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For Immediate Release: Thursday, August 11, 2022

Uninsured Rates Decrease in 251 Counties and Increase in 148 Counties

Press Release Number CB22-TPS.69

August 11, 2022 — The rate of Americans under the age of 65 without health insurance decreased significantly in 251 counties and increased in 148 counties between 2019 and 2020, according to data released today by the U.S. Census Bureau. 

The new data come from the Small Area Health Insurance Estimates (SAHIE) Program, the only source for single-year estimates of the number of people with and without health insurance coverage in each of the nation’s 3,142 counties. The county statistics are provided by sex and age groups and at income levels that reflect thresholds for state and federal assistance programs such as the Patient Protection and Affordable Care Act (ACA) and Medicaid eligibility. State estimates also include health insurance coverage data by race and Hispanic origin.

Uninsured rates of Americans under the age of 65 decreased significantly from 2013 (the year before many provisions of the ACA took effect) to 2020. During that span, uninsured rates dropped in 2,823 counties and rose in just five counties. Likewise, 1,068 (34%) U.S. counties had an estimated uninsured rate below 10% in 2020, up from 33.6% of counties in 2019 and 4.1% in 2013.

Other SAHIE highlights:

  • Estimated county uninsured rates ranged from 2.3% to 41.4%, with a median county uninsured rate of 10.7%.
  • The Northeast and Midwest had the nation’s largest share of counties with low (below 10.0%) uninsured rates, and the South had the largest share with high (above 15.0%) uninsured rates.
  • County uninsured rates of working-age adults (18 to 64) living at or below 138% of the poverty level ranged from 3.7% to 72.7%. The median county uninsured rate among this population was 21.3%.
  • In states that expanded Medicaid eligibility, 10.3% of counties (187 of 1,814) had an estimated uninsured rate above 20% among working-age adults living at or below 138% of poverty, compared to 82.5% of counties (1,096 of 1,328) in states that didn’t expand Medicaid eligibility.
  • State uninsured rates varied by race and ethnicity. Non-Hispanic White populations had lower estimated uninsured rates than both Hispanic and non-Hispanic Black populations under the age of 65 in every state and the District of Columbia. Hispanic populations had higher estimated uninsured rates than both non-Hispanic White and Black populations under the age of 65 in every state and the District of Columbia.

For more information, visit our interactive data and mapping tool on our website at <www.census.gov/data-tools/demo/sahie>. This tool allows users to create and download state and county custom tables, thematic maps and time-trend charts for all concepts available annually from 2006 to 2020.

No news release with this report. Tip sheet only.



Jasmine Pridgen
Public Information Office
301-763-3030 or
877-861-2010 (U.S. and Canada only)



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