The share of people lacking health coverage reached an all-time low for the second consecutive year in 2023, falling to 7.9 percent, according to American Community Survey (ACS) data the Census Bureau released today. That’s down from the previous record of 8.0 percent in 2022. Unfortunately, this welcome record is tempered by findings that children’s uninsured rate rose, climbing from 5.1 percent in 2022 to 5.4 percent in 2023.
The ACS data are consistent with the record-low uninsured rate found for 2023 in National Health Interview Survey (NHIS) preliminary data, released in June, as well as Congressional Budget Office preliminary estimates of a record-low uninsured rate in 2023. The Current Population Survey (CPS), released Tuesday, differed only modestly in finding an uninsured rate that was statistically unchanged from its record low in 2022. Of the three surveys, the ACS is by far the largest and therefore provides the most precise estimates, and the decline in the uninsured rate in the ACS from 2022 to 2023 is statistically significant.
For perspective, the uninsured rate was 15.5 percent in 2010, when the Affordable Care Act, or ACA, was adopted.
Rate of People Without Health Coverage Reached All-Time Low in ACS and NHIS in 2023
Uninsured rate, percent
- ACS
- NHIS
- CPS
048121620%’09’10’11’12’13’14’15’16’17’18’19’20’21’22’23
Dotted portions of lines reflect pandemic-related data collection disruptions, which caused 2020 American Community Survey (ACS) data not to be released and 2019 Current Population Survey (CPS) data not to be comparable to other years. Gaps within lines represent breaks in series due to changes in data collection or processing.
Source: Census Bureau, American Community Survey and Current Population Survey. Centers for Disease Control and Prevention, National Health Interview Survey early release estimates
Center on Budget and Policy Priorities | cbpp.org
Coverage gains were driven by enhanced premium tax credits (PTCs), which helped millions of people buy coverage in the ACA marketplace. The enhanced PTCs cut consumers’ premium costs by $824 per year on average in 2023 as compared to what they would have been without the expansion. First enacted in 2021, the PTC improvements have spurred rapid marketplace enrollment gains. Average monthly marketplace enrollment grew from 10.3 million people in 2020 to 16.2 million in 2023, administrative data show. And enrollment has continued to surge this year, reaching 20.8 million in February 2024.
Medicaid also played a role in coverage gains. Average monthly Medicaid enrollment reached an all-time high in 2023, but trends during the year were highly divergent. Enrollment hit record highs each month from January through April due to the pandemic-related continuous coverage protection, which since March 2020 had allowed enrollees to keep their coverage. But enrollment then dropped for the rest of the year after this temporary protection expired, with a large number of people disenrolled for procedural reasons (not because they were found ineligible). Some of those disenrolled were in fact still eligible for Medicaid and reapplied, while some others who were no longer eligible for Medicaid enrolled in the ACA marketplace.
In addition to the enhanced PTCs, other factors have helped boost coverage in recent years. These include a year-long special enrollment period for marketplace coverage for people with incomes below 150 percent of the poverty level ($22,590 for an individual in 2024); a fix to the “family glitch,” which had prevented millions of workers’ family members from accessing PTCs; and the continuation of historic investments for Navigators, who help people find affordable coverage in the marketplace or Medicaid.
Today’s ACS data also show that the ACA marketplace changes and increased access to Medicaid reduced health coverage differences across several racial and ethnic groups and income groups. From 2019 to 2023, uninsured rates fell for all racial and ethnic groups and income levels, but the declines were particularly large for Latino and Black people, whose uninsured rates fell by 2.1 and 1.6 percentage points, respectively, compared to an overall drop of 1.3 percentage points.
The uninsured rate for people with low and moderate incomes also fell considerably, by 2.6 percentage points for people with incomes under 138 percent of the poverty threshold and 1.6 percentage points for people with incomes between 138 and 400 percent of poverty (138 percent of poverty corresponds most closely to the income eligibility limit for Medicaid in expansion states). By comparison, the uninsured rate fell by 0.3 percentage points among people with incomes of 400 percent of the poverty threshold or greater.
The narrowing of coverage inequities in the ACS data is broadly consistent with ACA marketplace enrollment data, which show especially large gains in marketplace enrollment for Black and Latino people as well as people with low incomes since the PTCs were expanded. The PTC enhancements enabled enrollees with incomes under 150 percent of the poverty level to qualify for zero-cost premiums for benchmark coverage, contributing to the disproportionate enrollment gains among this group.
