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Analyzing the Census Bureau’s 2023 Poverty, Income, and Health Insurance Data
September 12, 2024 @ 11:00 am
The Census Bureau has released nationwide figures for poverty, income, and health insurance coverage in 2023 from its Current Population Survey. Additional health insurance data from the American Community Survey will follow September 12.
We’ll be posting our analysis of the data here. Bookmark and visit this page for more.
See our paper on what to watch for in the data.
That’s all the analysis on 2023 Census data that we’ll be posting here. Watch our other spaces for our expert analysis on these and other issues.
— CBPP
September 12, 2024, 4:28 pm
2023 Census Poverty Data Reveal Uneven Progress and Importance of Policy Choices
The tight labor market helped bring down poverty in 2023 under the official poverty measure, which only counts market income and cash benefits such as Social Security. The story was mixed under the Census Bureau’s more comprehensive measure, the Supplemental Poverty Measure (SPM), which counts income from non-cash programs such as the Supplemental Nutrition Assistance Program (SNAP) and rental assistance, and from refundable tax credits. Census reported that poverty increased in 2023 under the standard SPM, but that it was driven by a particularly large increase in the SPM’s thresholds (or “poverty line”) used to measure whether a family’s resources meet the definition of poverty.
SPM thresholds, which are updated each year in part based on changes in the amount typical families with children spend on basic needs such as food and housing averaged over five earlier years, increased in 2023 by between 6.8 and 8.6 percent, depending on homeownership status. This far exceeds the 4.1 percent inflation rate measured by the overall consumer price index, or CPI. (The official poverty measure uses the overall CPI to adjust its poverty thresholds.)
And, while recent research indicates that prices tend to rise somewhat faster for rent and other goods that low-income households spend their money on, the increase in the SPM thresholds also significantly exceeds the overall inflation rate of 4.6 percent for the poorest one-fifth of households, the Labor Department estimates.
This large increase in SPM thresholds in 2023 makes interpreting the change in SPM poverty more difficult this year. Using an alternative SPM poverty measure for 2023 that starts with the 2022 thresholds and adjusts only for inflation, Census reported that poverty did not increase in 2023. This shows that the reason poverty increased in 2023 under the standard SPM is the rise in the SPM thresholds — not because family resources declined in inflation-adjusted terms.
The Census analysis using the alternative SPM measure reveals that poverty in 2023 was statistically unchanged from 2022 for children and people aged 18 to 64, and declined for people 65 years and older. Poverty declined for white, non-Latino people and American Indian and Alaska Native people, and remained statistically unchanged for Black, Asian, and Latino people.
Across all racial and ethnic groups, overall poverty and child poverty in 2023 was much higher than in 2020 or 2021, under both the standard and alternative SPM measures. Temporary pandemic relief measures drove poverty to historic lows in 2020 and 2021 in data back to 1967.
Child poverty reached a record low in 2021. That was due largely to the American Rescue Plan’s Child Tax Credit expansion and other relief measures that contributed to a 46 percent reduction in child poverty from 2020 to 2021. The Child Tax Credit expansion helped bring racial and ethnic inequities in child poverty — which are driven by factors such as discrimination and governmental underinvestment — to their lowest level ever in 2021.
After Congress let the Child Tax Credit expansion expire, the credit reverted to a smaller and less equitable design that denies full participation to families with low or no earnings. An estimated 1 in 4 children — or roughly 19 million children — got less than the full $2,000-per-child credit or none at all in 2022 because their families’ incomes were too low. This included nearly half of Black children, 4 in 10 American Indian or Alaska Native children, more than 1 in 3 Latino children, and about 1 in 3 children living in rural areas.
By inflation-adjusted SPM measures, overall poverty and child poverty stand below their lowest pre-pandemic levels, whether you use a 2022 or a 2023 threshold. But that is still far higher than it needs to be.
Making the full Child Tax Credit available to the children who need it most would lower the number of children experiencing poverty, push back against long-standing inequities, and enable more families to offer their children a stronger foundation of income security and opportunity.
