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+Health Insurance Coverage Status and Type
+by Geography: 2021 and 2022
+American Community Survey Briefs
+ACSBR-015
+Issued September 2023
+Douglas Conway and Breauna Branch
+INTRODUCTION
+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.1 Public policy changes included
+the renewal of the Public Health Emergency, which
+allowed Medicaid enrollees to remain covered under
+the Continuous Enrollment Provision.2 The American
+Rescue Plan (ARP) enhanced Marketplace premium
+subsidies for those with incomes above 400 percent
+of the poverty level as well as for unemployed people.3
+In addition to national policies, individual states and
+the District of Columbia can affect health insurance
+coverage by making Marketplace or Medicaid more
+accessible and affordable. This variation may be
+more or less pronounced across states. Missouri and
+Oklahoma expanded Medicaid eligibility under the
+Patient Protection and Affordable Care Act (ACA) in
+2022, leaving only twelve states without expanded
+Medicaid eligibility, primarily in the South and parts
+1 The Bureau of Labor Statistics reported increases in national
+employment from 2021 to 2022. More information is available at
+<www.bls.gov/opub/mlr/2023/article/unemployment-rate-returnedto-its-prepandemic-level-in-2022.htm>.
+2 Juliette Cubanski et al., “What Happens When COVID-19
+Emergency Declarations End? Implications for Coverage, Costs, and
+Access?,” Kaiser Family Foundation, 2023, <www.kff.org/coronaviruscovid-19/issue-brief/what-happens-when-covid-19-emergencydeclarations-end-implications-for-coverage-costs-and-access/>.
+3 For more information, refer to the American Rescue Plan Act,
+P.L. 117-2, March 11, 2021, <www.congress.gov/bill/117th-congress/
+house-bill/1319/text>.
+of the Midwest.4, 5 Kentucky, Maine, and New Mexico
+created state-based health insurance marketplaces on
+November 1, 2021, to replace their previously federally
+run exchanges.6 State and federal policies designed to
+increase public coverage may also affect the supply
+and demand for private coverage. 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 differences in health insurance coverage status
+and select subtypes (Medicaid, direct purchase,
+and employer-based) for the 50 states, the District
+of Columbia, and the 25 most populous metropolitan areas (refer to the “What Is Health Insurance
+Coverage?” text box).7 It also examines year-to-year
+changes (2021 to 2022) across these geographies.
+4 Note that for the purposes of this brief, we consider a state
+to have expanded Medicaid eligibility if it expanded eligibility on
+or before January 1st of that expansion year. For a state to have
+expanded Medicaid eligibility in 2022, it would have had to expand
+eligibility after January 1, 2021, but before January 1, 2022. For more
+information, refer to the Patient Protection and Affordable Care
+Act, P.L. 111-148, March 23, 2010, available at <www.congress.gov/
+bill/111th-congress/house-bill/3590>.
+5 For more information on the U.S. Census Bureau’s geographic
+levels, refer to Geographic Levels at <www.census.gov/programssurveys/economic-census/guidance-geographies/levels.html>.
+6 “Kentucky, Maine, and New Mexico Launch State Marketplaces
+for 2022 Coverage,” Centers for Medicare & Medicaid Services press
+release, 2023, <www.cms.gov/newsroom/press-releases/kentuckymaine-and-new-mexico-launch-state-marketplaces-2022-coverage>.
+7 The Census Bureau has reviewed this data product to ensure
+appropriate access, use, and disclosure avoidance protection
+of the confidential source data used to produce this product
+(Disclosure Review Board (DRB) approval number: CBDRB-FY23-
+SEHSD003-049). For information on confidentiality protection,
+sampling error, nonsampling error, and definitions in the American
+Community Survey, refer to <https://www2.census.gov/programssurveys/acs/tech_docs/accuracy/ACS_Accuracy_of_Data_2022.pdf>.2 U.S. Census Bureau
+WHAT IS HEALTH INSURANCE COVERAGE?
+This brief presents state-level estimates of health insurance coverage
+using data from the American Community Survey (ACS). The
+U.S. Census Bureau conducts the ACS throughout the year; the
+survey asks respondents to report their coverage at the time of
+interview. The resulting measure of health insurance coverage,
+therefore, reflects an annual average of current comprehensive
+health insurance coverage status.* This uninsured rate measures a
+different concept than the measure based on the Current Population
+Survey Annual Social and Economic Supplement (CPS ASEC).
+For reporting purposes, the ACS broadly classifies health insurance
+coverage as private insurance or public insurance. The ACS defines
+private health insurance as a plan provided through an employer
+or a union, coverage purchased directly by an individual from an
+insurance company or through an exchange (such as healthcare.
+gov), or coverage through TRICARE. Public insurance coverage
+includes federal programs (such as Medicare, Medicaid, and the
+Children’s Health Insurance Program or CHIP), individual state
+health plans, and CHAMPVA (Civilian Health and Medical Program
+at the Department of Veterans Affairs), as well as care provided
+by the Department of Veterans Affairs. In the ACS, people are
+considered insured if they were covered by any of these types
+of health insurance at time of interview. People are considered
+uninsured if they were not covered by any of these types of health
+insurance at time of interview or if they only had coverage through
+the Indian Health Service (IHS), as IHS coverage is not considered
+comprehensive.
+* Comprehensive health insurance covers basic health care needs. This definition
+excludes single-service plans, such as accident, disability, dental, vision, or prescription
+medicine plans.
+The large sample size of the ACS
+allows for an examination of the
+uninsured rate and coverage by
+type for subnational geographies.8
+Key Findings
+• In 2022, the uninsured rate
+varied from 2.4 percent in
+Massachusetts to 16.6 percent
+in Texas (Figure 1 and Figure
+2). The District of Columbia
+was among the lowest with an
+uninsured rate of 2.9 percent,
+not statistically different from
+Massachusetts.
+• Utah and North Dakota reported
+the highest rate of private coverage (78.4 percent) in 2022,
+while New Mexico had the lowest private coverage rate (54.4
+percent) (Figure 3).9
+• Utah had the lowest rate of
+public coverage in 2022 (22.2
+percent), and New Mexico had
+the highest (Figure 4).
+• Twenty-seven states had lower
+uninsured rates in 2022 compared with 2021. Maine was the
+only state whose uninsured rate
+increased (6.6 percent in 2022,
+up from 5.7 percent in 2021)
+(Figure 1 and Appendix Table
+B-1).
+• From 2021 to 2022, 13 states
+reported increases in public coverage, with only Rhode Island
+reporting a decrease of 2.2
+percentage points (Appendix
+Table B-3).
+8 The Current Population Survey Annual
+Social and Economic Supplement (CPS
+ASEC) is the leading source of national level
+estimates of health insurance coverage. For a
+comparison of ACS and CPS ASEC measures
+of health insurance coverage, refer to <www.
+census.gov/topics/health/health-insurance/
+guidance.html>.
+9 Respondents may have more than one
+health insurance coverage type at the time
+of interview. As a result, adding the total
+number of people with private coverage and
+the total number with public coverage will
+sum to more than the total number with any
+coverage.
+• From 2021 to 2022, nine states
+reported increases in private
+coverage, while seven reported
+decreases (Appendix Table B-2).
+DIFFERENCES IN THE
+UNINSURED RATE BY STATE
+IN 2022
+In 2022, uninsured rates at the
+time of interview ranged across
+states from a low of 2.4 percent
+in Massachusetts to a high of 16.6
+percent in Texas, compared to the
+national rate of 8.0 percent.10 Ten
+of the 15 states with uninsured
+10 The uninsured rates in the District
+of Columbia and Massachusetts were not
+statistically different.
+rates above the national average were states that have not
+expanded Medicaid eligibility, and
+two of those 15 states, Oklahoma
+(11.7 percent) and Missouri (8.6
+percent), had recently expanded
+Medicaid eligibility in 2022.11
+Twenty-nine states and the District
+of Columbia had an uninsured
+rate below the national average.
+11 Between January 1, 2014, and January 1,
+2022, 38 states and the District of Columbia
+elected to expand Medicaid eligibility under
+the ACA. The 12 states that had not expanded
+Medicaid eligibility under the ACA on or
+before January 1, 2021, included Alabama,
+Florida, Georgia, Kansas, Mississippi, North
+Carolina, South Carolina, South Dakota,
+Tennessee, Texas, Wisconsin, and Wyoming.
+For more information on expansion states,
+refer to Appendix Table A-1.U.S. Census Bureau 3
+Figure 1.
+Percentage of People Without Health Insurance Coverage by State and State Medicaid
+Expansion Status: 2021 and 2022
+(Civilian, noninstitutionalized population)
+* Denotes a statistically significant change between 2021 and 2022 at the 90 percent confidence level.
+Note: State Medicaid expansion status in 2022 is used to estimate change between 2021 and 2022. For information on expansion status, refer
+to Appendix Table A-1. For information on confidentiality protection, sampling error, nonsampling error, and definitions in the American
+Community Survey, refer to <https://www2.census.gov/programs-surveys/acs/tech_docs/accuracy/ACS_Accuracy_of_Data_2022.pdf>.
+Source: U.S. Census Bureau, 2021 and 2022 American Community Survey, 1-year estimates.
+*UNITED STATES
+*EXPANSION STATES
+Massachusetts
+District Of Columbia
+Hawaii
+Vermont
+Rhode Island
+Iowa
+Minnesota
+*Michigan
+*New York
+New Hampshire
+Connecticut
+Pennsylvania
+Kentucky
+Delaware
+*Ohio
+West Virginia
+Oregon
+Maryland
+*Washington
+*North Dakota
+*Virginia
+*California
+*Illinois
+*Maine
+Nebraska
+*New Jersey
+*Louisiana
+*Indiana
+*Colorado
+*Utah
+Idaho
+*New Mexico
+Montana
+*Arkansas
+*Missouri
+Arizona
+Alaska
+Nevada
+*Oklahoma
+*NONEXPANSION STATES
+Wisconsin
+*South Dakota
+*Kansas
+*Alabama
+*South Carolina
+*North Carolina
+*Tennessee
+*Mississippi
+*Florida
+Wyoming
+*Georgia
+*Texas
+0 2 4 6 8 10 12 14 16 18 20
+United States
+Expansion states
+Nonexpansion states
+2021 20224 U.S. Census Bureau
+Among that group, only Wisconsin
+had not expanded Medicaid eligibility. As a group, the states that
+expanded Medicaid eligibility had
+a lower uninsured rate (6.3 percent) compared with nonexpansion states (11.8 percent).12
+States in the South had some of
+the highest uninsured rates, while
+states in the Northeast had some
+of the lowest uninsured rates. Of
+the 15 states that had uninsured
+rates above the national average,
+nine were in the South, ranging
+12 Nonexpansion states are states that did
+not expand Medicaid eligibility.
