The uninsured rate among individuals under 65 in the United States decreased in 194 counties and increased in 85 counties from 2022 to 2023, according to new data released by the U.S. Census Bureau’s Small Area Health Insurance Estimates (SAHIE).
SAHIE provides annual county-level estimates of health insurance coverage for people under age 65, breaking down the data by sex, age groups, and income levels relevant to state and federal assistance programs such as Medicaid. State-level figures also report coverage by race and Hispanic origin.
“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,” according to the U.S. Census Bureau.
In 2023, an estimated 1,455 counties—representing about 46.3% of all U.S. counties—had uninsured rates below 10%. This figure has risen from previous years: in 2022, it was 45.2%, and in 2021 it was just over one-third at 39.2%.
The median county uninsured rate dropped slightly to 9.3% in 2023 from 9.4% in the prior year; this continues a downward trend from a rate of 10.4% in 2021.
Other findings show that uninsured rates among working-age adults (18-64) declined in more than three times as many counties as they increased: decreases were seen in 182 counties while increases occurred in just over fifty. However, among children (0-18), rates fell in only twenty-seven counties but rose in eighty-nine.
Data further indicate that women aged between eighteen and sixty-four had lower estimated uninsured rates than men within this group across sixty-two percent of U.S. counties.
Among working-age adults living at or below one hundred thirty-eight percent of poverty—a threshold relevant for Medicaid—the median county uninsured rate continued its decline to seventeen point seven percent, compared with eighteen point six percent last year and twenty point three percent two years ago.
Additional interactive tools are available through the Census Bureau’s website, allowing users to access custom tables, maps, and time-trend charts covering different regions and demographic breakdowns annually since 2006.