Unfortunately, the ACS data confirm the increase in the uninsured rate for children from 2022 to 2023 that was found in Tuesday’s CPS release. According to the ACS, 5.4 percent of children were uninsured in 2023, up from 5.1 percent in 2022. In contrast, the uninsured rate for adults aged 19-64 fell from 11.3 percent to 11.0 percent. In the ACS, the uninsured rate increase for children is largely accounted for by a decline in the rate of Medicaid coverage (though the change is not statistically significant), while in the CPS it is driven by a decline in employment-based coverage.
Trends at the state level are consistent with the overwhelming evidence that the ACA’s Medicaid expansion boosts overall health coverage. Nine more states have implemented the expansion since 2019, the latest being South Dakota and North Carolina in 2023, and all nine states have seen larger-than-average reductions in uninsured rates since 2019. Oklahoma and Missouri, the two states that expanded Medicaid in 2021, comprised two of the top three states with the largest reductions in uninsured rates since 2021, while also seeing the largest increases in Medicaid enrollment.
In the ten non-expansion states, more than 1.6 million people are in the Medicaid coverage gap: they don’t qualify for financial help in the ACA marketplace because their incomes are below the poverty level ($15,060 for an individual), yet they don’t qualify for Medicaid because their state still hasn’t expanded eligibility. Sixty-five percent of people in the coverage gap are people of color.
Uninsured Rate Decreased Across Most States Following Policy Improvements
Uninsured rate, 2019-2023
Policy improvements include enhanced ACA marketplace premium tax credits (enacted in 2021), Medicaid continuous coverage protections (March 2020 – March 2023), and Medicaid expansions (nine states over 2019-2023), among other improvements.
Legend:
Decrease
20192023
No significant change
20192023}Margin of error
Hover over states for additional detail.
United States
| Uninsured Rate | ||
| 2019 | 9.2% | ± 0.1% |
| 2021 | 8.6% | ± 0.1% |
| 2022 | 8.0% | ± 0.1% |
| 2023 | 7.9% | ± 0.1% |
| Change, 2019-23: | -1.3% | ± 0.1% |
| Medicaid Expansion: | ||
Alabama
| Uninsured Rate | ||
| 2019 | 9.7% | ± 0.3% |
| 2021 | 9.9% | ± 0.4% |
| 2022 | 8.8% | ± 0.3% |
| 2023 | 8.5% | ± 0.3% |
| Change, 2019-23: | -1.2% | ± 0.4% |
| Medicaid Expansion: Expansion not adopted | ||
5%10%15%20192023
Alaska
| Uninsured Rate | ||
| 2019 | 12.2% | ± 0.8% |
| 2021 | 11.4% | ± 0.8% |
| 2022 | 11.0% | ± 0.8% |
| 2023 | 10.4% | ± 0.7% |
| Change, 2019-23: | -1.8% | ± 1.1% |
| Medicaid Expansion: Implemented expansion on 9/1/2015 | ||
5%10%15%20192023
Arizona
| Uninsured Rate | ||
| 2019 | 11.3% | ± 0.3% |
| 2021 | 10.7% | ± 0.4% |
