The U.S. Census Bureau has reported that the percentage of people under age 65 without health insurance declined in 194 counties and rose in 85 counties from 2022 to 2023, based on new Small Area Health Insurance Estimates (SAHIE). SAHIE remains the only source providing single-year estimates of health insurance coverage for individuals under age 65 across all 3,143 U.S. counties.
These statistics are broken down by sex, age groups, and income levels that correspond to eligibility thresholds for programs such as Medicaid. State-level data also includes breakdowns by race and Hispanic origin.
According to the Census Bureau: “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.”
Other findings from SAHIE include a median county uninsured rate of 9.3% in 2023, compared to rates of 9.4% in the previous year and 10.4% two years prior. For working-age adults between ages 18 and 64, uninsured rates fell in 182 counties but increased in another 51 during this period. Among children aged up to eighteen, uninsured rates decreased in just over two dozen counties while rising in eighty-nine.
The report also notes differences by gender: “Working-age women had lower estimated uninsured rates than working-age men in 62.0% of counties (1,950).” Additionally, for working-age adults living at or below an income level equal to or less than138% of the poverty threshold—the cutoff for some assistance programs—the median county uninsured rate was recorded at17.7%, a decrease from both previous years.
More information can be accessed through interactive tools provided by the Census Bureau at www.census.gov/data-tools/demo/sahie.