Supplemental Poverty MeasureSupplemental Nutrition Assistance ProgramSupplemental Poverty MeasureSupplemental Poverty MeasureSupplemental Poverty MeasureConsumer Price IndexConsumer Price IndexSupplemental Poverty MeasureSupplemental Poverty MeasureSupplemental Poverty MeasureSupplemental Poverty MeasureSupplemental Poverty MeasureSupplemental Poverty MeasureSupplemental Poverty MeasureSupplemental Poverty MeasureSupplemental Poverty Measure
September 12, 2024, 4:24 pm
Tagged
Poverty Child Tax Credit
Uninsured Rates Remained Low in All Three Surveys, Decreased in Most States Since 2019
The American Community Survey (ACS), Current Population Survey (CPS), and National Health Interview Survey (NHIS) all recorded low uninsured rates in 2023: 7.9 percent in the ACS, 8.0 percent in the CPS, and 7.6 percent in the NHIS. For the ACS and NHIS, these uninsured rates marked an all-time low, while for the CPS the rate was statistically unchanged from its record low in 2022.
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
NHIS, 2011: 15.1%
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
The ACS reports that from 2019 to 2023, the national uninsured rate fell by 1.3 percentage points, from 9.2 percent to 7.9 percent. As discussed in previous posts, ACA marketplace and Medicaid policy improvements beginning in 2020 drove recent declines in the uninsured rate. These improvements are also evident in changes in the uninsured rate from state to state. This year’s ACS data reveal that from 2019 to 2023, 42 states and the District of Columbia saw a decrease in their uninsured rate, and eight states saw no statistically significant change. No states saw an increase in their uninsured rate.
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
The largest decreases were in Oklahoma, which saw a 2.9 percentage point decrease; Mississippi, which saw a 2.7 percentage point decrease; and Missouri and Florida, both of which saw a 2.5 percentage point decrease. In Mississippi and Florida — two states that have not expanded Medicaid — this was driven by dramatic increases in average monthly marketplace enrollment of 144 percent and 105 percent, respectively, demonstrating how enhanced premium tax credits have provided coverage for millions who otherwise would not have it. Oklahoma and Missouri both expanded Medicaid in 2021, and as a result, from 2019 to 2023, they saw the greatest increases in average monthly Medicaid enrollment of any state: 70 percent and 68 percent, respectively. Nebraska, Virginia, Maine, Idaho, and Utah also adopted expansion between 2019 and 2021, and they all saw greater decreases in uninsured rates and greater increases in Medicaid enrollment compared to the national average. South Dakota and North Carolina expanded Medicaid in the latter part of 2023; 2024 data should begin to show the impact of expansion in these states.
Also notable is the fact that ten states had uninsured rates of less than 5 percent in 2023, led by Massachusetts and Hawai‘i, which had uninsured rates of 2.6 percent and 3.2 percent, respectively. The District of Columbia also had a low uninsured rate of 2.7 percent. In addition to having expanded Medicaid, most of these states also provide additional state subsidies or have taken other options under the ACA to provide more affordable coverage. States like Massachusetts and Hawai‘i demonstrate that universal coverage is attainable with adequate federal and state support.
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September 12, 2024, 3:10 pm
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Health ACA Medicaid Premium Tax Credits
New Census Data Show Widening Income-Rent Gap and Increased Impact of Rental Assistance
New American Community Survey (ACS) data released today show rents rose at a significantly faster pace than renter incomes in 2023, widening the gap between housing costs and the amount many households can afford. From 2022 to 2023, the median rent rose by 3.9 percent while the median renter household’s income went up 1 percent, contributing to a decades-long trend in which renters’ incomes haven’t caught up to rising housing costs. Since 2001, rent has increased by 23.4 percent while renters’ incomes have risen only 5.3 percent, after adjusting for inflation. (See graph.)
Private rent data show that the increases in the cost of newly rented units slowed sharply in 2023 and 2024, but it will take time for that slowdown to be fully reflected in the ACS data, which captures housing costs for all renter households. The gap between trends in rents and incomes hits people with the lowest incomes hardest, since they often pay very high shares of their income for rent and are far more likely than higher-income households to experience eviction, overcrowding, and homelessness. The most effective way to address these problems and help people with very low incomes afford housing is through housing vouchers and other rental assistance.
Current Population Survey (CPS) data released Tuesday showed that rental assistance lifted 2.8 million people above the poverty line in 2023, a 4.4 percent increase above the 2022 level. This included 885,000 children, 702,000 adults 65 and older (rental assistance has the largest poverty-reduction impact among seniors of any program except Social Security), and nearly 1.2 million other adults. These effects could be much greater — and the poverty rate could be substantially lower — if lawmakers expanded rental assistance toward the goal of reaching all people in need. Currently fewer than 1 in 4 households in need receive rental assistance due to inadequate funding.