| 2022 | 10.3% | ± 0.3% |
| 2023 | 9.9% | ± 0.3% |
| Change, 2019-23: | -1.4% | ± 0.4% |
| Medicaid Expansion: Implemented expansion on 1/1/2014 | ||
5%10%15%20192023
Arkansas
| Uninsured Rate | ||
| 2019 | 9.1% | ± 0.4% |
| 2021 | 9.2% | ± 0.5% |
| 2022 | 8.4% | ± 0.4% |
| 2023 | 8.9% | ± 0.4% |
| Change, 2019-23: | -0.2% | ± 0.6%* |
| Medicaid Expansion: Implemented expansion on 1/1/2014 | ||
| *Change is not significant at the 90% confidence level. | ||
5%10%15%20192023
California
| Uninsured Rate | ||
| 2019 | 7.7% | ± 0.1% |
| 2021 | 7.0% | ± 0.1% |
| 2022 | 6.5% | ± 0.1% |
| 2023 | 6.4% | ± 0.1% |
| Change, 2019-23: | -1.3% | ± 0.1% |
| Medicaid Expansion: Implemented expansion on 1/1/2014 | ||
5%10%15%20192023
Colorado
| Uninsured Rate | ||
| 2019 | 8.0% | ± 0.3% |
| 2021 | 8.0% | ± 0.3% |
| 2022 | 7.1% | ± 0.3% |
| 2023 | 6.7% | ± 0.2% |
| Change, 2019-23: | -1.3% | ± 0.4% |
| Medicaid Expansion: Implemented expansion on 1/1/2014 | ||
5%10%15%20192023
Connecticut
| Uninsured Rate | ||
| 2019 | 5.9% | ± 0.3% |
| 2021 | 5.2% | ± 0.3% |
| 2022 | 5.2% | ± 0.3% |
| 2023 | 5.7% | ± 0.4% |
| Change, 2019-23: | -0.2% | ± 0.5%* |
| Medicaid Expansion: Implemented expansion on 1/1/2014 | ||
| *Change is not significant at the 90% confidence level. | ||
5%10%15%20192023
Delaware
| Uninsured Rate | ||
| 2019 | 6.6% | ± 0.6% |
| 2021 | 5.7% | ± 0.6% |
| 2022 | 5.6% | ± 0.6% |
| 2023 | 6.5% | ± 0.8% |
| Change, 2019-23: | -0.1% | ± 1.0%* |
| Medicaid Expansion: Implemented expansion on 1/1/2014 | ||
| *Change is not significant at the 90% confidence level. | ||
5%10%15%20192023
District of Columbia
| Uninsured Rate | ||
| 2019 | 3.5% | ± 0.6% |
| 2021 | 3.7% | ± 0.6% |
| 2022 | 2.9% | ± 0.5% |
| 2023 | 2.7% | ± 0.5% |
| Change, 2019-23: | -0.8% | ± 0.8% |
| Medicaid Expansion: Implemented expansion on 1/1/2014 | ||
5%10%15%20192023
Florida
| Uninsured Rate | ||
| 2019 | 13.2% | ± 0.2% |
| 2021 | 12.1% | ± 0.2% |
| 2022 | 11.2% | ± 0.2% |
| 2023 | 10.7% | ± 0.2% |
| Change, 2019-23: | -2.5% | ± 0.3% |
| Medicaid Expansion: Expansion not adopted | ||
5%10%15%20192023
Georgia
| Uninsured Rate | ||
| 2019 | 13.4% | ± 0.3% |
| 2021 | 12.6% | ± 0.3% |
| 2022 | 11.7% | ± 0.2% |
| 2023 | 11.4% | ± 0.2% |
| Change, 2019-23: | -2.0% | ± 0.4% |
| Medicaid Expansion: Expansion not adopted | ||
5%10%15%20192023
Hawaiʻi
| Uninsured Rate | ||
| 2019 | 4.2% | ± 0.4% |
| 2021 | 3.9% | ± 0.4% |
| 2022 | 3.5% | ± 0.4% |
| 2023 | 3.2% | ± 0.3% |
| Change, 2019-23: | -1.0% | ± 0.5% |
| Medicaid Expansion: Implemented expansion on 1/1/2014 | ||
5%10%15%20192023
Idaho
| Uninsured Rate | ||
| 2019 | 10.8% | ± 0.5% |
| 2021 | 8.8% | ± 0.6% |
| 2022 | 8.2% | ± 0.5% |
| 2023 | 8.9% | ± 0.5% |
| Change, 2019-23: | -1.9% | ± 0.7% |
| Medicaid Expansion: Implemented expansion on 1/1/2020 | ||
