AUGUST 6, 2026 — The rate of individuals under age 65 without health insurance in the United States decreased in 65 counties and increased in 427 counties between 2023 and 2024, according to the 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 group 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. This is the first SAHIE release to include a breakdown of health insurance estimates for the age group 21-29.

According to SAHIE, 1,300, or 41.4%, of U.S. counties had an estimated uninsured rate below 10% in 2024, down from 46.3% of counties in 2023 and 45.2% of counties in 2022.

Other SAHIE highlights:

• The median county uninsured rate in 2024 was 9.8%, up from 9.3% in 2023 and 9.4% in 2022.
• Uninsured rates among working-age adults ages 18 to 64 decreased in 73 counties and increased in 296 counties. Meanwhile, uninsured rates among children younger than 19 decreased in nine counties and increased in 185 counties.
• Working-age women had lower estimated uninsured rates than working-age men in 70.2% (2,205) of counties.
• The median county uninsured rate among working-age adults living at or below 138% of the poverty threshold was 18.4%, compared with 17.7% in 2023 and 18.6% in 2022.

For more information, visit our interactive data and mapping tools. 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 2024.

No news release with this report. Tip sheet only.

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