+from 8.8 percent to 16.6 percent.
+All states in the Northeast—
+Connecticut, Maine, Massachusetts,
+New Hampshire, New Jersey, New
+York, Pennsylvania, Rhode Island,
+and Vermont—had uninsured rates
+below the national average.13
+PRIVATE HEALTH INSURANCE
+COVERAGE BY STATE IN 2022
+Private coverage may be held
+through an individual’s or family
+member’s employer, by buying
+13 For more information on states by
+region, refer to <www.census.gov/programssurveys/economic-census/guidancegeographies/levels.html#par_textimage_34>.
+it directly on the Marketplace
+Exchange or through a broker
+(direct purchase), or through
+TRICARE for current or retired
+members of the military or their
+dependents.
+Private health insurance coverage
+at the time of interview ranged
+from a low of 54.4 percent in New
+Mexico to a high of 78.4 percent in
+Utah and North Dakota.14 Louisiana
+had the second-lowest rate of
+private coverage (58.1 percent)
+14 In 2022, the private coverage rates were
+not statistically different in North Dakota and
+Utah.
+TX
+AZ
+NV
+WY
+FL
+OK
+MS GA
+AK
+DC
+CA
+MT
+ID
+NM
+CO
+IL
+OR
+UT
+KS
+IA
+NE
+SD
+MN
+ND
+WI
+MO
+WA
+AL
+LA
+AR
+MI
+IN
+PA
+NY
+NC
+TN
+VA
+KY
+OH
+SC
+ME
+WV
+VT
+NH
+NJ
+MA
+CT
+MD
+DE
+RI
+9.6 or more
+7.6 to 9.5
+4.6 to 7.5
+Less than 4.6
+Percentage without
+health insurance
+coverage
+U.S. uninsured rate: 8.0%
+HI
+Figure 2.
+(Civilian, noninstitutionalized population)
+Uninsured Rate by State: 2022
+0 500 Miles
+0 100 Miles
+0 100 Miles
+A state abbreviation surrounded by the “ ” symbol denotes that the state expanded Medicaid eligibility on or before January 1, 2022.
+Note: For information on confidentiality protection, sampling error, nonsampling error, and definitions in the American Community Survey,
+visit <https://www2.census.gov/programs-surveys/acs/tech-docs/accuracy/ACS-Accuracy_of_Data_2022.pdf>.
+Source: U.S. Census Bureau, 2022 American Community Survey, 1-year estimates.U.S. Census Bureau 5
+followed by Arkansas (60.0
+percent). Hawaii (75.0 percent),
+Minnesota (74.7 percent), and New
+Hampshire (75.6 percent) had
+among the highest rates of private
+coverage (Figure 3 and Appendix
+Table B-2).15
+States that had high rates of private health coverage at the time
+of interview were also among the
+states with the highest employersponsored coverage rates: Hawaii
+(61.3 percent), Minnesota (61.0
+percent), New Hampshire (62.0
+percent), North Dakota (60.9 percent), and Utah (64.4 percent).16 A
+high rate of employer-sponsored
+coverage may be related to a low
+unemployment rate in a state.
+Unemployment rates in Minnesota
+(2.7 percent), New Hampshire (2.5
+percent), North Dakota (2.1 percent), and Utah (2.3 percent) were
+lower than the national average of
+3.6 percent.17
+Four of the five states with the
+highest private coverage rates
+had higher direct-purchase coverage rates than the national
+average of 13.9 percent in 2022.
+Direct-purchase coverage rates
+in those states were: Minnesota
+(16.2 percent), New Hampshire
+(15.3 percent), North Dakota (19.2
+percent), and Utah (15.4 percent).18
+This may be related to the cost
+of direct purchase plans. Two of
+these states, Minnesota and New
+Hampshire, had the lowest average benchmark ACA Marketplace
+15 In 2022, the private coverage rates in
+Hawaii, Minnesota, and New Hampshire were
+not statistically different.
+16 In 2022, the rates of employersponsored health coverage in Hawaii,
+Minnesota, New Hampshire, and North
+Dakota were not statistically different from
+one another.
+17 U.S. Department of Labor, Bureau of
+Labor Statistics, Local Area Unemployment
+Statistics, Table A, <www.bls.gov/news.
+release/pdf/srgune.pdf>.
+18 In 2022, the direct-purchase coverage
+rates were not statistically different in New
+Hampshire and Utah.
+premiums of any state.19 North
+Dakota had one of the highest
+direct-purchase coverage rates at
+19.2 percent, which likely contributed to its high private coverage
+rate.
+Although it is possible for states
+that expand Medicaid eligibility
+to have lower private coverage
+rates triggered by an increase in
+public coverage, it is also possible
+that Medicaid and private coverage complement each other, and,
+thus, private coverage may go up
+with Medicaid eligibility expansion due to competitive pricing.
+For example, a report from the
+Department of Health and Human
+Services indicated that states that
+expand Medicaid eligibility have,
+on average, 7 percent lower ACA
+Marketplace premiums.20 In 2022,
+the private coverage rate for the
+group of states that expanded
+Medicaid eligibility was 67.9 percent, while the group of nonexpansion states had a private coverage
+rate of 65.6 percent (Appendix
+Table B-5).
+PUBLIC HEALTH INSURANCE
+COVERAGE BY STATE IN 2022
+Public health insurance coverage
+may be obtained through Medicare
+(coverage for most people aged
+65 or older or people with certain
+disabilities), Medicaid (coverage
+for those with low incomes or
+19 The Kaiser Family Foundation analyzed
+monthly premium data for all tiers (bronze,
+silver, and gold) for a 40-year-old in each
+state and county, weighted by county plan
+selections. Refer to <www.kff.org/healthreform/state-indicator/average-marketplacepremiums-by-metal-tier/?currentTimeframe=
+0&sortModel=%7B%22colId%22:%22
+Average%20Benchmark%20Premium%22,%2
+2sort%22:%22asc%22%7D>.
+20 Aditi Sen and Thomas DeLeire, “The
+Effect of Medicaid Expansion on Marketplace
+Premiums,” 2016, <https://aspe.hhs.gov/sites/
+default/files/migrated_legacy_files//153561/
+McaidExpMktplPrem.pdf>. The Urban
+Institute also found lower premiums among
+Medicaid expansion states. Refer to <www.
+urban.org/sites/default/files/2023-03/
+Changes%20in%20Marketplace%20
+Premiums%20and%20Insurer%20
+Participation%2C%202022-2023.pdf>.
+a disability), or the Department
+of Veterans Affairs (coverage
+for eligible veterans: VA Care or
+CHAMPVA).
+As in 2021, New Mexico had the
+highest rate of public health
+insurance coverage at 51.2 percent, while Utah had the lowest
+rate at 22.2 percent (Figure 4 and
+Appendix Table B-3).21 While the
+public coverage was high in New
+Mexico, it had the lowest rate of
+private coverage rate in 2022, leaving it with an uninsured rate near
+the national average. Similarly,
+Utah’s low public coverage rate
+was offset by its relatively high private coverage, also resulting in an
+uninsured rate close to the national
+average.
+If a state expanded its Medicaid
+eligibility as part of the ACA, that
+may affect its public coverage rate.
+Examining expansion states as a
+group, the prevalence of public
+coverage in 2022 was 38.5 percent, 4.2 percentage points higher
+than nonexpansion states, at 34.3
+percent (Appendix Table B-5).
+Medicaid coverage accounted
+for a portion of that difference.
+Medicaid coverage was 22.7 percent in the group of states that
+expanded Medicaid eligibility and
+18.0 percent in the group of nonexpansion states.
+CHANGES IN THE UNINSURED
+RATE BY STATE FROM 2021
+TO 2022
+From 2021 to 2022, uninsured rates
+decreased across 27 states, while
+only Maine had an increase. The
+uninsured rate in Maine increased
+from 5.7 percent to 6.6 percent,
+although it remained below the
+national average. Maine’s uninsured
+rate was still below 8.0 percent,
+21 Douglas Conway and Breauna Branch,
+“Health Insurance Coverage Status and Type
+by Geography: 2019 and 2021,” 2022, <www.
+census.gov/content/dam/Census/library/
+publications/2022/acs/acsbr-013.pdf>.6 U.S. Census Bureau
+Figure 3.
+Percentage of People With Private Coverage by State and State Medicaid Expansion Status:
+2021 and 2022
+(Civilian, noninstitutionalized population)
+*UNITED STATES
+EXPANSION STATES
+New Mexico
+Louisiana
+Arkansas
+Oklahoma
+West Virginia
+Kentucky
+Nevada
+California
+Arizona
+*Montana
+*New York
+*Alaska
+Oregon
+*Ohio
+Idaho
+Indiana
+*Maine
+*Missouri
+Connecticut
+Illinois
+Vermont
+Michigan
+Rhode Island
+Colorado
+Washington
+Pennsylvania
+New Jersey
+Delaware
+District Of Columbia
+Maryland
+*Virginia
+*Iowa
+Massachusetts
+*Nebraska
+*Minnesota
+Hawaii
+New Hampshire
+North Dakota
+Utah
+*NONEXPANSION STATES
+*Mississippi
+*Texas
+*Florida
+Georgia
+*South Carolina
+Alabama
+Tennessee
+*North Carolina
+Wyoming
+Wisconsin
+South Dakota
+*Kansas
+* Denotes a statistically significant change between 2021 and 2022 at the 90 percent confidence level.