5%10%15%20192023
Illinois
| Uninsured Rate | ||
| 2019 | 7.4% | ± 0.2% |
| 2021 | 7.0% | ± 0.2% |
| 2022 | 6.6% | ± 0.2% |
| 2023 | 6.2% | ± 0.2% |
| Change, 2019-23: | -1.2% | ± 0.3% |
| Medicaid Expansion: Implemented expansion on 1/1/2014 | ||
5%10%15%20192023
Indiana
| Uninsured Rate | ||
| 2019 | 8.7% | ± 0.3% |
| 2021 | 7.5% | ± 0.3% |
| 2022 | 7.0% | ± 0.2% |
| 2023 | 6.9% | ± 0.3% |
| Change, 2019-23: | -1.8% | ± 0.4% |
| Medicaid Expansion: Implemented expansion on 2/1/2015 | ||
5%10%15%20192023
Iowa
| Uninsured Rate | ||
| 2019 | 5.0% | ± 0.3% |
| 2021 | 4.8% | ± 0.3% |
| 2022 | 4.5% | ± 0.2% |
| 2023 | 5.0% | ± 0.3% |
| Change, 2019-23: | 0.0% | ± 0.4%* |
| Medicaid Expansion: Implemented expansion on 1/1/2014 | ||
| *Change is not significant at the 90% confidence level. | ||
5%10%15%20192023
Kansas
| Uninsured Rate | ||
| 2019 | 9.2% | ± 0.4% |
| 2021 | 9.2% | ± 0.4% |
| 2022 | 8.6% | ± 0.3% |
| 2023 | 8.4% | ± 0.4% |
| Change, 2019-23: | -0.8% | ± 0.6% |
| Medicaid Expansion: Expansion not adopted | ||
5%10%15%20192023
Kentucky
| Uninsured Rate | ||
| 2019 | 6.4% | ± 0.3% |
| 2021 | 5.7% | ± 0.3% |
| 2022 | 5.6% | ± 0.3% |
| 2023 | 5.4% | ± 0.2% |
| Change, 2019-23: | -1.0% | ± 0.4% |
| Medicaid Expansion: Implemented expansion on 1/1/2014 | ||
5%10%15%20192023
Louisiana
| Uninsured Rate | ||
| 2019 | 8.9% | ± 0.3% |
| 2021 | 7.6% | ± 0.3% |
| 2022 | 6.9% | ± 0.3% |
| 2023 | 6.9% | ± 0.3% |
| Change, 2019-23: | -2.0% | ± 0.4% |
| Medicaid Expansion: Implemented expansion on 7/1/2016 | ||
5%10%15%20192023
Maine
| Uninsured Rate | ||
| 2019 | 8.0% | ± 0.5% |
| 2021 | 5.7% | ± 0.4% |
| 2022 | 6.6% | ± 0.5% |
| 2023 | 5.9% | ± 0.4% |
| Change, 2019-23: | -2.1% | ± 0.6% |
| Medicaid Expansion: Implemented expansion on 1/10/2019 | ||
5%10%15%20192023
Maryland
| Uninsured Rate | ||
| 2019 | 6.0% | ± 0.3% |
| 2021 | 6.1% | ± 0.2% |
| 2022 | 6.1% | ± 0.3% |
| 2023 | 6.3% | ± 0.3% |
| Change, 2019-23: | 0.3% | ± 0.4%* |
| Medicaid Expansion: Implemented expansion on 1/1/2014 | ||
| *Change is not significant at the 90% confidence level. | ||
5%10%15%20192023
Massachusetts
| Uninsured Rate | ||
| 2019 | 3.0% | ± 0.2% |
| 2021 | 2.5% | ± 0.1% |
| 2022 | 2.4% | ± 0.2% |
| 2023 | 2.6% | ± 0.2% |
| Change, 2019-23: | -0.4% | ± 0.3% |
| Medicaid Expansion: Implemented expansion on 1/1/2014 | ||
5%10%15%20192023
Michigan
| Uninsured Rate | ||
| 2019 | 5.8% | ± 0.2% |
| 2021 | 5.0% | ± 0.1% |
| 2022 | 4.5% | ± 0.2% |
| 2023 | 4.5% | ± 0.1% |
| Change, 2019-23: | -1.3% | ± 0.2% |
| Medicaid Expansion: Implemented expansion on 4/1/2014 | ||
5%10%15%20192023
Minnesota
| Uninsured Rate | ||
| 2019 | 4.9% | ± 0.2% |
| 2021 | 4.5% | ± 0.2% |
| 2022 | 4.5% | ± 0.2% |
| 2023 | 4.2% | ± 0.2% |
| Change, 2019-23: | -0.7% | ± 0.3% |
