The U.S. Census Bureau has reported changes in health insurance coverage rates for people under 65 across the country, based on new Small Area Health Insurance Estimates (SAHIE) released for 2023. According to the data, 194 counties saw a decrease in uninsured rates, while 85 counties experienced an increase between 2022 and 2023.
SAHIE provides annual county-level estimates of health insurance coverage by age, sex, and income groups relevant to programs such as Medicaid. It remains the only single-year source covering all 3,143 U.S. counties. State-level estimates also break down coverage by race and Hispanic origin.
In 2023, there were 1,455 counties—46.3% of all U.S. counties—with estimated uninsured rates below 10%. This figure marks a continued improvement from previous years: in 2022, the rate was 45.2%, and in 2021 it was 39.2%.
The median uninsured rate for all counties dropped slightly to 9.3% in 2023 from 9.4% in the prior year and from 10.4% in 2021.
Further breakdowns show that among working-age adults (18-64), uninsured rates decreased in 182 counties but increased in another 51 counties during this period. For children (0-18), uninsured rates went down in just 27 counties but rose in 89 others.
Gender differences persist; “Working-age women had lower estimated uninsured rates than working-age men in 62.0% of counties (1,950).”
Income levels also play a role: “The median county uninsured rate of working-age adults living at or below 138% of poverty was 17.7%, down from 18.6% in 2022 and 20.3% in 2021.”
For those seeking more details or specific county data over time, the Census Bureau offers interactive tools for creating custom tables and maps at www.census.gov/data-tools/demo/sahie.
