The U.S. Census Bureau reported a decrease in the rate of individuals under 65 without health insurance in 194 counties, while 85 counties saw an increase between 2022 and 2023. These findings come from the Small Area Health Insurance Estimates (SAHIE), which provide annual county-level data on health insurance coverage for people under age 65 across all 3,143 U.S. counties.
SAHIE is currently the only source that offers single-year estimates of health insurance coverage at this level of detail, breaking down statistics by sex, age groups, and income levels relevant to programs like Medicaid. State-level data also include breakdowns by race and Hispanic origin.
According to the new data, “1,455 or 46.3% of U.S. counties had an estimated uninsured rate below 10% in 2023, up from 45.2% of counties in 2022 and 39.2% in 2021.” The median county uninsured rate was recorded at 9.3% for 2023, a slight improvement from previous years.
The report also notes differences among demographic groups: “Uninsured rates of working-age adults (ages 18 to 64) decreased in 182 counties and increased in 51 counties. Meanwhile, the uninsured rates of children (ages 0 to 18) decreased in 27 counties and increased in 89 counties.” Additionally, “Working-age women had lower estimated uninsured rates than working-age men in 62.0% of counties (1,950).”
For those living at or below the poverty threshold used for Medicaid eligibility—138% of the poverty line—the median county uninsured rate dropped to “17.7%, down from 18.6% in 2022 and 20.3% in 2021.”
More information and interactive tools for exploring these statistics are available on the Census Bureau’s website at https://www.census.gov/data-tools/demo/sahie.