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— Will Fischer and Erik Gartland
September 12, 2024, 1:45 pm
Tagged
Housing Rental Assistance
American Community Survey Shows Progress in Reducing Coverage Inequities by Race and Ethnicity and by Income
The American Community Survey (ACS) data confirm the impact of the pandemic-related continuous coverage provision and implementation of enhanced premium tax credits: reduced health coverage inequities among Black and Latino people and people with low to moderate incomes. In comparison to the Current Population Survey (CPS), ACS uninsured rates are reported for a wider range of racial and ethnic groups, and all of the statistically insignificant trends from 2020 to 2023 in the CPS are statistically significant from 2019 to 2023 in the ACS (2019 CPS data are not comparable to other years due to pandemic-related issues), likely due to the ACS’s larger sample size.
Between 2019 and 2023, the uninsured rate fell by 2.1 percentage points for Latino people and by 1.6 percentage points for Black people. That compares to smaller drops of 1.2 percentage points for white people and 1.3 percentage points for Asian people, two groups that have historically had lower uninsured rates. Of note, the uninsured rate decreased by an even smaller amount — 0.8 percentage points — for American Indian and Alaska Native people and did not change significantly for Native Hawaiian and Pacific Islander people; the reasons for these findings are unclear and require further study.
While the drops since 2020 for Latino and Asian people were statistically insignificant in the CPS, the drops since 2019 for Latino and Asian people were significant in the ACS.
For those with incomes below 138 percent of the poverty threshold (calculated using the official poverty measure), the uninsured rate fell by 2.6 percentage points, from 15.9 percent to 13.3 percent. This threshold corresponds most closely to 138 percent of the federal poverty level, the income eligibility limit for Medicaid in expansion states.
The uninsured rate also fell by 1.6 percentage points for those with incomes between 138 and 399 percent of the poverty threshold, from 11.7 percent to 10.1 percent. In comparison, those with incomes above 400 percent of the poverty threshold saw a smaller decline of 0.3 percentage points, from 3.9 percent to 3.6 percent.
The ACS also reports uninsured rates for people with incomes below 100 percent of the poverty threshold; while the drop since 2020 for this group was statistically insignificant in the CPS, their uninsured rate since 2019 fell by 2.5 percentage points, from 16 percent to 13.5 percent in the ACS.
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September 12, 2024, 12:58 pm
Tagged
Health ACA Premium Tax Credits Medicaid
American Community Survey: Uninsured Rate Fell to Record Low of 7.9 Percent
Today’s release of American Community Survey (ACS) data shows the uninsured rate reaching a new all-time low of 7.9 percent in 2023, down from its prior record of 8.0 percent achieved in 2022.
These data are broadly consistent with preliminary data released in June from the National Health Interview Survey (NHIS). Current Population Survey (CPS) data, released on Tuesday, differed 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 (ACA) was adopted. It fell to 8.6 percent in 2016, with most of the decrease coming after the ACA’s major coverage provisions went into effect in 2014.
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.
As the ACA was strengthened in recent years — with nine additional states implementing the ACA’s Medicaid expansion since 2019, and the adoption of enhanced premium tax credits for ACA marketplace coverage in 2021 — the uninsured rate fell further. The pandemic-related continuous coverage protection also played a key role in preventing Medicaid enrollees from losing coverage. Today’s data show that the uninsured rate in 2023 was roughly half of what it was when the ACA was first enacted. Some 47.2 million people lacked health coverage in 2010; that number fell to 26.2 million in 2023.
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September 12, 2024, 11:02 am
Tagged
Health ACA Medicaid
That’s it for today. We’ll continue to update this page with further analyses, notably including health data in the American Community Survey on Thursday.
— CBPP
September 10, 2024, 5:15 pm
Stay Tuned for Thursday’s Release of ACS Data
Stay tuned for the American Community Survey (ACS) data release on Thursday. The ACS has a much larger sample than the Current Population Survey (CPS) and the National Health Interview Survey (NHIS). Compared to the CPS, the ACS has also maintained a more consistent methodology over time for its health insurance measures.
Like the CPS and NHIS, we expect the 2023 ACS will either reach a new all-time low uninsured rate or remain close to its 2022 low. Given its large sample size, the ACS may provide a more definitive answer on whether and how the uninsured rate changed between 2022 and 2023. The higher degree of precision in ACS estimates will also provide a great opportunity to look at differences between states and among demographic groups. In particular, we’ll be watching for whether the increase in the uninsured rate for children that was found in the CPS is also evident in the ACS.