+Note: State Medicaid expansion status in 2022 is used to compare change between 2021 and 2022. For more information on expansion states,
+refer to Appendix Table A-1. For information on confidentiality protection, sampling error, nonsampling error, and definitions in the American
+Community Survey, refer to <https://www2.census.gov/programs-surveys/acs/tech_docs/accuracy/ACS_Accuracy_of_Data_2022.pdf>.
+Source: U.S. Census Bureau, 2021 and 2022 American Community Survey, 1-year estimates.
+0 40 50 60 70 80 90
+United States
+Expansion states
+Nonexpansion states
+2021 2022U.S. Census Bureau 7
+Figure 4.
+Percentage of People With Public Coverage by State and State Medicaid Expansion Status:
+2021 and 2022
+(Civilian, noninstitutionalized population)
+*UNITED STATES
+*EXPANSION STATES
+Utah
+North Dakota
+*Nebraska
+Colorado
+New Hampshire
+New Jersey
+District Of Columbia
+*Virginia
+*Missouri
+Maryland
+*Minnesota
+*Illinois
+Washington
+Iowa
+*Indiana
+Nevada
+Alaska
+Idaho
+Connecticut
+Massachusetts
+*Rhode Island
+Arizona
+Ohio
+*Pennsylvania
+Hawaii
+Delaware
+*Oklahoma
+*California
+Maine
+Montana
+*Michigan
+Oregon
+Vermont
+*New York
+Arkansas
+Kentucky
+Louisiana
+West Virginia
+New Mexico
+NONEXPANSION STATES
+Texas
+Wyoming
+Kansas
+South Dakota
+*Georgia
+Wisconsin
+Tennessee
+North Carolina
+Florida
+*Alabama
+South Carolina
+Mississippi
+* Denotes a statistically significant change between 2021 and 2022 at the 90 percent confidence level.
+Note: State Medicaid expansion status in 2022 is used to compare change between 2021 and 2022. For more information on expansion states,
+refer to Appendix Table A-1. For information on confidentiality protection, sampling error, nonsampling error, and definitions in the American
+Community Survey, refer to <https://www2.census.gov/programs-surveys/acs/tech_docs/accuracy/ACS_Accuracy_of_Data_2022.pdf>.
+Source: U.S. Census Bureau, 2021 and 2022 American Community Survey, 1-year estimates.
+0 10 20 30 40 50 60
+United States
+Expansion states
+Nonexpansion states
+2021 20228 U.S. Census Bureau
+which was the state’s uninsured
+rate in 2019, the year before it
+expanded Medicaid eligibility.22
+Declines in the uninsured rate in
+the majority of these states were
+related to changes in their public
+and private coverage rates. For
+seven of the states with lower
+uninsured rates in 2022, the difference was driven by increases
+in private coverage. These states
+were Florida, Kansas, Mississippi,
+North Carolina, Ohio, South
+Carolina, and Texas.
+For seven states, the uninsured
+rate decrease was related to
+increases in public coverage with
+no corresponding change in the
+level of private coverage. These
+states were Alabama, California,
+Georgia, Illinois, Indiana, Michigan,
+and Oklahoma. In three states
+(Missouri, New York, and Virginia),
+it was shifts in coverage from private to public that contributed to
+the decline in their uninsured rates.
+The uninsured rate in expansion
+states as a group decreased from
+6.8 percent to 6.3 percent; nonexpansion states experienced a
+decrease in the uninsured rate
+from 12.8 percent to 11.8 percent,
+which was driven by an increase in
+private coverage.
+CHANGES IN PRIVATE HEALTH
+INSURANCE COVERAGE BY
+STATE FROM 2021 TO 2022
+Changes in private insurance
+subtypes in a state can affect the
+overall distribution of changes
+in private coverage. Sixteen
+states had changes to private
+health insurance coverage; nine
+had increases and seven had
+decreases.
+22 Douglas Conway and Laryssa Mykyta,
+“Decline in Share of People Without Health
+Insurance Driven by Increase in Public
+Coverage in 36 States,” 2022, <www.census.
+gov/library/stories/2022/09/uninsured-ratedeclined-in-28-states.html>.
+Of the nine states in which private
+coverage rose, three reported
+combined increases in employersponsored and direct-purchase
+coverage (Iowa, North Carolina,
+and Texas); three reported
+increases in direct-purchase coverage only (Florida, Kansas, and
+Mississippi); and two reported
+increases in employer-based
+coverage only (Alaska and South
+Carolina) (Appendix Table B-4).
+The Centers for Medicare and
+Medicaid Services (CMS) reported
+that Marketplace enrollment in the
+U.S. increased from 12.0 to 14.5
+million people between 2021 to
+2022.23 Many states with increases
+in direct-purchase coverage also
+showed increases in Marketplace
+enrollment of 22 percent or greater
+(based on CMS data), and many
+states with increases in employerbased coverage had decreases in
+unemployment rates.24
+For the seven states with declines
+in private coverage rates, two
+experienced decreases in
+employer-sponsored coverage
+(Appendix Table B-2). Decreases
+in direct-purchase coverage
+were also seen in Minnesota (0.5
+23 In January 2021, an executive order
+extended a special enrollment period to
+sign up for Marketplace coverage, continued
+and expanded through 2022. Kaiser Family
+Foundation, “Marketplace Enrollment
+2014–2023,” based on analysis of Centers for
+and Medicare Marketplace Open Enrollment
+Period Public Use Files. Refer to <www.
+cms.gov/files/document/health-insuranceexchanges-2022-open-enrollment-reportfinal.pdf>, <www.kff.org/health-reform/
+state-indicator/marketplace-enrollment/?cu
+rrentTimeframe=0&sortModel=%7B%22colId
+%22:%22Location%22,%22sort%22:%22asc%2
+2%7D>, and <www.healthaffairs.org/content/
+forefront/new-biden-executive-order-aimsbuild-coverage-gains>.
+24 U.S. Department of Labor, Bureau of
+Labor Statistics, Local Area Unemployment
+Statistics, Unemployment Rates for States,
+2022 Annual Averages, <www.bls.gov/lau/
+lastrk22.htm>, and Unemployment Rates for
+States, 2021 Annual Averages, <www.bls.gov/
+lau/lastrk21.htm>. For estimates of direct
+purchase health insurance coverage by state,
+refer to Appendix Table B-4 in this brief
+https://www.cms.gov/files/document/healthinsurance-exchanges-2022-open-enrollmentreport-final.pdf.
+percentage points) and Missouri
+(0.8 percentage points).25
+While states that expanded
+Medicaid eligibility as a group did
+not experience a change to the private coverage rate, nonexpansion
+states as a group had an increase
+of 0.8 percentage points.
+CHANGES IN PUBLIC
+COVERAGE BY STATE FROM
+2021 TO 2022
+In 2022, 13 states saw increases in
+public health insurance coverage
+while only one state, Rhode Island,
+had a decrease. This led to an
+increased public coverage rate for
+the nation overall at 37.2 percent
+in 2022. As with private coverage, changes in the distribution
+of public coverage subtypes (e.g.,
+Medicaid) may affect the overall
+public coverage rate. Rhode Island
+reported a decrease in public
+coverage of 2.2 percentage points,
+which was driven by a decrease
+in people reporting Medicaid (2.3
+percentage points) (Figure 4 and
+Appendix Table B-3).26 Increases in
+public health insurance coverage
+ranged from 0.6 percentage points
+to 2.3 percentage points across
+states.
+At the time of interview, 21.2
+percent of people were covered through Medicaid in 2022.
+In general, people in states that
+expanded Medicaid eligibility
+may report higher rates of public
+coverage than those in nonexpansion states, and with potentially larger increases in states
+that more recently expanded
+25 There was no statistical difference in
+the decrease in the direct-purchase rate in
+in Minnesota and Missouri between 2021 and
+2022.
+26 Per CMS, Rhode Island reported
+a decline in Child Medicaid and CHIP
+(Children’s Health Insurance Program)
+enrollment from December 2021 to January
+2022. Refer to <www.medicaid.gov/
+medicaid/national-medicaid-chip-programinformation/downloads/dec-2021-jan-2022-
+medicaid-chip-enrollment-trend-snapshot.
+pdf>.U.S. Census Bureau 9
+Medicaid eligibility. Eleven of the
+38 expansion states reported
+increases in public coverage from
+2021 to 2022. Oklahoma, which
+expanded Medicaid eligibility in
+2022, reported one of the largest increases (2.3 percentage
+points).27 Among other states that
+had expanded Medicaid eligibility
+recently, Missouri (on/after January
+1, 2022), Nebraska (on/after
+January 1, 2020), and Virginia (on/
+after January 1, 2018) all reported
+increases of 1.0 percentage point
+or greater from 2021. Only two
+nonexpansion states experienced
+increases in public coverage in
+2022 (Alabama and Georgia).
+As a group, states that expanded
+Medicaid eligibility may have
+increased Medicaid rates over
+time, but rates may also decrease
+in some years due to economic
+conditions.28 Between 2021 and
+2022, the group of states that
+had expanded Medicaid eligibility
+saw an increase of 0.2 percentage
+points in Medicaid coverage, to
+22.7 percent; however, there was
+no increase for the group of nonexpansion states.29 The increase
+in public coverage, and by extension Medicaid, was consistent with
+Medicaid enrollment, which has
+increased since 2020, as reported
+by CMS.30
+27 There was no statistical difference in
+the increase in the public coverage rate in
+Nebraska and Oklahoma between 2021 and
+2022.
+28 State Medicaid eligibility expansion
+status in 2022 is used to compare change
+between 2021 and 2022.
+29 There was no statistically significant
+change among nonexpansion states from
+2021 to 2022.
+30 Data from the CMS showed that
+Medicaid enrollment continued to increase
+in 2022, following increases in 2020 and
+2021. At the end of 2021, 44.2 million adults
+were enrolled in Medicaid, while 40.0 million
+children were enrolled in Medicaid/CHIP.
