring Survey (HRMS) weights reflect the probability of sample selection from the KnowledgePanel and post-stratification to the characteristics of nonelderly adults in the United States based on benchmarks from the Current Population Survey and American Community Survey. Variables used in the post-stratification weighting of the KnowledgePanel and the post stratification weighting of the HRMS include sex, age, race and ethnicity, primary language, education, presence of children in households, household income, family income as a percentage of federal poverty levels (FPL), homeownership status, internet access, urban or rural status, state group, and census region. In January 2017, all rounds of the HRMS were reweighted due to a change in the Current Population Survey question on Internet access that was being used to create benchmarks for the construction of the post stratification weights.
description: Response Rates: The cumulative response rate for the April 2021 HRMS is 3.9 percent.
description: For each HRMS round, a stratified random sample of adults ages 18-64 is drawn from the Knowledge Panel, a probability-based, nationally representative Internet panel maintained by Ipsos. The approximately 55,000 adults in the panel include households with and without Internet access. Panel members are recruited from an address-based sample frame derived from the United States Postal Service Delivery Sequence File, which covers 97 percent of United States households. The 2021 HRMS sample includes 9,067 nonelderly adults, including oversamples of low-and moderate-income adults by race and ethnicity and an oversample of adults ages 18 to 29.
description: Datasets: 
DS0: Study-Level Files
DS1: Public-Use Data
DS2: Restricted-Use Data
description: Household population aged 18-64. Smallest Geographic Unit: Census region
description: web-based surveyThe public-use and restricted-use data files are exactly the same with the exception of the variable PPREG4. The valid data for this variable has been set to missing in the public-use version of the dataset. Everything else (data, labels, open-ended responses) will be the same between the public-use and restricted-use versions. Please review the processing notes at the front of each codebook for additional information regarding the data.Previous public use files contained indicators for insured and uninsured status based on the Urban Institute's coverage editing process. These variables are not included in the 2021 public use file because of a change in the editing process for respondents who reported having health insurance but did not report a specific coverage type and who did not enroll in a health plan through the Marketplace. Because of this change, estimates using the updated coverage status indicators in 2021 would not be directly comparable to estimates using the indicators from the public use files for the previous rounds of the survey.More information about this study is available on the HRMS website.Demographic variables are provided by the KnowledgePanel.