The U.S. Census Bureau has reported that the percentage of people under age 65 without health insurance dropped in 194 counties and rose in 85 counties from 2022 to 2023. The findings come from the latest Small Area Health Insurance Estimates (SAHIE), which offer annual data for every county in the country.
SAHIE is recognized as the only source providing single-year health insurance estimates for people under age 65 at the county level, broken down by sex, age group, and income levels relevant to programs like Medicaid. State-level data also include breakdowns 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 marks a continued improvement from previous years; in 2022, it was 45.2%, and in 2021, it was 39.2%.
The median uninsured rate among all counties fell slightly to 9.3% in 2023 from 9.4% the year before and from 10.4% in 2021.
Among working-age adults (ages 18 to 64), uninsured rates declined in 182 counties but increased in another 51 counties over the same period. For children (ages 0 to 18), however, there were decreases in just 27 counties while increases were noted in 89.
Women aged between 18 and 64 had lower estimated uninsured rates than men of the same age group in about two-thirds of all counties (62%).
For working-age adults living at or below the poverty threshold set at or below138%, the median county uninsured rate decreased to17.7%in2023from18.6%in2022and20.3%in2021.
Additional resources are available through interactive tools on the Census Bureau’s website that allow users to create custom tables, maps, and trend charts for states and counties across different demographic groups from2006to2023: https://www.census.gov/data-tools/demo/sahie
“SAHIE is the only source for single-year estimates of people under age65with health insurance in each of thenation’s3,143counties.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.”
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