+At the end of 2022, Medicaid enrollment in
+adults increased by about 4.2 million and
+1.7 million in children. Refer to Appendix B
+of the December 2022 Medicaid and CHIP
+Enrollment Trends Snapshot at <www.
+medicaid.gov/medicaid/national-medicaidchip-program-information/downloads/
+December-2022-medicaid-chip-enrollmenttrend-snapshot.pdf>.
+METROPOLITAN AREAS
+Differences in the Uninsured
+Rate in the 25 Most Populous
+Metropolitan Areas in 2022
+The uninsured rates in the 25
+most populous metropolitan areas
+of the United States followed a
+similar pattern to the states, with
+uninsured rates ranging from 2.4
+percent in Boston-CambridgeNewton, MA-NH, to 18.0 percent
+in Houston-The WoodlandsSugar Land, TX. The BostonCambridge-Newton, MA-NH,
+metropolitan area has a competitive ACA Marketplace, both states
+expanded Medicaid eligibility, and
+Massachusetts has an individual
+health insurance mandate, all of
+which may have contributed to the
+low rate.31 Among the most populous metropolitan areas, the San
+Francisco-Oakland-Berkeley, CA,
+metropolitan area had the secondlowest uninsured rate, and has
+expanded its healthcare, both in
+the private and public markets, via
+its Medi-Cal system and Healthy
+San Francisco program for the
+uninsured.32 In May 2022, California
+expanded Medi-Cal to all adults
+50 years or older, which also may
+contribute to the higher insured
+rates in this metropolitan area.33 By
+31 John Holahan, Erik Wengle, and Claire
+O’Brien, “Marketplace Competition and
+Premiums, 2019–2022,” Urban Institute,
+April 2022, <www.urban.org/sites/default/
+files/2022-04/Marketplace%20Premiums%20
+and%20Competition%202019-22.pdf>; ACA
+Marketplace Participation Tracker 2015–
+2023, Robert Wood Johnson Foundation,
+<www.rwjf.org/en/insights/our-research/
+interactives/aca-marketplace-participationtracker.html>. Massachusetts implemented
+a state individual health insurance mandate
+starting in 2006.
+32 Caroline Davis, “San Francisco
+Bay Area: Regional Health Systems Vie
+for Market Share,” California Health
+Care Almanac, California Health Care
+Foundation, April 2021, <www.chcf.
+org/wp-content/uploads/2021/04/
+RegionalMarketAlmanac2020BayArea.pdf>.
+33 For more information, refer to Older
+Care Expansion at California Department
+of Health Care Services at <www.dhcs.
+ca.gov/services/medi-cal/eligibility/Pages/
+OlderAdultExpansion.aspx>.
+contrast, the three metropolitan
+areas with the highest uninsured
+rates—two of which accounted for
+about half of the state population
+(Dallas-Fort Worth-Arlington and
+Houston-The Woodlands-Sugar
+Land)—were in Texas, a nonexpansion state with the highest uninsured rate for a second year in a
+row.34
+Changes in the Uninsured Rate by
+25 Most Populous Metropolitan
+Areas from 2021 to 2022
+Between 2021 and 2022, 11 out
+of the 25 most populous metropolitan areas in the United States
+saw declines in the uninsured rate;
+and none experienced an increase
+in uninsured rates.35 CharlotteConcord-Gastonia, NC-SC,
+experienced one of the largest
+decreases (1.8 percentage points)
+in the uninsured rate from 2021 to
+2022, which is consistent with the
+decrease in the uninsured rates
+in both South Carolina and North
+Carolina.36 The uninsured rate in 14
+metropolitan areas did not statistically change between 2021 and
+2022.
+34 These most populous metropolitan
+areas had the highest uninsured rates in
+2022 and 2021. Refer to <www.census.
+gov/content/dam/Census/library/
+publications/2022/acs/acsbr-013.pdf>.
+35 When comparing metropolitan areas
+from 2021 to 2022, we used the 25 most
+populous metropolitan areas in 2022 as
+the basis for comparison. However, none of
+the 25 most populous metropolitan areas
+changed from 2021 to 2022; only the order
+of their population ranking within the 25
+metro areas did.
+36 The changes in the uninsured
+rates from 2021 to 2022 in Dallas-Fort
+Worth-Arlington, TX (1.0 percentage
+points); Denver-Aurora-Lakewood, CO
+(1.4 percentage points); Houston-The
+Woodlands-Sugar Land, TX (1.3 percentage
+points); and Orlando-Kissimmee-Sanford, FL
+(1.4 percentage points), were not statistically
+different from the change in CharlotteConcord-Gastonia, NC-SC.10 U.S. Census Bureau
+SUMMARY
+The uninsured rate fell in 27 states
+(mainly states that had expanded
+Medicaid eligibility), while only
+Maine had an increase of 0.8
+percentage points. Only one state
+saw a decrease in public coverage
+(Rhode Island), while seven states
+experienced decreases in private
+coverage. As groups, states that
+expanded Medicaid eligibility saw
+an increase in public coverage,
+while states that did not expand
+Medicaid eligibility saw an increase
+in private coverage from 2021 to
+2022, although expansion states
+had both higher private and public
+coverage rates than nonexpansion
+states to start with in both 2021 and
+2022. Massachusetts had the lowest uninsured rate and Texas had
+the highest in 2022.37 In 2022, Utah
+had the highest private coverage
+and lowest public coverage rate,
+while New Mexico had the highest public coverage and the lowest
+private coverage rate, consistent
+37 The uninsured rates in the District
+of Columbia and Massachusetts were not
+statistically different from one another.
+with the pattern in 2021.38, 39 Across
+the 25 most populous metropolitan
+areas, Boston-Cambridge-Newton,
+MA-NH, had the lowest uninsured
+rate in 2022, while three metropolitan areas in Texas had the highest
+uninsured rates, consistent with the
+state’s uninsured state ranking.
+38 Douglas Conway and Breauna Branch,
+“Health Insurance Coverage Status and Type
+by Geography: 2019 and 2021,” American
+Community Survey Briefs, ACSBR-013,
+U.S. Census Bureau, Washington, DC, 2022,
+<www.census.gov/content/dam/Census/
+library/publications/2022/acs/acsbr-013.pdf>.
+39 In 2022, the private coverage rates were
+not statistically different in North Dakota and
+Utah.
+Figure 5.
+Percentage of Uninsured People for the 25 Most Populous Metropolitan
+Areas: 2021 and 2022
+(Civilian, noninstitutionalized population)
+* Denotes a statistically significant change between 2021 and 2022 at the 90 percent confidence level.
+Note: For information on confidentiality protection, sampling error, nonsampling error, and definitions in the American Community
+Survey, refer to <https://www2.census.gov/programs-surveys/acs/tech_docs/accuracy/ACS_Accuracy_of_Data_2022.pdf>.
+Source: U.S. Census Bureau, 2021 and 2022 American Community Survey, 1-year estimates.
+Boston-Cambridge-Newton, MA-NH
+San Francisco-Oakland-Berkeley, CA
+*Detroit-Warren-Dearborn, MI
+Minneapolis-St. Paul-Bloomington, MN-WI
+Baltimore-Columbia-Towson, MD
+Philadelphia-Camden-Wilmington, PA-NJ-DE-MD
+Seattle-Tacoma-Bellevue, WA
+Portland-Vancouver-Hillsboro, OR-WA
+*St. Louis, MO-IL
+*New York-Newark-Jersey City, NY-NJ-PA
+San Diego-Chula Vista-Carlsbad, CA
+*Denver-Aurora-Lakewood, CO
+Washington-Arlington-Alexandria, DC-VA-MD-WV
+Chicago-Naperville-Elgin, IL-IN-WI
+*Los Angeles-Long Beach-Anaheim, CA
+*Riverside-San Bernardino-Ontario, CA
+*Charlotte-Concord-Gastonia, NC-SC
+*Orlando-Kissimmee-Sanford, FL
+Phoenix-Mesa-Chandler, AZ
+Tampa-St. Petersburg-Clearwater, FL
+*Atlanta-Sandy Springs-Alpharetta, GA
+Miami-Fort Lauderdale-Pompano Beach, FL
+San Antonio-New Braunfels, TX
+*Dallas-Fort Worth-Arlington, TX
+*Houston-The Woodlands-Sugar Land, TX
+25 20 15 10 5 0
+2021 2022
+0 5 10 15 20 25U.S. Census Bureau 11
+SOURCE AND ACCURACY
+The data presented in this brief
+are based on the ACS sample
+interviewed from January 2021
+through December 2021 (2021
+ACS) and the ACS sample
+interviewed from January 2022
+through December 2022 (2022
+ACS). The estimates based
+on these samples describe
+the average values of person,
+household, and housing unit
+characteristics over the period
+of collection. Data presented in
+this brief are subject to sampling
+and nonsampling error. Sampling
+error is the uncertainty between
+an estimate based on a sample
+and the corresponding value
+that would be obtained if the
+estimates were based on the entire
+population (as from a census).
+Measures of sampling error are
+provided in the form of margins
+of error for all estimates included
+in this brief. All comparative
+statements in this brief have
+undergone statistical testing, and
+comparisons are significant at the
+90 percent confidence level, unless
+otherwise noted. In addition to
+sampling error, nonsampling error
+may be introduced during any
+of the operations used to collect
+and process survey data such as
+editing, reviewing, or keying data
+from questionnaires. For more
+information on sampling and
+estimation methods, confidentiality
+protection, and sampling and
+nonsampling errors, refer to the
+2022 ACS Accuracy of the Data
+document at <https://www2.
+census.gov/programs-surveys/
+acs/tech_docs/accuracy/ACS_
+Accuracy_of_Data_2022.pdf>.12 U.S. Census Bureau
+Table A-1.
