The U.S. Census Bureau has reported changes in health insurance coverage rates across the United States for individuals under 65 years old. According to new Small Area Health Insurance Estimates (SAHIE) data, the uninsured rate declined in 194 counties and increased in 85 counties between 2022 and 2023.
SAHIE provides single-year estimates of health insurance coverage for people under age 65 in all 3,143 U.S. counties. The data is broken down by sex, age groups, and income levels relevant to state and federal assistance programs such as Medicaid eligibility. At the state level, estimates also include information on health coverage by race and Hispanic origin.
In 2023, an estimated 1,455 counties—representing 46.3% of all U.S. counties—had uninsured rates below 10%. This figure marks an increase from both the previous year (45.2% in 2022) and two years prior (39.2% in 2021).
Additional findings from SAHIE show that the median county uninsured rate was 9.3% in 2023, compared to 9.4% in 2022 and 10.4% in 2021.
Uninsured rates among working-age adults (ages 18 to 64) decreased in a total of 182 counties but rose in another 51 counties during this period. For children ages birth through eighteen, uninsured rates dropped in only 27 counties while increasing in eighty-nine.
The data also reveal that working-age women had lower estimated uninsured rates than their male counterparts in about sixty-two percent of all counties (1,950 out of more than three thousand).
Among working-age adults living at or below one hundred thirty-eight percent of the poverty line—a key threshold for Medicaid eligibility—the median county uninsured rate fell to seventeen point seven percent last year from eighteen point six percent a year earlier and twenty point three percent two years ago.
Interactive tools for exploring these statistics are available at www.census.gov/data-tools/demo/sahie, allowing users to create custom tables and maps or review trends over time at various geographic levels.
“SAHIE is the only source for single-year estimates of people under age 65 with health insurance in each of the nation’s 3,143 counties,” according to the U.S. Census Bureau.
