Demographic shifts as well as economic and government policy changes can affect people’s access to health coverage. For example, between 2021 and 2022, the labor market continued to improve, which may have affected private coverage in the United States during that time. Public policy changes included the renewal of the Public Health Emergency, which allowed Medicaid enrollees to remain covered under the Continuous Enrollment Provision. The American Rescue Plan enhanced Marketplace premium subsidies for those with incomes above 400 percent of the poverty level as well as for unemployed people. In addition to national policies, individual state policies can affect health insurance coverage by making Marketplace or Medicaid more accessible and affordable. As a result, a variety of changes in coverage rates are possible. This brief uses the 2021 and 2022 American Community Survey (ACS) 1-year estimates to examine geographical differences in health insurance coverage status.