The U.S. Census Bureau reported that the rate of individuals under 65 without health insurance fell in 194 counties and rose in 85 counties from 2022 to 2023, according to newly released Small Area Health Insurance Estimates (SAHIE). SAHIE provides single-year estimates for people under age 65 with health insurance across all 3,143 U.S. counties. The data is available by sex, age group, and income levels relevant to programs such as Medicaid. State-level estimates also break down coverage by race and Hispanic origin.
In 2023, an estimated 1,455 counties—or about 46.3%—had uninsured rates below 10%. This figure has increased steadily over recent years; it was up from 45.2% in 2022 and from 39.2% in 2021.
Other findings include a slight decrease in the median county uninsured rate, which moved from 9.4% in 2022 to 9.3% in 2023. For working-age adults between ages 18 and 64, uninsured rates dropped in 182 counties but increased in another 51 counties during this period. For children aged zero to eighteen, the trend differed: only twenty-seven counties saw decreases while eighty-nine experienced increases.
Women of working age were found to have lower estimated uninsured rates than men of the same age group in about sixty-two percent of counties nationwide (1,950 out of all counties). Additionally, among working-age adults living at or below one hundred thirty-eight percent of the poverty line—a threshold important for Medicaid eligibility—the median county uninsured rate declined from eighteen-point-six percent in twenty-twenty-two to seventeen-point-seven percent last year.
Interactive data tools with customizable tables and maps are available on the Census Bureau’s website (https://www.census.gov/data-tools/demo/sahie), providing access to annual information dating back to 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.”