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September 10, 2024, 5:00 pm
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Health
Persistent Gap Between Medicaid Expansion and Non-Expansion States
States that expanded Medicaid under the Affordable Care Act had an uninsured rate of 6.4 percent, a little over half the 11.3 percent uninsured rate of non-expansion states. The large gap in uninsured rates between Medicaid expansion and non-expansion states has persisted over time. Once again, this year’s Census data, along with numerous studies, confirm: Medicaid expansion boosts overall health coverage. States that continue to choose not to adopt Medicaid expansion leave large shares of their populations without access to health insurance, facing poorer health outcomes, more medical debt, and higher mortality rates.
September 10, 2024, 4:56 pm
Tagged
Health ACA Medicaid
Coverage Gains Particularly Strong for Black People and People With Moderate Incomes
Inequities in health coverage rates have existed historically between racial and ethnic groups and across socioeconomic status. The reasons for these trends are complex but include factors such as systemic racism and discrimination, immigration- and language-related barriers, and lack of affordable and accessible coverage options. Today’s Current Population Survey (CPS) data show that recent policies such as Medicaid continuous coverage provisions and enhanced premium tax credits have made progress in reducing certain coverage disparities.
Between 2020 and 2023, the uninsured rate fell by 2.3 percentage points for Black people, from 10.4 percent to 8.1 percent. That compares to a smaller drop for white people — 0.4 percentage points, from 5.4 percent to 5.0 percent. For Asian and Latino people, the drops in uninsured rates were statistically insignificant.
For those with incomes between 200 and 299 percent of the poverty threshold, the uninsured rate fell by 1.1 percentage points, from 11.9 percent to 10.8 percent. The uninsured rate also fell by 0.9 percentage points for those with incomes between 300 and 399 percent of the poverty threshold, from 8.9 percent to 8.0 percent. That compares to a smaller decline of 0.3 percentage points, from 3.4 percent to 3.1 percent, for those with incomes above 400 percent of the poverty threshold. The declines in uninsured rates for those with the lowest incomes — below 200 percent of the poverty threshold — were statistically insignificant.
These patterns differ slightly from data released by the National Health Interview Survey earlier this year, which found particularly steep declines in the uninsured rates for both Latino and Black adults and for all groups of adults with incomes less than 400 percent of the poverty level from 2019 and 2023 (recent CPS data cannot be compared to 2019 CPS data due to pandemic-related disruptions).
Stay tuned for the American Community Survey (ACS) data release on Thursday, which provides a breakdown of uninsured rates across a wider range of racial and ethnic groups. The ACS is much larger than the CPS, allowing for more precise estimates and more definitive answers as to how coverage rates changed among demographic groups.
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September 10, 2024, 4:52 pm
Tagged
Health Medicaid
CPS Uninsured Rate Declines in Recent Years Consistent With National Health Interview Survey
June’s release of preliminary National Health Interview Survey (NHIS) data shows that the share of people lacking coverage fell from 10.3 percent in 2019 to an all-time low of 7.6 percent in 2023. This is broadly consistent with the Current Population Survey (CPS), which found a decline in the uninsured rate from 8.6 percent in 2020 to 8.0 percent in 2023. (2019 CPS data are not comparable to other years due to pandemic-related data collection disruptions.)
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September 10, 2024, 4:47 pm
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Health
ACA Marketplace and Medicaid Drove High Rates of Coverage
As I mentioned in my first post, administrative data show that the low uninsured rate in 2023 was driven by record enrollment in the Affordable Care Act (ACA) marketplace and Medicaid.
Gains in ACA marketplace coverage were primarily due to enhanced premium tax credits (PTCs) that Congress adopted in the 2021 American Rescue Plan and extended through 2025 in the Inflation Reduction Act. With marketplace enrollees’ premium costs cut by $824 on average in 2023, marketplace coverage became far more affordable and enrollment surged, with particularly rapid increases for people with low incomes and Black and Latino people. The enhanced PTCs are estimated to reduce the number of uninsured people by 4 million, with almost half the coverage gains among Black and Latino people.
Medicaid enrollment in 2023 was higher than any other year on average, though trends during the year were disparate. Medicaid enrollment reached record highs each month through April 2023 due to the pandemic-related continuous coverage protection that prevented Medicaid enrollees from being disenrolled. On April 1, 2023, that temporary protection expired, leading to enrollment declines from May through the remainder of the year. While a large number lost their health insurance for procedural reasons (not because they were found ineligible) and had to reapply for Medicaid, a substantial number of people also enrolled in the ACA marketplace, which with the PTC enhancements in place offers zero-cost premiums for benchmark coverage to people under 150 percent of the poverty level.
