Uninsured and the Supplemental Nutrition Assistance Program
States have extensive information about many uninsured individuals and families because of these people’s connections to other public programs, like the Supplemental Nutrition Assistance Program (SNAP, formerly known as food stamps). More than 90 percent of SNAP households include members who may qualify for coverage in states that are expanding Medicaid under the Affordable Care Act. And, as the map below clearly shows, every state can significantly reduce the amount of time and resources they will need to spend reaching the uninsured by leveraging existing data from SNAP.
In a letter to state health officials and state Medicaid directors on May 17, 2013, the Centers for Medicare and Medicaid Services (CMS) outlined a variety of ways that states can implement this enrollment automation strategy.
This map shows the distribution of the uninsured already connected to the SNAP by combining Census "Public-Use Microdata Areas" (PUMAs) and data from CMS. The map is interactive with the ability to zoom in and out. Placing your cursor on any PUMA will also display more information on the number of uninsured and the percentage of uninsured in that PUMA who are already connected to SNAP.
What are "Public-Use Microdata Areas" (PUMAs)?
Each PUMA is an area within a state that contains at least 100,000 residents. In densely populated areas, PUMAs are limited to smaller areas within a county. In sparsely populated areas, PUMAs typically comprise one or more neighboring counties within a given state. For example, Los Angeles County in California – with a population of nearly 10 million – is divided into 67 PUMAs, while the state of Wyoming – with a population of approximately 570,000 – is divided into only 4 PUMAs despite having 23 counties. Because of the wide variation in the size of states and counties, PUMAs provide a more “apples-to-apples” picture of the distribution of the uninsured in the country than using state-level or county-level distributions.
Where do the data come from?
The Centers for Medicare and Medicaid Services (CMS) partnered with the Office of the Assistant Secretary for Planning and Evaluation (ASPE) to estimate the number of eligible uninsured people living in each PUMA in the United States. These estimates are available on the CMS website. CMS and ASPE used the Census Bureau’s 2011 American Community Survey (ACS) for the analysis. All estimates represent the eligible uninsured population aged 0-64 and have been adjusted by ASPE to account for eligibility due to immigration status.