The Small Area Health Insurance Estimates (SAHIE) program was created to develop model-based estimates of health insurance coverage for counties and states. This program builds on the work of the Small Area Income and Poverty Estimates (SAIPE) program. SAHIE is the only source of single-year health insurance coverage estimates.

SAHIE data can be used to analyze geographic variation in health insurance coverage, as well as disparities in coverage by race/ethnicity, sex, age and income levels that reflect thresholds for state and federal assistance programs. Because consistent estimates are available from 2008 to 2021, SAHIE reflects annual changes over time.

For 2008-2021, SAHIE publishes STATE and COUNTY estimates of population with and without health insurance coverage, along with measures of uncertainty, for the full cross-classification of:

• 5 age categories: 0-64, 18-64, 21-64, 40-64, and 50-64
  
• 3 sex categories: both sexes, male, and female
  
• 6 income categories: all incomes, as well as income-to-poverty ratio (IPR) categories 0-138%, 0-200%, 0-250%, 0-400%, and 138-400% of the poverty threshold
  
• 8 races/ethnicities (for states only): all races/ethnicities, White alone (not Hispanic or Latino), Black or African American alone (not Hispanic or Latino), American Indian and Alaska Native alone (not Hispanic or Latino), Asian alone (not Hispanic or Latino), Native Hawaiian and Other Pacific Islander alone (not Hispanic or Latino), Two or More Races (not Hispanic or Latino), Hispanic or Latino (any race).

In addition, estimates for age category 0-18 by the income categories listed above are published.

Each year’s estimates are adjusted so that, before rounding, the county estimates sum to their respective state totals, and for key demographics the state estimates sum to the national ACS numbers insured and uninsured.

This program is partially funded by the Centers for Disease Control and Prevention's (CDC) Division of Cancer Prevention and Control (DCPC). The CDC have a congressional mandate to provide screening services for breast and cervical cancer to low-income, uninsured, and underserved women through the National Breast and Cervical Cancer Early Detection Program (NBCCEDP). Most state NBCCEDPs define low-income as 200 or 250 percent of the poverty threshold. Also included are IPR categories relevant to the Affordable Care Act (ACA). In 2014, provisions of the ACA were implemented that increased access to health insurance. In participating states, Medicaid programs expanded access to individuals and families with incomes less than or equal to 138 percent of the poverty line. For those living between 138 and 400 percent of the poverty line, tax credits became available to help pay for health coverage through the health insurance exchanges.