Uninsured Rates Decreased in Over Half of U.S. States in 2022

Changes in Types of Health Insurance Coverage Contributed to Declines in Uninsured Rates From 2021 to 2022

September 14, 2023

Written by:

Caitlin Carter

The share of people without health insurance coverage decreased in 27 states between 2021 and 2022, according to a U.S. Census Bureau report released today.

In 25 states where the uninsured rate decreased, at least one of the many types of public or private insurance changed significantly. Only Utah and North Dakota had decreases in the uninsured rate without significant changes in the types of coverage.

Fifteen of the 27 states where uninsured rates dropped in 2022 had increases in Medicare coverage; eight had increases in Medicaid coverage; and six had increases in VA coverage.

Types of health insurance coverage include:

Public coverage offered through Medicare, which provides coverage to most people aged 65 and older or with certain disabilities; Medicaid, which provides coverage to those with low incomes or a disability; or through the Department of Veterans Affairs (VA), which provides coverage to eligible veterans.
Private coverage, which may be provided through an individual’s or family member’s employer; the marketplace exchange or a broker (direct purchase); or TRICARE for current or retired members of the military and their family members.

Two new visualization tools depict health insurance coverage rates and types by state based on the 2022 American Community Survey 1-year estimates. Users can compare estimates within and across geographic areas to see the types of coverage and percentage of people without insurance in their state.

Hover over the dots in the interactive figure below to explore the rates of uninsured in your state.

Percentage of Population Without Health Insurance Coverage by State: 2021 and 2022

Note: Select the image to go to the interactive data visualization.

How Types of Public Health Insurance Coverage Changed Across States

Increases in the types of public health insurance coverage contributed to decreases in uninsured rates in a number of states in 2022.

Fifteen of the 27 states where uninsured rates dropped in 2022 had increases in Medicare coverage; eight had increases in Medicaid coverage; and six had increases in VA coverage.

Across the nation, 22 states with increases in public health insurance coverage types had either decreases or no changes in private health insurance coverage types. Eleven of these states had lower uninsured rates in 2022: Alabama, Illinois, Indiana, Michigan, Missouri, New Jersey, New York, Ohio, Oklahoma, South Dakota and Virginia.

Overall, Medicaid rates increased in 10 states in 2022 and all but one (Alabama) had expanded Medicaid eligibility on or before January 1, 2022.

Select a coverage type and hover over the dots in the visualization below to see the percentage and type of health insurance coverage in your state.

Percentage and Type of Health Insurance Coverage by State: 2021 and 2022

Note: Select the image to go to the interactive data visualization.

Changes in Private Health Insurance Coverage Types Across States

Changes in private health insurance coverage types also had an impact on uninsured rates in 2022.

What happened between 2021 and 2022:

Of the 27 states that had decreases in uninsured rates in 2022, six experienced increases in employer-sponsored coverage and nine had increases in direct-purchase coverage. None of these states had increases in TRICARE coverage.
Eight states with increases in private health insurance coverage types had either decreases or no changes in public health insurance coverage types: Colorado, Georgia, Kansas, Mississippi, Nevada, Rhode Island, South Carolina and Texas.
Overall, employment-sponsored insurance coverage increased in Alaska, Arkansas, Colorado, Iowa, New Mexico, North Carolina, South Carolina and Texas.
Employment-sponsored insurance coverage decreased in Indiana, Nebraska, New Hampshire and Virginia.
Direct-purchase coverage increased in 13 states: Arizona, California, Florida, Georgia, Iowa, Kansas, Louisiana, Mississippi, New Hampshire, North Carolina, Rhode Island, Texas and Washington.
Direct-purchase coverage decreased in Delaware, Kentucky, Minnesota, Missouri, New Mexico and Pennsylvania.