| Medicaid Expansion: Implemented expansion on 1/1/2014 | ||
5%10%15%20192023
Mississippi
| Uninsured Rate | ||
| 2019 | 13.0% | ± 0.5% |
| 2021 | 11.9% | ± 0.5% |
| 2022 | 10.8% | ± 0.4% |
| 2023 | 10.3% | ± 0.5% |
| Change, 2019-23: | -2.7% | ± 0.7% |
| Medicaid Expansion: Expansion not adopted | ||
5%10%15%20192023
Missouri
| Uninsured Rate | ||
| 2019 | 10.0% | ± 0.3% |
| 2021 | 9.4% | ± 0.3% |
| 2022 | 8.6% | ± 0.3% |
| 2023 | 7.5% | ± 0.3% |
| Change, 2019-23: | -2.5% | ± 0.4% |
| Medicaid Expansion: Implemented expansion on 10/1/2021 | ||
5%10%15%20192023
Montana
| Uninsured Rate | ||
| 2019 | 8.3% | ± 0.5% |
| 2021 | 8.2% | ± 0.5% |
| 2022 | 8.3% | ± 0.6% |
| 2023 | 8.4% | ± 0.6% |
| Change, 2019-23: | 0.1% | ± 0.8%* |
| Medicaid Expansion: Implemented expansion on 1/1/2016 | ||
| *Change is not significant at the 90% confidence level. | ||
5%10%15%20192023
Nebraska
| Uninsured Rate | ||
| 2019 | 8.3% | ± 0.4% |
| 2021 | 7.1% | ± 0.4% |
| 2022 | 6.7% | ± 0.4% |
| 2023 | 6.1% | ± 0.4% |
| Change, 2019-23: | -2.2% | ± 0.6% |
| Medicaid Expansion: Implemented expansion on 10/1/2020 | ||
5%10%15%20192023
Nevada
| Uninsured Rate | ||
| 2019 | 11.4% | ± 0.5% |
| 2021 | 11.6% | ± 0.4% |
| 2022 | 11.1% | ± 0.4% |
| 2023 | 10.8% | ± 0.5% |
| Change, 2019-23: | -0.6% | ± 0.7%* |
| Medicaid Expansion: Implemented expansion on 1/1/2014 | ||
| *Change is not significant at the 90% confidence level. | ||
5%10%15%20192023
New Hampshire
| Uninsured Rate | ||
| 2019 | 6.3% | ± 0.6% |
| 2021 | 5.1% | ± 0.5% |
| 2022 | 4.9% | ± 0.4% |
| 2023 | 4.7% | ± 0.4% |
| Change, 2019-23: | -1.6% | ± 0.7% |
| Medicaid Expansion: Implemented expansion on 8/15/2014 | ||
5%10%15%20192023
New Jersey
| Uninsured Rate | ||
| 2019 | 7.9% | ± 0.2% |
| 2021 | 7.2% | ± 0.2% |
| 2022 | 6.8% | ± 0.2% |
| 2023 | 7.2% | ± 0.2% |
| Change, 2019-23: | -0.7% | ± 0.3% |
| Medicaid Expansion: Implemented expansion on 1/1/2014 | ||
5%10%15%20192023
New Mexico
| Uninsured Rate | ||
| 2019 | 10.0% | ± 0.6% |
| 2021 | 10.0% | ± 0.6% |
| 2022 | 8.2% | ± 0.5% |
| 2023 | 9.1% | ± 0.5% |
| Change, 2019-23: | -0.9% | ± 0.8% |
| Medicaid Expansion: Implemented expansion on 1/1/2014 | ||
5%10%15%20192023
New York
| Uninsured Rate | ||
| 2019 | 5.2% | ± 0.1% |
| 2021 | 5.2% | ± 0.1% |
| 2022 | 4.9% | ± 0.1% |
| 2023 | 4.8% | ± 0.1% |
| Change, 2019-23: | -0.4% | ± 0.1% |
| Medicaid Expansion: Implemented expansion on 1/1/2014 | ||
5%10%15%20192023
North Carolina
| Uninsured Rate | ||
| 2019 | 11.3% | ± 0.3% |
| 2021 | 10.4% | ± 0.2% |
| 2022 | 9.3% | ± 0.2% |
| 2023 | 9.2% | ± 0.3% |
| Change, 2019-23: | -2.1% | ± 0.4% |
| Medicaid Expansion: Implemented expansion on 12/1/2023 | ||
5%10%15%20192023
North Dakota
| Uninsured Rate | ||
| 2019 | 6.9% | ± 0.7% |
