JUNE 24, 2021 — The rates of Americans under 65 without health insurance decreased significantly between 2013 – the year before many provisions of the Patient Protection and Affordable Care Act (ACA) took effect – and 2019.
According to the Census Bureau’s 2019 Small Area Health Insurance Estimates (SAHIE) report, uninsured rates dropped in 2,909 U.S. counties and rose in just four counties after implementation of ACA. The lower uninsured numbers held in most of the nation’s roughly 3,141 counties post-ACA, despite inching up in more (237) counties than they decreased in (54) between 2018 and 2019.
SAHIE is the only source of single-year estimates of the number of people with health coverage in each of the nation’s counties. The county statistics are provided by sex and age groups, and at income levels that reflect thresholds for state and federal assistance programs. State estimates include health insurance coverage data by race and Hispanic origin.
In 2019, 33.6% (or 1,054) of U.S. counties had an estimated uninsured rate below 10%, down from 38.6% in 2016, 38.4% in 2017, and 37.7% a year earlier but up from 2013 when only 4.1% or 130 counties had uninsured rates under 10%.
Other SAHIE highlights:
The 2019 SAHIE report describes demographic and economic differences and trends in health insurance coverage in states and counties. 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 2019.
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