+Medicaid Expansion States
+Year of expansion States
+As of January 1, 2014 Arizona, Arkansas, California, Colorado, Connecticut,
+Delaware, District of Columbia, Hawaii, Illinois, Iowa,
+Kentucky, Maryland, Massachusetts, Minnesota, Nevada,
+New Jersey, New Mexico, New York, North Dakota, Ohio,
+Oregon, Rhode Island, Vermont, Washington, and
+West Virginia
+After January 1, 2014, and on or before January 1, 2015 Michigan, New Hampshire, and Pennsylvania
+After January 1, 2015, and on or before January 1, 2016 Alaska, Indiana, and Montana
+After January 1, 2016, and on or before January 1, 2017 Louisiana
+After January 1, 2017, and on or before January 1, 2018 No states expanded Medicaid during this period
+After January 1, 2018, and on or before January 1, 2019 Virginia
+After January 1, 2019, and on or before January 1, 2020 Maine (coverage retroactive to July 2018), Idaho, and Utah
+After January 1, 2020, and on or before January 1, 2021 Nebraska
+After January 1, 2021, and on or before January 1, 2022 Missouri and Oklahoma
+Source: Kaiser Family Foundation Status of State Action on the Medicaid Expansion Decision, <www.kff.org/health-reform/state-indicator/
+state-activity-around-expanding-medicaid-under-the-affordable-care-act/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%
+22sort%22:%22asc%22%7D>.U.S. Census Bureau 13
+Table B-1.
+Percentage of People Without Health Insurance Coverage by State: 2021 and 2022
+(Civilian, noninstitutionalized population. For information on confidentiality protection, sampling error, nonsampling error, and
+definitions, refer to <https://www2.census.gov/programs-surveys/acs/tech_docs/accuracy/ACS_Accuracy_of_Data_2022.pdf>)
+State
+2022 2021 Change 2022 less 2021
+Uninsured
+(percent)
+Margin of
+error1
+Uninsured
+(percent)
+Margin of
+error1
+Uninsured
+(percent)
+Margin of
+error1
+United States 8.0 0.1 8.6 0.1 *–0.6 0.1
+Alabama . . . . . . . . . . . . . . . . 8.8 0.3 9.9 0.4 *–1.1 0.5
+Alaska2 . . . . . . . . . . . . . . . . . . 11.0 0.8 11.4 0.8 –0.4 1.1
+Arizona2 . . . . . . . . . . . . . . . . . 10.3 0.3 10.7 0.4 –0.4 0.5
+Arkansas2. . . . . . . . . . . . . . . . 8.4 0.4 9.2 0.5 *–0.7 0.6
+California2 . . . . . . . . . . . . . . . 6.5 0.1 7.0 0.1 *–0.5 0.1
+Colorado2. . . . . . . . . . . . . . . . 7.1 0.3 8.0 0.3 *–0.9 0.4
+Connecticut2 . . . . . . . . . . . . . 5.2 0.3 5.2 0.3 Z 0.4
+Delaware2 . . . . . . . . . . . . . . . 5.6 0.6 5.7 0.6 –0.1 0.9
+District of Columbia2. . . . . . 2.9 0.5 3.7 0.6 –0.7 0.8
+Florida . . . . . . . . . . . . . . . . . . 11.2 0.2 12.1 0.2 *–0.9 0.2
+Georgia . . . . . . . . . . . . . . . . . 11.7 0.2 12.6 0.3 *–1.0 0.4
+Hawaii2 . . . . . . . . . . . . . . . . . . 3.5 0.4 3.9 0.4 –0.4 0.5
+Idaho2. . . . . . . . . . . . . . . . . . . 8.2 0.5 8.8 0.6 –0.6 0.8
+Illinois2 . . . . . . . . . . . . . . . . . . 6.6 0.2 7.0 0.2 *–0.5 0.2
+Indiana2 . . . . . . . . . . . . . . . . . 7.0 0.2 7.5 0.3 *–0.6 0.4
+Iowa2. . . . . . . . . . . . . . . . . . . . 4.5 0.2 4.8 0.3 –0.3 0.4
+Kansas . . . . . . . . . . . . . . . . . . 8.6 0.3 9.2 0.4 *–0.6 0.5
+Kentucky2 . . . . . . . . . . . . . . . 5.6 0.3 5.7 0.3 –0.1 0.4
+Louisiana2 . . . . . . . . . . . . . . . 6.9 0.3 7.6 0.3 *–0.7 0.4
+Maine2. . . . . . . . . . . . . . . . . . . 6.6 0.5 5.7 0.4 *0.8 0.6
+Maryland2 . . . . . . . . . . . . . . . 6.1 0.3 6.1 0.2 Z 0.4
+Massachusetts2. . . . . . . . . . . 2.4 0.2 2.5 0.1 –0.1 0.2
+Michigan2. . . . . . . . . . . . . . . . 4.5 0.2 5.0 0.1 *–0.4 0.2
+Minnesota2. . . . . . . . . . . . . . . 4.5 0.2 4.5 0.2 Z 0.2
+Mississippi . . . . . . . . . . . . . . . 10.8 0.4 11.9 0.5 *–1.0 0.6
+Missouri2 . . . . . . . . . . . . . . . . 8.6 0.3 9.4 0.3 *–0.8 0.4
+Montana2 . . . . . . . . . . . . . . . . 8.3 0.6 8.2 0.5 Z 0.8
+Nebraska2 . . . . . . . . . . . . . . . 6.7 0.4 7.1 0.4 –0.4 0.6
+Nevada2 . . . . . . . . . . . . . . . . . 11.1 0.4 11.6 0.4 –0.5 0.6
+New Hampshire2. . . . . . . . . . 4.9 0.4 5.1 0.5 –0.2 0.6
+New Jersey2 . . . . . . . . . . . . . 6.8 0.2 7.2 0.2 *–0.3 0.3
+New Mexico2 . . . . . . . . . . . . . 8.2 0.5 10.0 0.6 *–1.8 0.8
+New York2 . . . . . . . . . . . . . . . 4.9 0.1 5.2 0.1 *–0.3 0.2
+North Carolina . . . . . . . . . . . 9.3 0.2 10.4 0.2 *–1.1 0.3
+North Dakota2. . . . . . . . . . . . 6.4 0.7 7.9 0.7 *–1.5 0.9
+Ohio2. . . . . . . . . . . . . . . . . . . . 5.9 0.2 6.5 0.2 *–0.6 0.3
+Oklahoma2. . . . . . . . . . . . . . . 11.7 0.3 13.8 0.3 *–2.0 0.4
+Oregon2 . . . . . . . . . . . . . . . . . 6.0 0.3 6.1 0.3 –0.1 0.4
+Pennsylvania2 . . . . . . . . . . . . 5.3 0.2 5.5 0.2 –0.2 0.3
+Rhode Island2 . . . . . . . . . . . . 4.2 0.6 4.3 0.6 –0.1 0.8
+South Carolina . . . . . . . . . . . 9.1 0.3 10.0 0.4 *–1.0 0.5
+South Dakota . . . . . . . . . . . . 8.1 0.5 9.5 0.8 *–1.4 0.9
+Tennessee . . . . . . . . . . . . . . . 9.3 0.3 10.0 0.2 *–0.7 0.4
+Texas. . . . . . . . . . . . . . . . . . . . 16.6 0.2 18.0 0.2 *–1.4 0.3
+Utah2. . . . . . . . . . . . . . . . . . . . 8.1 0.5 9.0 0.5 *–0.9 0.7
+Vermont2 . . . . . . . . . . . . . . . . 3.9 0.5 3.7 0.5 0.2 0.7
+Virginia2 . . . . . . . . . . . . . . . . . 6.5 0.2 6.8 0.2 *–0.4 0.3
+Washington2 . . . . . . . . . . . . . 6.1 0.2 6.4 0.2 *–0.3 0.3
+West Virginia2. . . . . . . . . . . . 5.9 0.4 6.1 0.4 –0.2 0.6
+Wisconsin . . . . . . . . . . . . . . . 5.2 0.2 5.4 0.2 –0.2 0.3
+Wyoming. . . . . . . . . . . . . . . . 11.5 1.2 12.2 1.1 –0.7 1.6
+* Denotes a statistically significant change between 2021 and 2022 at the 90 percent confidence level.
+Z Represents or rounds to zero.
+1 Data are based on a sample and are subject to sampling variability. A margin of error is a measure of an estimate’s variability. The larger the
+margin of error in relation to the size of the estimate, the less reliable the estimate. When added to and subtracted from the estimate, the margin
+of error forms the 90 percent confidence interval.
+2 State expanded Medicaid eligibility on or before January 1, 2022.
+Note: Differences are calculated with unrounded numbers, which may produce different results from using the rounded values in the table.
+Source: U.S. Census Bureau, 2021 and 2022 American Community Survey, 1-year estimates.14 U.S. Census Bureau
+Table B-2.