| 2021 | 7.9% | ± 0.7% |
| 2022 | 6.4% | ± 0.7% |
| 2023 | 4.5% | ± 0.5% |
| Change, 2019-23: | -2.4% | ± 0.9% |
| Medicaid Expansion: Implemented expansion on 1/1/2014 | ||
5%10%15%20192023
Ohio
| Uninsured Rate | ||
| 2019 | 6.6% | ± 0.2% |
| 2021 | 6.5% | ± 0.2% |
| 2022 | 5.9% | ± 0.2% |
| 2023 | 6.1% | ± 0.2% |
| Change, 2019-23: | -0.5% | ± 0.3% |
| Medicaid Expansion: Implemented expansion on 1/1/2014 | ||
5%10%15%20192023
Oklahoma
| Uninsured Rate | ||
| 2019 | 14.3% | ± 0.3% |
| 2021 | 13.8% | ± 0.3% |
| 2022 | 11.7% | ± 0.3% |
| 2023 | 11.4% | ± 0.3% |
| Change, 2019-23: | -2.9% | ± 0.4% |
| Medicaid Expansion: Implemented expansion on 7/1/2021 | ||
5%10%15%20192023
Oregon
| Uninsured Rate | ||
| 2019 | 7.2% | ± 0.3% |
| 2021 | 6.1% | ± 0.3% |
| 2022 | 6.0% | ± 0.3% |
| 2023 | 5.5% | ± 0.3% |
| Change, 2019-23: | -1.7% | ± 0.4% |
| Medicaid Expansion: Implemented expansion on 1/1/2014 | ||
5%10%15%20192023
Pennsylvania
| Uninsured Rate | ||
| 2019 | 5.8% | ± 0.2% |
| 2021 | 5.5% | ± 0.2% |
| 2022 | 5.3% | ± 0.2% |
| 2023 | 5.4% | ± 0.2% |
| Change, 2019-23: | -0.4% | ± 0.3% |
| Medicaid Expansion: Implemented expansion on 1/1/2015 | ||
5%10%15%20192023
Rhode Island
| Uninsured Rate | ||
| 2019 | 4.1% | ± 0.6% |
| 2021 | 4.3% | ± 0.6% |
| 2022 | 4.2% | ± 0.6% |
| 2023 | 4.5% | ± 0.5% |
| Change, 2019-23: | 0.4% | ± 0.8%* |
| Medicaid Expansion: Implemented expansion on 1/1/2014 | ||
| *Change is not significant at the 90% confidence level. | ||
5%10%15%20192023
South Carolina
| Uninsured Rate | ||
| 2019 | 10.8% | ± 0.3% |
| 2021 | 10.0% | ± 0.4% |
| 2022 | 9.1% | ± 0.3% |
| 2023 | 9.1% | ± 0.3% |
| Change, 2019-23: | -1.7% | ± 0.4% |
| Medicaid Expansion: Expansion not adopted | ||
5%10%15%20192023
South Dakota
| Uninsured Rate | ||
| 2019 | 10.2% | ± 0.7% |
| 2021 | 9.5% | ± 0.8% |
| 2022 | 8.1% | ± 0.5% |
| 2023 | 8.3% | ± 0.7% |
| Change, 2019-23: | -1.9% | ± 1.0% |
| Medicaid Expansion: Implemented expansion on 7/1/2023 | ||
5%10%15%20192023
Tennessee
| Uninsured Rate | ||
| 2019 | 10.1% | ± 0.3% |
| 2021 | 10.0% | ± 0.2% |
| 2022 | 9.3% | ± 0.3% |
| 2023 | 9.3% | ± 0.3% |
| Change, 2019-23: | -0.8% | ± 0.4% |
| Medicaid Expansion: Expansion not adopted | ||
5%10%15%20192023
Texas
| Uninsured Rate | ||
| 2019 | 18.4% | ± 0.2% |
| 2021 | 18.0% | ± 0.2% |
| 2022 | 16.6% | ± 0.2% |
| 2023 | 16.4% | ± 0.2% |
| Change, 2019-23: | -2.0% | ± 0.3% |
| Medicaid Expansion: Expansion not adopted | ||
5%10%15%20192023
Utah
| Uninsured Rate | ||
| 2019 | 9.7% | ± 0.5% |
| 2021 | 9.0% | ± 0.5% |
| 2022 | 8.1% | ± 0.5% |
| 2023 | 8.0% | ± 0.4% |
| Change, 2019-23: | -1.7% | ± 0.6% |
| Medicaid Expansion: Implemented expansion on 1/1/2020 | ||
5%10%15%20192023
Vermont
| Uninsured Rate | ||
| 2019 | 4.5% | ± 0.5% |
| 2021 | 3.7% | ± 0.5% |
