Changes in health insurance coverage at the state level are shaped by a variety of factors, including demographic changes (such as differences in the age distribution), variation in state-level economic conditions, and policy changes that impact coverage rates. Across the United States, job losses associated with the COVID-19 recession and job gains in the subsequent recovery may have varied across geographies. At the same time, states differed in their implementation and timing of the federal efforts to improve access to health coverage during the COVID-19 public health emergency, as well as in extending state policies to increase coverage. This brief uses the 2019 and 2021 American Community Survey (ACS) 1-year estimates to examine state differences in health insurance coverage status and type by comparing health coverage in 2019 before the COVID-19 pandemic to health coverage in 2021 as the pandemic continued to shape health and well-being.
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