+Percentage of People With Private Health Insurance Coverage by State: 2021 and 2022
+(Civilian, noninstitutionalized population. For information on confidentiality protection, sampling error, nonsampling error, and
+definitions, refer to <https://www2.census.gov/programs-surveys/acs/tech_docs/accuracy/ACS_Accuracy_of_Data_2022.pdf>)
+State
+2022 2021 Change 2022 less 2021
+With private
+coverage
+(percent)
+Margin of
+error1
+With private
+coverage
+(percent)
+Margin of
+error1
+With private
+coverage
+(percent change)
+Margin of
+error1
+United States 67.2 0.1 67.0 0.1 *0.2 0.2
+Alabama . . . . . . . . . . . . . . 67.0 0.5 66.4 0.6 0.6 0.8
+Alaska2. . . . . . . . . . . . . . . . 66.4 1.2 64.2 1.4 *2.2 1.8
+Arizona2. . . . . . . . . . . . . . . 63.9 0.5 63.2 0.5 0.6 0.7
+Arkansas2 . . . . . . . . . . . . . 60.0 0.8 59.0 0.7 0.9 1.1
+California2 . . . . . . . . . . . . . 63.8 0.2 63.7 0.2 Z 0.3
+Colorado2 . . . . . . . . . . . . . 70.5 0.5 70.1 0.5 0.4 0.7
+Connecticut2 . . . . . . . . . . 68.9 0.6 69.2 0.7 –0.3 0.9
+Delaware2 . . . . . . . . . . . . . 71.8 1.2 71.2 1.3 0.6 1.7
+District of Columbia2 . . . 72.5 1.5 71.9 1.3 0.6 2.0
+Florida . . . . . . . . . . . . . . . . 63.6 0.3 63.1 0.3 *0.5 0.4
+Georgia . . . . . . . . . . . . . . . 66.6 0.4 66.1 0.5 0.5 0.7
+Hawaii2. . . . . . . . . . . . . . . . 75.0 0.8 74.5 0.9 0.5 1.2
+Idaho2. . . . . . . . . . . . . . . . . 68.3 0.9 68.1 1.0 0.3 1.4
+Illinois2 . . . . . . . . . . . . . . . . 69.3 0.4 69.4 0.3 –0.1 0.5
+Indiana2 . . . . . . . . . . . . . . . 68.4 0.5 69.0 0.4 –0.6 0.7
+Iowa2 . . . . . . . . . . . . . . . . . 73.3 0.5 72.3 0.5 *1.0 0.7
+Kansas . . . . . . . . . . . . . . . . 73.7 0.6 72.6 0.6 *1.1 0.8
+Kentucky2 . . . . . . . . . . . . . 62.8 0.6 62.8 0.6 Z 0.8
+Louisiana2 . . . . . . . . . . . . . 58.1 0.7 57.1 0.7 1.0 1.0
+Maine2 . . . . . . . . . . . . . . . . 68.7 1.0 70.6 1.0 *–1.9 1.4
+Maryland2 . . . . . . . . . . . . . 72.8 0.5 73.0 0.5 –0.2 0.7
+Massachusetts2 . . . . . . . . 73.4 0.4 73.9 0.4 –0.5 0.6
+Michigan2 . . . . . . . . . . . . . 70.4 0.4 70.5 0.4 –0.1 0.5
+Minnesota2 . . . . . . . . . . . . 74.7 0.5 75.9 0.4 *–1.1 0.6
+Mississippi. . . . . . . . . . . . . 61.5 0.6 59.7 0.8 *1.8 1.0
+Missouri2 . . . . . . . . . . . . . . 68.8 0.5 69.8 0.4 *–1.0 0.6
+Montana2. . . . . . . . . . . . . . 65.2 1.0 66.9 1.0 *–1.7 1.5
+Nebraska2 . . . . . . . . . . . . . 73.6 0.7 74.8 0.7 *–1.2 1.0
+Nevada2. . . . . . . . . . . . . . . 63.4 0.8 62.7 0.7 0.7 1.1
+New Hampshire2 . . . . . . . 75.6 0.8 76.6 0.9 –1.0 1.2
+New Jersey2 . . . . . . . . . . . 71.2 0.4 71.2 0.3 Z 0.5
+New Mexico2. . . . . . . . . . . 54.4 1.0 53.3 1.1 1.1 1.5
+New York2 . . . . . . . . . . . . . 65.4 0.3 65.9 0.3 *–0.5 0.4
+North Carolina . . . . . . . . . 67.8 0.4 66.9 0.3 *0.9 0.5
+North Dakota2 . . . . . . . . . 78.4 1.1 77.3 1.1 1.1 1.6
+Ohio2 . . . . . . . . . . . . . . . . . 68.1 0.4 67.6 0.3 *0.6 0.5
+Oklahoma2 . . . . . . . . . . . . 61.7 0.5 62.2 0.5 –0.5 0.7
+Oregon2. . . . . . . . . . . . . . . 67.1 0.6 67.0 0.6 0.1 0.9
+Pennsylvania2. . . . . . . . . . 71.2 0.3 71.7 0.4 –0.5 0.5
+Rhode Island2. . . . . . . . . . 70.5 1.3 69.2 1.4 1.3 1.9
+South Carolina. . . . . . . . . 66.9 0.5 65.4 0.5 *1.5 0.7
+South Dakota . . . . . . . . . . 73.3 0.9 72.5 1.1 0.8 1.4
+Tennessee. . . . . . . . . . . . . 67.2 0.5 66.7 0.5 0.4 0.7
+Texas . . . . . . . . . . . . . . . . . 62.8 0.3 61.4 0.3 *1.4 0.4
+Utah2 . . . . . . . . . . . . . . . . . 78.4 0.6 77.8 0.6 0.7 0.9
+Vermont2. . . . . . . . . . . . . . 70.0 1.2 70.0 1.0 Z 1.6
+Virginia2. . . . . . . . . . . . . . . 73.0 0.4 73.9 0.4 *–0.9 0.6
+Washington2. . . . . . . . . . . 70.8 0.4 70.5 0.4 0.3 0.6
+West Virginia2 . . . . . . . . . 61.8 1.0 62.7 1.1 –0.9 1.5
+Wisconsin . . . . . . . . . . . . . 73.3 0.4 73.5 0.4 –0.2 0.6
+Wyoming. . . . . . . . . . . . . . 71.0 1.6 71.8 1.4 –0.9 2.1
+* Denotes a statistically significant change between 2021 and 2022 at the 90 percent confidence level.
+Z Represents or rounds to zero.
+1 Data are based on a sample and are subject to sampling variability. A margin of error is a measure of an estimate’s variability. The larger the
+margin of error in relation to the size of the estimate, the less reliable the estimate. When added to and subtracted from the estimate, the margin
+of error forms the 90 percent confidence interval.
+2 State expanded Medicaid eligibility on or before January 1, 2022.
+Note: Differences are calculated with unrounded numbers, which may produce different results from using the rounded values in the table.
+Source: U.S. Census Bureau, 2021 and 2022 American Community Survey, 1-year estimates.U.S. Census Bureau 15
+Table B-3.
+Percentage of People With Public Health Insurance Coverage by State: 2021 and 2022
+(Civilian, noninstitutionalized population. For information on confidentiality protection, sampling error, nonsampling error, and
+definitions, refer to <https://www2.census.gov/programs-surveys/acs/tech_docs/accuracy/ACS_Accuracy_of_Data_2022.pdf>)
+State
+2022 2021 Change 2022 less 2021
+With public
+coverage
+(percent)
+Margin of
+error1
+With public
+coverage
+(percent)
+Margin of
+error1
+With public
+coverage
+(percent change)
+Margin of
+error1
+United States 37.2 0.1 36.8 0.1 *0.4 0.1
+Alabama . . . . . . . . . . . . . . . 38.4 0.4 37.3 0.4 *1.1 0.6
+Alaska2. . . . . . . . . . . . . . . . . 37.2 1.2 37.6 1.3 –0.4 1.7
+Arizona2. . . . . . . . . . . . . . . . 38.3 0.5 39.0 0.5 –0.7 0.7
+Arkansas2 . . . . . . . . . . . . . . 45.0 0.7 44.4 0.7 0.6 0.9
+California2 . . . . . . . . . . . . . . 40.0 0.2 39.3 0.2 *0.7 0.3
+Colorado2 . . . . . . . . . . . . . . 33.3 0.4 33.3 0.4 Z 0.6
+Connecticut2 . . . . . . . . . . . 37.6 0.6 37.7 0.7 –0.1 0.9
+Delaware2 . . . . . . . . . . . . . . 39.5 1.0 40.1 1.2 –0.6 1.6
+District of Columbia2 . . . . 33.8 1.5 34.5 1.4 –0.7 2.1
+Florida . . . . . . . . . . . . . . . . . 37.5 0.2 37.4 0.2 0.1 0.3
+Georgia . . . . . . . . . . . . . . . . 33.0 0.3 32.4 0.4 *0.6 0.5
+Hawaii2. . . . . . . . . . . . . . . . . 39.4 0.8 39.8 0.9 –0.4 1.2
+Idaho2. . . . . . . . . . . . . . . . . . 37.2 0.8 36.8 0.8 0.5 1.1
+Illinois2 . . . . . . . . . . . . . . . . . 35.8 0.4 35.0 0.3 *0.8 0.4
+Indiana2 . . . . . . . . . . . . . . . . 36.8 0.4 35.9 0.4 *0.9 0.5
+Iowa2 . . . . . . . . . . . . . . . . . . 36.8 0.5 37.0 0.5 –0.2 0.7
+Kansas . . . . . . . . . . . . . . . . . 31.2 0.4 31.2 0.5 Z 0.6
+Kentucky2 . . . . . . . . . . . . . . 45.2 0.5 45.4 0.5 –0.2 0.7
+Louisiana2 . . . . . . . . . . . . . . 47.7 0.6 47.0 0.6 0.8 0.9
+Maine2 . . . . . . . . . . . . . . . . . 40.5 0.9 39.8 0.9 0.7 1.2
+Maryland2 . . . . . . . . . . . . . . 35.2 0.5 35.4 0.3 –0.2 0.6
+Massachusetts2 . . . . . . . . . 37.8 0.4 37.3 0.4 0.5 0.6
+Michigan2 . . . . . . . . . . . . . . 41.0 0.3 40.4 0.4 *0.6 0.5
+Minnesota2 . . . . . . . . . . . . . 35.3 0.4 34.3 0.4 *1.1 0.6
+Mississippi. . . . . . . . . . . . . . 40.1 0.6 40.2 0.6 –0.1 0.8
+Missouri2 . . . . . . . . . . . . . . . 34.3 0.4 32.9 0.3 *1.4 0.5
+Montana2. . . . . . . . . . . . . . . 40.6 0.8 39.8 1.0 0.8 1.3
+Nebraska2 . . . . . . . . . . . . . . 32.3 0.7 30.5 0.5 *1.8 0.9
+Nevada2. . . . . . . . . . . . . . . . 36.9 0.7 36.6 0.7 0.3 1.0
+New Hampshire2 . . . . . . . . 33.5 0.8 32.6 0.8 0.9 1.1
+New Jersey2 . . . . . . . . . . . . 33.6 0.4 33.2 0.3 0.4 0.5
+New Mexico2. . . . . . . . . . . . 51.2 0.9 50.9 1.1 0.3 1.4
+New York2 . . . . . . . . . . . . . . 42.9 0.3 41.9 0.3 *1.0 0.4
+North Carolina . . . . . . . . . . 35.9 0.3 35.8 0.3 0.2 0.4
+North Dakota2 . . . . . . . . . . 29.5 1.2 28.4 1.0 1.1 1.6
+Ohio2 . . . . . . . . . . . . . . . . . . 38.8 0.3 38.6 0.3 0.2 0.5
+Oklahoma2 . . . . . . . . . . . . . 39.6 0.5 37.3 0.4 *2.3 0.6
+Oregon2. . . . . . . . . . . . . . . . 41.2 0.5 41.3 0.5 –0.2 0.7
+Pennsylvania2. . . . . . . . . . . 38.8 0.3 38.2 0.3 *0.6 0.4
+Rhode Island2. . . . . . . . . . . 37.9 1.2 40.1 1.2 *–2.2 1.7
+South Carolina. . . . . . . . . . 38.7 0.4 38.9 0.5 –0.2 0.7
+South Dakota . . . . . . . . . . . 32.0 0.8 31.0 0.8 1.0 1.1
+Tennessee. . . . . . . . . . . . . . 35.9 0.4 36.5 0.4 –0.6 0.6
+Texas . . . . . . . . . . . . . . . . . . 29.6 0.2 29.7 0.2 –0.1 0.3
+Utah2 . . . . . . . . . . . . . . . . . . 22.2 0.5 22.3 0.4 –0.1 0.7
+Vermont2. . . . . . . . . . . . . . . 41.9 1.1 41.6 0.9 0.3 1.4
+Virginia2. . . . . . . . . . . . . . . . 34.2 0.3 32.7 0.3 *1.5 0.4
+Washington2. . . . . . . . . . . . 36.3 0.4 36.5 0.4 –0.1 0.5
+West Virginia2 . . . . . . . . . . 49.2 0.9 48.8 0.9 0.4 1.3
+Wisconsin . . . . . . . . . . . . . . 35.7 0.4 35.1 0.4 0.5 0.5
+Wyoming. . . . . . . . . . . . . . . 31.2 1.0 30.1 1.2 1.1 1.5
+* Denotes a statistically significant change between 2021 and 2022 at the 90 percent confidence level.