Average monthly ACA marketplace enrollment grew from 10.3 million in 2020 to 16.2 million in 2023. And enrollment has continued to surge, reaching 20.8 million in February 2024.
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September 10, 2024, 4:42 pm
Tagged
Health ACA Medicaid
Census: Uninsured Rate in 2023 Unchanged From Record Low in 2022
The share of people lacking health coverage was 8.0 percent in 2023, statistically unchanged from its record low of 7.9 percent in 2022, according to Current Population Survey (CPS) data released today by the Census Bureau.
The CPS data differ from preliminary projections from the Congressional Budget Office, which estimated an all-time low uninsured rate of 7.2 percent in 2023. According to the CPS, ACA marketplace enrollment increased to a record high in 2023, but this increase was offset by a decline in employer coverage — particularly for children, whose uninsured rate increased. American Community Survey (ACS) data, which include a larger sample than the CPS and allow for more precise estimates by subgroup, will be released on Thursday. It will be important to check whether the increase in the uninsured rate for children that was found in the CPS is also evident in the ACS.
While coverage from 2022 to 2023 remained unchanged in the CPS, coverage has increased substantially since 2020, when the uninsured rate stood at 8.6 percent. The gains from 2020 to 2023 reflect record high Affordable Care Act (ACA) marketplace enrollment, which was driven by enhanced premium tax credits (PTCs) that substantially reduced people’s costs to enroll in marketplace coverage. In addition, the pandemic-related continuous coverage protection, which allowed Medicaid enrollees to maintain uninterrupted coverage from March 2020 through March 2023, elevated Medicaid enrollment to record highs in the first quarter of 2023. While average monthly Medicaid enrollment over the course of 2023 was higher than in any other year, enrollment declined rapidly after the continuous coverage protection expired on April 1, 2023.
Going forward, further gains in health insurance coverage can be made by maintaining and building on policies that have strengthened the ACA, and by avoiding policies — such as those from Republican lawmakers and Project 2025 — that would undermine it. Medicaid enrollment has declined in 2024 due to the unwinding of the continuous coverage protection, and this may lead to some retrenchment of recent coverage gains. To make even greater progress, policymakers need to take additional steps, including extending the enhanced PTCs for ACA marketplace coverage (which will expire after 2025 without congressional action), closing the coverage gap in states that won’t adopt the ACA Medicaid expansion, and eliminating immigration-related barriers to coverage.
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September 10, 2024, 4:37 pm
Tagged
Health ACA
Programs That Reduce Poverty, Improve Health Coverage Would Suffer Deep Cuts Under Conservative Budget Plans, Project 2025
Programs targeted for deep cuts in Project 2025 and recent conservative congressional budget plans are effective at reducing poverty and expanding access to health insurance, today’s data show.
Food assistance from SNAP (formerly food stamps) lifted the family incomes of 3.4 million people above the poverty line in 2023. Housing programs lifted 2.8 million people above the poverty line. Proposals from some congressional Republicans and the conservative Project 2025 to limit eligibility for SNAP and housing assistance and reduce benefit levels would take away assistance from millions of people (including children), significantly weakening the programs’ impact and increasing poverty.
Medicaid provides health coverage to nearly 74 million people. The ACA marketplaces cover an additional 21 million people, with more than 9 in 10 receiving tax credits to help afford premiums. The recent conservative congressional budget proposals and Project 2025 would impose massive cuts on both programs, raising people’s costs while leading tens of millions of people to lose coverage. The uninsured rate — which today’s Census data show essentially remained flat in 2023 — would spike.
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— Danilo Trisi and Gideon Lukens
September 10, 2024, 4:27 pm
Tagged
SNAP Child Tax Credit Earned Income Tax Credit ACA
Parrott: Census Data Show Income Growth and Steady Health Coverage, With Significant Work to Do to Bring Down Poverty
CBPP President Sharon Parrott has commented on today’s Census data:
What is most striking in this year’s Census data is how the data again demonstrate that if policymakers made different choices and adopted common-sense measures like an expanded Child Tax Credit, far fewer people would live in households that struggle to afford the basics. Some measures of poverty in 2023 reached or remained at all-time lows except for 2020 and 2021, when pandemic relief measures including an expanded Child Tax Credit drove poverty down dramatically. Poverty stood far above the levels achieved in those pandemic years despite a stronger economy in 2023, providing clear evidence that more robust policies could dramatically reduce poverty. . . .
