The U.S. Census Bureau reported that the percentage of people under age 65 without health insurance fell in 194 counties and rose in 85 counties from 2022 to 2023, based on data from the Small Area Health Insurance Estimates (SAHIE) program.
SAHIE provides single-year estimates for every county in the United States, focusing on individuals under age 65. The statistics are broken down by sex, age groups, and income levels relevant to programs like Medicaid. State-level data also includes information 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 compared to previous years: in 2022, it was 45.2%, and in 2021, it was 39.2%.
Additional findings show that the median county uninsured rate decreased slightly to 9.3% in 2023 from 9.4% the year before and from 10.4% in 2021. For working-age adults (ages 18 to 64), uninsured rates dropped in 182 counties but increased in another 51 counties during this period. In contrast, among children (ages 0 to 18), uninsured rates went down in only 27 counties while rising in another 89.
The data also revealed gender differences: “Working-age women had lower estimated uninsured rates than working-age men in 62.0% of counties (1,950).” Among adults living at or below the poverty threshold set at or below138%, the median county uninsured rate declined to17.7%in2023from18.6%in2022and20.3%in2021.
For those seeking more detailed information or wanting to explore trends over time and across demographic groups since2006,the Census Bureau offers interactive mapping tools online at https://www.census.gov/data-tools/demo/sahie.
“SAHIE is the only source for single-year estimates of people under age65with health insurance ineveryofthenation’s3,143counties.The countystatisticsareprovidedbysexandagegroupsandatincomelevelsreflectingthresholdsforstateandfederalassistanceprograms,suchasMedicaideligibility.StateestimatesalsoincludehealthcoveragebyraceandHispanicorigin.”
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