+Z Represents or rounds to zero.
+1 Data are based on a sample and are subject to sampling variability. A margin of error is a measure of an estimate’s variability. The larger the
+margin of error in relation to the size of the estimate, the less reliable the estimate. When added to and subtracted from the estimate, the margin
+of error forms the 90 percent confidence interval.
+2 State expanded Medicaid eligibility on or before January 1, 2022.
+Note: Differences are calculated with unrounded numbers, which may produce different results from using the rounded values in the table.
+Source: U.S. Census Bureau, 2021 and 2022 American Community Survey, 1-year estimates.16 U.S. Census Bureau
+Table B-4.
+Percentage of People With Health Insurance Coverage by Selected Subtype and State:
+2021 and 2022
+(Civilian, noninstitutionalized population. For information on confidentiality protection, sampling error, nonsampling error, and
+definitions, refer to <https://www2.census.gov/programs-surveys/acs/tech_docs/accuracy/ACS_Accuracy_of_Data_2022.pdf>)
+State
+2022 2021
+Employmentbased
+Direct
+purchase Medicaid Employment- based purchase Direct Medicaid
+Percent
+Margin
+of
+error1 Percent
+Margin
+of
+error1 Percent
+Margin
+of
+error1 Percent
+Margin
+of
+error1 Percent
+Margin
+of
+error1 Percent
+Margin
+of
+error1
+United States 54.8 0.1 13.9 Z 21.2 0.1 54.7 0.1 13.7 Z 21.1 0.1
+Alabama . . . . . . . . . . . . . . 53.6 0.5 14.3 0.3 20.5 0.4 53.1 0.6 14.4 0.4 19.4 0.4
+Alaska2. . . . . . . . . . . . . . . . 55.4 1.3 8.7 0.7 23.1 1.1 53.1 1.4 8.7 0.9 24.2 1.2
+Arizona2. . . . . . . . . . . . . . . 51.2 0.5 13.5 0.3 20.8 0.5 50.9 0.5 12.9 0.3 21.4 0.5
+Arkansas2 . . . . . . . . . . . . . 47.1 0.7 13.9 0.5 27.4 0.6 46.0 0.7 13.5 0.5 27.2 0.7
+California2 . . . . . . . . . . . . . 52.5 0.2 13.1 0.1 27.0 0.2 52.5 0.2 12.9 0.1 26.6 0.2
+Colorado2 . . . . . . . . . . . . . 57.4 0.5 13.6 0.3 18.4 0.4 56.4 0.5 13.5 0.3 18.7 0.4
+Connecticut2 . . . . . . . . . . 58.9 0.7 12.4 0.4 22.4 0.6 58.7 0.7 12.5 0.3 22.5 0.6
+Delaware2 . . . . . . . . . . . . . 60.2 1.2 14.3 0.8 19.8 1.0 58.6 1.3 15.6 0.9 20.9 1.2
+District of Columbia2 . . . 62.3 1.7 12.2 0.9 24.1 1.6 61.2 1.5 12.6 1.0 24.9 1.5
+Florida . . . . . . . . . . . . . . . . 45.5 0.3 18.8 0.2 17.8 0.2 45.5 0.3 18.4 0.2 17.9 0.2
+Georgia . . . . . . . . . . . . . . . 53.9 0.4 13.8 0.3 18.3 0.3 53.9 0.5 12.6 0.3 18.0 0.4
+Hawaii2. . . . . . . . . . . . . . . . 61.3 1.0 13.7 0.6 19.6 0.8 60.5 0.9 13.6 0.7 20.8 0.9
+Idaho2. . . . . . . . . . . . . . . . . 53.0 1.0 16.1 0.7 20.6 0.7 52.8 1.1 15.5 0.7 20.2 0.9
+Illinois2 . . . . . . . . . . . . . . . . 58.8 0.4 12.9 0.2 20.2 0.3 58.8 0.4 12.8 0.2 19.7 0.3
+Indiana2 . . . . . . . . . . . . . . . 57.4 0.5 13.0 0.3 20.7 0.4 58.2 0.5 12.6 0.3 20.1 0.4
+Iowa2 . . . . . . . . . . . . . . . . . 59.5 0.6 16.1 0.3 19.8 0.5 58.6 0.6 15.6 0.4 20.4 0.5
+Kansas . . . . . . . . . . . . . . . . 58.2 0.6 17.2 0.4 14.5 0.5 57.9 0.7 15.9 0.5 14.9 0.5
+Kentucky2 . . . . . . . . . . . . . 52.9 0.6 11.4 0.3 28.2 0.5 52.2 0.6 11.8 0.3 28.7 0.5
+Louisiana2 . . . . . . . . . . . . . 47.3 0.7 11.9 0.4 32.4 0.6 46.9 0.7 11.2 0.4 32.0 0.6
+Maine2 . . . . . . . . . . . . . . . . 53.9 0.9 15.3 0.5 20.0 0.9 55.3 1.1 15.3 0.6 19.9 0.9
+Maryland2 . . . . . . . . . . . . . 61.7 0.6 13.3 0.3 19.9 0.5 61.5 0.5 13.2 0.3 20.1 0.4
+Massachusetts2 . . . . . . . . 62.4 0.5 14.2 0.3 23.1 0.4 62.6 0.5 14.2 0.3 23.1 0.4
+Michigan2 . . . . . . . . . . . . . 59.8 0.4 13.2 0.2 23.7 0.3 59.9 0.4 13.0 0.2 23.5 0.3
+Minnesota2 . . . . . . . . . . . . 61.0 0.5 16.2 0.3 18.8 0.4 61.5 0.5 16.7 0.3 18.1 0.4
+Mississippi. . . . . . . . . . . . . 47.3 0.8 15.3 0.5 24.1 0.6 46.8 0.8 13.5 0.5 24.1 0.5
+Missouri2 . . . . . . . . . . . . . . 56.4 0.5 13.6 0.3 16.5 0.4 57.0 0.4 14.3 0.3 15.1 0.3
+Montana2. . . . . . . . . . . . . . 48.1 1.1 17.3 0.7 21.3 0.8 49.2 1.1 18.0 0.7 20.2 0.9
+Nebraska2 . . . . . . . . . . . . . 57.8 0.8 17.2 0.6 16.3 0.6 59.9 0.8 16.8 0.5 14.7 0.5
+Nevada2. . . . . . . . . . . . . . . 52.2 0.9 11.6 0.4 20.7 0.7 51.3 0.7 11.8 0.5 20.5 0.7
+New Hampshire2 . . . . . . . 62.0 1.0 15.3 0.7 13.4 0.7 64.0 0.9 14.1 0.6 13.5 0.8
+New Jersey2 . . . . . . . . . . . 61.2 0.4 12.6 0.4 18.4 0.4 61.2 0.4 12.6 0.3 18.4 0.3
+New Mexico2. . . . . . . . . . . 43.8 1.0 10.5 0.5 33.6 0.9 42.3 1.0 11.3 0.6 33.6 1.1
+New York2 . . . . . . . . . . . . . 55.1 0.3 13.3 0.2 28.5 0.3 55.2 0.3 13.4 0.2 27.7 0.3
+North Carolina . . . . . . . . . 52.6 0.4 15.6 0.2 18.5 0.3 51.9 0.4 15.2 0.3 18.7 0.2
+North Dakota2 . . . . . . . . . 60.9 1.3 19.2 1.0 13.4 1.1 59.8 1.4 18.5 1.0 12.0 1.0
+Ohio2 . . . . . . . . . . . . . . . . . 58.1 0.4 12.2 0.2 21.3 0.3 57.6 0.3 12.1 0.2 21.5 0.3
+Oklahoma2 . . . . . . . . . . . . 48.7 0.5 13.3 0.3 22.4 0.4 49.0 0.6 13.5 0.3 20.2 0.4
+Oregon2. . . . . . . . . . . . . . . 54.4 0.6 14.4 0.4 23.4 0.6 54.1 0.6 14.1 0.4 23.5 0.5
+Pennsylvania2. . . . . . . . . . 58.9 0.3 14.9 0.2 21.2 0.3 59.1 0.4 15.3 0.2 20.8 0.3
+Rhode Island2. . . . . . . . . . 56.4 1.4 16.3 0.9 21.6 1.1 56.3 1.5 15.1 0.8 23.9 1.3
+South Carolina. . . . . . . . . 52.1 0.6 15.5 0.4 19.5 0.5 50.8 0.6 15.2 0.3 20.0 0.4
+South Dakota . . . . . . . . . . 55.5 1.2 17.9 0.7 13.9 0.8 54.8 1.2 18.1 0.9 13.7 0.8
+Tennessee. . . . . . . . . . . . . 53.3 0.5 14.5 0.3 19.3 0.4 53.6 0.4 14.9 0.4 19.9 0.4
+Texas . . . . . . . . . . . . . . . . . 51.4 0.3 12.2 0.2 16.9 0.2 50.4 0.4 11.6 0.1 17.0 0.2
+Utah2 . . . . . . . . . . . . . . . . . 64.4 0.7 15.4 0.6 10.9 0.5 63.7 0.7 15.2 0.6 11.3 0.4
+Vermont2. . . . . . . . . . . . . . 55.4 1.3 16.3 0.7 22.1 1.0 55.9 1.1 15.8 0.7 23.1 0.9
+Virginia2. . . . . . . . . . . . . . . 59.1 0.4 13.0 0.3 16.6 0.3 59.9 0.4 12.7 0.3 15.5 0.3
+Washington2. . . . . . . . . . . 58.6 0.4 13.2 0.3 20.7 0.4 58.2 0.4 12.8 0.2 21.2 0.4
+West Virginia2 . . . . . . . . . 52.9 0.9 11.6 0.5 28.4 0.9 53.1 1.0 12.3 0.6 28.2 0.9
+Wisconsin . . . . . . . . . . . . . 60.6 0.4 14.9 0.3 18.3 0.3 60.6 0.4 15.1 0.3 18.2 0.4
+Wyoming. . . . . . . . . . . . . . 54.5 1.6 16.7 1.2 11.6 1.0 54.6 1.7 16.7 1.0 11.8 1.1
+Z Represents or rounds to zero.
