The U.S. Census Bureau has reported a decline in the rate of people under 65 without health insurance in most counties across the country between 2022 and 2023. According to new data from the Small Area Health Insurance Estimates (SAHIE), uninsured rates dropped in 194 counties while increasing in 85.
SAHIE remains the only source for single-year estimates of health insurance coverage for individuals under age 65 at the county level nationwide. The data includes breakdowns by sex, age groups, and income levels relevant to programs like Medicaid. State-level figures also report on coverage by race and Hispanic origin.
In 2023, an estimated 1,455 counties—46.3% of all U.S. counties—had uninsured rates below 10%. This is an increase from both the previous year’s figure of 45.2% and from 39.2% recorded in 2021.
Additional findings show that the median county uninsured rate was 9.3% in 2023, slightly lower than the previous year’s rate of 9.4%, and down from 10.4% in 2021. Among working-age adults (18 to 64 years old), uninsured rates fell in 182 counties but rose in another 51 during this period. For children aged up to eighteen, rates decreased in just twenty-seven counties but increased in eighty-nine.
Women between ages eighteen and sixty-four had lower estimated uninsured rates than men of the same age group in about sixty-two percent of counties (1,950 out of more than three thousand). For working-age adults living at or below one hundred thirty-eight percent of poverty—a key threshold for Medicaid eligibility—the median county uninsured rate declined to seventeen point seven percent, compared with eighteen point six percent last year and over twenty percent two years ago.
Interactive tools are available on the Census Bureau website (www.census.gov/data-tools/demo/sahie) allowing users to access custom tables, maps, and trend charts covering annual data since two thousand six.
“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. The county statistics are provided by sex and age groups and at income levels reflecting thresholds for state and federal assistance programs, such as Medicaid eligibility. State estimates also include health coverage by race and Hispanic origin.”
###
