JULY 31, 2025 — The rate of individuals in the United States under the age of 65 without health insurance decreased in 194 counties and increased in 85 counties between 2022 and 2023, according to Small Area Health Insurance Estimates (SAHIE) released today by the U.S. Census Bureau.

SAHIE is the only source for single-year estimates of people under age 65 with health insurance in each of the nation’s 3,143 counties. The county statistics are provided by sex and age groups and at income levels reflecting thresholds for state and federal assistance programs, such as Medicaid eligibility. State estimates also include health coverage by race and Hispanic origin.

According to SAHIE, 1,455 or 46.3% of U.S. counties had an estimated uninsured rate below 10% in 2023, up from 45.2% of counties in 2022 and 39.2% in 2021.

Other SAHIE highlights:

• The median county uninsured rate in 2023 was 9.3%, compared to 9.4% in 2022 and 10.4% in 2021.
• Uninsured rates of working-age adults (ages 18 to 64) decreased in 182 counties and increased in 51 counties. Meanwhile, the uninsured rates of children (ages 0 to 18) decreased in 27 counties and increased in 89 counties.
• Working-age women had lower estimated uninsured rates than working-age men in 62.0% of counties (1,950).
• 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 more information, visit our interactive data and mapping tools 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 different geographic levels and demographic groups available annually from 2006 to 2023.

No news release with this report. Tip sheet only.

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