+1 Data are based on a sample and are subject to sampling variability. A margin of error is a measure of an estimate’s variability. The larger the
+margin of error in relation to the size of the estimate, the less reliable the estimate. When added to and subtracted from the estimate, the margin
+of error forms the 90 percent confidence interval.
+2 State expanded Medicaid eligibility on or before January 1, 2022.
+Note: Differences are calculated with unrounded numbers, which may produce different results from using the rounded values in the table.
+Source: U.S. Census Bureau, 2021 and 2022 American Community Survey, 1-year estimates.U.S. Census Bureau 17
+Table B-5.
+Number and Percentage of People by Health Insurance Coverage Status and Type by State
+Medicaid Expansion Status: 2021 and 2022
+(Numbers in thousands. Civilian, noninstitutionalized population. For information on confidentiality protection, sampling error,
+nonsampling error, and definitions, refer to <https://www2.census.gov/programs-surveys/acs/tech_docs/accuracy/ACS_
+Accuracy_of_Data_2022.pdf>)
+Expansion state
+status and
+insurance type
+2022 2021 Change 2022
+less 2021
+Number
+Margin
+of error1 Percent
+Margin
+of error1 Number
+Margin
+of error1 Percent
+Margin
+of error1
+Percent
+change
+Margin
+of error1
+Expansion State
+Uninsured . . . . . . . . . . . 14,240 119 6.3 0.1 15,230 119 6.8 0.1 *–0.4 0.1
+Private coverage . . . . . 153,200 326 67.9 0.1 153,400 260 68.0 0.1 –0.1 0.2
+Public coverage. . . . . . 86,740 217 38.5 0.1 85,510 184 37.9 0.1 *0.5 0.1
+ Medicaid . . . . . . . . . . 51,190 231 22.7 0.1 50,620 196 22.5 0.1 *0.2 0.1
+Nonexpansion State
+Uninsured . . . . . . . . . . . 12,120 90 11.8 0.1 13,000 104 12.8 0.1 *–1.0 0.1
+Private coverage . . . . . 67,440 180 65.6 0.2 65,700 167 64.8 0.2 *0.8 0.2
+Public coverage. . . . . . 35,270 119 34.3 0.1 34,690 110 34.2 0.1 0.1 0.2
+ Medicaid . . . . . . . . . . 18,530 127 18.0 0.1 18,360 110 18.1 0.1 –0.1 0.2
+* Denotes a statistically significant change between 2021 and 2022 at the 90 percent confidence level.
+1 Data are based on a sample and are subject to sampling variability. A margin of error is a measure of an estimate’s variability. The larger the
+margin of error in relation to the size of the estimate, the less reliable the estimate. When added to and subtracted from the estimate, the margin
+of error forms the 90 percent confidence interval.
+Note: State Medicaid expansion status in 2022 is used to compare change between 2021 and 2022. Differences are calculated with unrounded
+numbers, which may produce different results from using the rounded values in the table.
+Source: U.S. Census Bureau, 2021 and 2022 American Community Survey, 1-year estimates.18 U.S. Census Bureau
+Table B-6.
+Percentage of People Without Health Insurance Coverage in the 25 Most Populous Metropolitan
+Areas: 2021 and 2022
+(Civilian, noninstitutionalized population. For information on confidentiality protection, sampling error, nonsampling error, and
+definitions, refer to <https://www2.census.gov/programs-surveys/acs/tech_docs/accuracy/ACS_Accuracy_of_Data_2022.pdf>)
+Metropolitan area
+2022 2021 Change 2022 less 2021
+Uninsured
+(percent)
+Margin of
+error1
+Uninsured
+(percent)
+Margin of
+error1
+Uninsured
+(percent
+change)
+Margin of
+error1
+Atlanta-Sandy Springs-Alpharetta, GA . . . . . . . . . . . . . 11.1 0.3 11.8 0.4 *–0.7 0.5
+Baltimore-Columbia-Towson, MD. . . . . . . . . . . . . . . . . . 4.6 0.4 4.9 0.4 –0.3 0.5
+Boston-Cambridge-Newton, MA-NH. . . . . . . . . . . . . . . 2.4 0.2 2.6 0.2 –0.2 0.2
+Charlotte-Concord-Gastonia, NC-SC. . . . . . . . . . . . . . . 8.6 0.5 10.4 0.5 *–1.8 0.7
+Chicago-Naperville-Elgin, IL-IN-WI . . . . . . . . . . . . . . . . 7.3 0.2 7.6 0.2 –0.2 0.3
+Dallas-Fort Worth-Arlington, TX. . . . . . . . . . . . . . . . . . . 15.8 0.3 16.8 0.3 *–1.0 0.5
+Denver-Aurora-Lakewood, CO . . . . . . . . . . . . . . . . . . . . 6.9 0.4 8.3 0.4 *–1.4 0.6
+Detroit-Warren-Dearborn, MI. . . . . . . . . . . . . . . . . . . . . . 4.3 0.2 4.8 0.2 *–0.5 0.3
+Houston-The Woodlands-Sugar Land, TX . . . . . . . . . . 18.0 0.4 19.3 0.5 *–1.3 0.6
+Los Angeles-Long Beach-Anaheim, CA . . . . . . . . . . . . 7.7 0.2 8.5 0.2 *–0.7 0.2
+Miami-Fort Lauderdale-Pompano Beach, FL. . . . . . . . 13.0 0.4 13.3 0.4 –0.3 0.5
+Minneapolis-St. Paul-Bloomington, MN-WI . . . . . . . . . 4.4 0.2 4.2 0.2 0.2 0.3
+New York-Newark-Jersey City, NY-NJ-PA . . . . . . . . . . 6.0 0.1 6.5 0.1 *–0.6 0.2
+Orlando-Kissimmee-Sanford, FL . . . . . . . . . . . . . . . . . . 10.5 0.6 11.9 0.5 *–1.4 0.8
+Philadelphia-Camden-Wilmington, PA-NJ-DE-MD . . 5.1 0.3 5.1 0.3 Z 0.4
+Phoenix-Mesa-Chandler, AZ . . . . . . . . . . . . . . . . . . . . . . 10.6 0.4 10.6 0.4 Z 0.6
+Portland-Vancouver-Hillsboro, OR-WA. . . . . . . . . . . . . 5.5 0.3 5.5 0.3 –0.1 0.5
+Riverside-San Bernardino-Ontario, CA . . . . . . . . . . . . . 7.7 0.3 8.5 0.4 *–0.8 0.5
+San Antonio-New Braunfels, TX . . . . . . . . . . . . . . . . . . . 15.0 0.6 15.7 0.6 –0.7 0.9
+San Diego-Chula Vista-Carlsbad, CA . . . . . . . . . . . . . . 6.4 0.4 6.7 0.4 –0.3 0.5
+San Francisco-Oakland-Berkeley, CA . . . . . . . . . . . . . . 3.9 0.2 3.9 0.2 –0.1 0.3
+Seattle-Tacoma-Bellevue, WA. . . . . . . . . . . . . . . . . . . . . 5.3 0.3 5.6 0.3 –0.3 0.4
+St. Louis, MO-IL. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.5 0.3 6.2 0.3 *–0.7 0.5
+Tampa-St. Petersburg-Clearwater, FL . . . . . . . . . . . . . . 10.7 0.5 11.3 0.4 –0.7 0.7
+Washington-Arlington-Alexandria, DC-VA-MD-WV. . 7.2 0.3 7.2 0.3 Z 0.4
+* Denotes a statistically significant change between 2021 and 2022 at the 90 percent confidence level.
+Z Represents or rounds to zero.
+1 Data are based on a sample and are subject to sampling variability. A margin of error is a measure of an estimate’s variability. The larger the
+margin of error in relation to the size of the estimate, the less reliable the estimate. When added to and subtracted from the estimate, the margin
+of error forms the 90 percent confidence interval.
+Note: Differences are calculated with unrounded numbers, which may produce different results from using the rounded values in the table.
+Source: U.S. Census Bureau, 2021 and 2022 American Community Survey, 1-year estimates.