| 2022 | 3.9% | ± 0.5% |
| 2023 | 3.4% | ± 0.4% |
| Change, 2019-23: | -1.1% | ± 0.6% |
| Medicaid Expansion: Implemented expansion on 1/1/2014 | ||
5%10%15%20192023
Virginia
| Uninsured Rate | ||
| 2019 | 7.9% | ± 0.3% |
| 2021 | 6.8% | ± 0.2% |
| 2022 | 6.5% | ± 0.2% |
| 2023 | 6.4% | ± 0.2% |
| Change, 2019-23: | -1.5% | ± 0.4% |
| Medicaid Expansion: Implemented expansion on 1/1/2019 | ||
5%10%15%20192023
Washington
| Uninsured Rate | ||
| 2019 | 6.6% | ± 0.3% |
| 2021 | 6.4% | ± 0.2% |
| 2022 | 6.1% | ± 0.2% |
| 2023 | 6.3% | ± 0.2% |
| Change, 2019-23: | -0.3% | ± 0.4% |
| Medicaid Expansion: Implemented expansion on 1/1/2014 | ||
5%10%15%20192023
West Virginia
| Uninsured Rate | ||
| 2019 | 6.7% | ± 0.4% |
| 2021 | 6.1% | ± 0.4% |
| 2022 | 5.9% | ± 0.4% |
| 2023 | 5.9% | ± 0.4% |
| Change, 2019-23: | -0.8% | ± 0.6% |
| Medicaid Expansion: Implemented expansion on 1/1/2014 | ||
5%10%15%20192023
Wisconsin
| Uninsured Rate | ||
| 2019 | 5.7% | ± 0.2% |
| 2021 | 5.4% | ± 0.2% |
| 2022 | 5.2% | ± 0.2% |
| 2023 | 4.9% | ± 0.2% |
| Change, 2019-23: | -0.8% | ± 0.3% |
| Medicaid Expansion: Expansion not adopted | ||
5%10%15%20192023
Wyoming
| Uninsured Rate | ||
| 2019 | 12.3% | ± 1.3% |
| 2021 | 12.2% | ± 1.1% |
| 2022 | 11.5% | ± 1.2% |
| 2023 | 10.7% | ± 1.0% |
| Change, 2019-23: | -1.6% | ± 1.6% |
| Medicaid Expansion: Expansion not adopted | ||
5%10%15%20192023AKAKMEME0%10%VTVTNHNH0%10%WAWAMTMTNDNDMNMNWIWIMIMINYNYMAMARIRI0%10%IDIDWYWYSDSDIAIAILILININOHOHPAPANJNJCTCT0%10%ORORNVNVCOCONENEMOMOKYKYWVWVMDMDDEDE0%10%CACAAZAZUTUTKSKSARARTNTNVAVANCNCDCDC0%10%NMNMOKOKLALAMSMSALALSCSC0%10%TXTXGAGA0%10%HIHIFLFL0%10%
Source: U.S. Census Bureau, American Community Survey
Colored states denote statistically significant changes at the 90% confidence level. American Community Survey data were not released in 2020 due to disruptions to data collection caused by the COVID-19 pandemic.
Center on Budget and Policy Priorities | cbpp.org
Going forward, policymakers can make further coverage gains by maintaining and building on policies that have strengthened the ACA, and by avoiding policies — such as proposals from the Republican Study Committee, the House Budget Committee, and the Heritage Foundation’s Project 2025 — that would undermine the ACA and leave tens of millions more people without coverage. Medicaid enrollment has declined in 2024 due to the unwinding of the pandemic-related continuous coverage protection, which may lead to some retrenchment of recent coverage gains. Policymakers should take steps such as extending the enhanced PTCs for marketplace coverage (which will expire after 2025 unless Congress acts), closing the coverage gap in states that won’t adopt the Medicaid expansion, and eliminating immigration-related barriers to coverage.