As of 2023, nearly *** million people in the United States had some kind of health insurance, a significant increase from around *** million insured people in 2010. However, as of 2023, there were still approximately ** million people in the United States without any kind of health insurance. Insurance coverage The United States does not have universal health insurance, and so health care cost is mostly covered through different private and public insurance programs. In 2021, almost ** percent of the insured population of the United States were insured through employers, while **** percent of people were insured through Medicaid, and **** percent of people through Medicare. As of 2022, about *** percent of people were uninsured in the U.S., compared to ** percent in 2010. The Affordable Care Act The Affordable Care Act (ACA) significantly reduced the number of uninsured people in the United States, from **** million uninsured people in 2013 to **** million people in 2015. However, since the repeal of the individual mandate the number of people without health insurance has risen. Healthcare reform in the United States remains an ongoing political issue with public opinion on a Medicare-for-all plan consistently divided.

In 2023, 25 million people in the United States had no health insurance. The share of Americans without health insurance saw a steady increase from 2015 to 2019 before starting to decline in 2020 to 2023. Factors like the implementation of Medicaid expansion in additional states and growth in private health insurance coverage led to the decline in uninsured population, despite the economic challenges due to the pandemic in 2020. Positive impact of Affordable Care Act In the U.S. there are public and private forms of health insurance, as well as social welfare programs such as Medicaid and programs just for veterans such as CHAMPVA. The Affordable Care Act (ACA) was enacted in 2010, which dramatically reduced the share of uninsured Americans, though there’s still room for improvement. In spite of its success in providing more Americans with health insurance, ACA has had an almost equal number of proponents and opponents since its introduction, though the share of Americans in favor of it has risen since mid-2017 to the majority. Persistent disparity among ethnic groups The share of uninsured people is higher in certain demographic groups. For instance, Hispanics continue to be the ethnic group with the highest rate of uninsured people, even after ACA. Meanwhile the share of uninsured White and Asian people is lower than the national average.

The percentage of people in the United States with health insurance has increased over the past decade with a noticeably sharp increase in 2014 when the Affordable Care Act (ACA) was enacted. As of 2023, around 92 percent of people in the United States had some form of health insurance, compared to around 84 percent in 2010. Despite the increases in the percentage of insured people in the U.S., there were still over 25 million people in the United States without health insurance as of 2023. Insurance coverage Health insurance in the United States consists of different private and public insurance programs such as those provided by private employers or those provided publicly through Medicare and Medicaid. Almost half of the insured population in the United States were insured privately through an employer as of 2021, while 18.9 percent of people were insured through Medicaid, and 15.4 percent through Medicare . The Affordable Care Act The Affordable Care Act (ACA), enacted in 2014, has significantly reduced the number of uninsured people in the United States. In 2014, the percentage of U.S. individuals with health insurance increased to almost 90 percent. Furthermore, the percentage of people without health insurance reached an all time low in 2022. Public opinion on healthcare reform in the United States remains an ongoing political issue with public opinion consistently divided.

This layer shows Health Insurance Coverage. This is shown by state and county boundaries. This service contains the 2017-2021 release of data from the American Community Survey (ACS) 5-year data, and contains estimates and margins of error. There are also additional calculated attributes related to this topic, which can be mapped or used within analysis. This layer is symbolized to show percent uninsured. To see the full list of attributes available in this service, go to the "Data" tab, and choose "Fields" at the top right. Current Vintage: 2017-2021ACS Table(s): B27010, DP03Data downloaded from: Census Bureau's API for American Community SurveyDate of API call: February 16, 2023National Figures: data.census.govThe United States Census Bureau's American Community Survey (ACS):About the SurveyGeography & ACSTechnical DocumentationNews & UpdatesThis ready-to-use layer can be used within ArcGIS Pro, ArcGIS Online, its configurable apps, dashboards, Story Maps, custom apps, and mobile apps. Data can also be exported for offline workflows. Please cite the Census and ACS when using this data.Data Note from the Census:Data are based on a sample and are subject to sampling variability. The degree of uncertainty for an estimate arising from sampling variability is represented through the use of a margin of error. The value shown here is the 90 percent margin of error. The margin of error can be interpreted as providing a 90 percent probability that the interval defined by the estimate minus the margin of error and the estimate plus the margin of error (the lower and upper confidence bounds) contains the true value. In addition to sampling variability, the ACS estimates are subject to nonsampling error (for a discussion of nonsampling variability, see Accuracy of the Data). The effect of nonsampling error is not represented in these tables.Data Processing Notes:Boundaries come from the Cartographic Boundaries via US Census TIGER geodatabases. Boundaries are updated at the same time as the data updates, and the boundary vintage appropriately matches the data vintage as specified by the Census. These are Census boundaries with water and/or coastlines clipped for cartographic purposes. For state and county boundaries, the water and coastlines are derived from the coastlines of the 500k TIGER Cartographic Boundary Shapefiles. The original AWATER and ALAND fields are still available as attributes within the data table (units are square meters). The States layer contains 52 records - all US states, Washington D.C., and Puerto Rico. The Counties (and equivalent) layer contains 3221 records - all counties and equivalent, Washington D.C., and Puerto Rico municipios. See Areas Published. Percentages and derived counts, and associated margins of error, are calculated values (that can be identified by the "_calc_" stub in the field name), and abide by the specifications defined by the American Community Survey.Field alias names were created based on the Table Shells.Margin of error (MOE) values of -555555555 in the API (or "*****" (five asterisks) on data.census.gov) are displayed as 0 in this dataset. The estimates associated with these MOEs have been controlled to independent counts in the ACS weighting and have zero sampling error. So, the MOEs are effectively zeroes, and are treated as zeroes in MOE calculations. Other negative values on the API, such as -222222222, -666666666, -888888888, and -999999999, all represent estimates or MOEs that can't be calculated or can't be published, usually due to small sample sizes. All of these are rendered in this dataset as null (blank) values.

Although the American Community Survey (ACS) produces population, demographic and housing unit estimates, it is the Census Bureau's Population Estimates Program that produces and disseminates the official estimates of the population for the nation, states, counties, cities, and towns and estimates of housing units for states and counties..Supporting documentation on code lists, subject definitions, data accuracy, and statistical testing can be found on the American Community Survey website in the Technical Documentation section.Sample size and data quality measures (including coverage rates, allocation rates, and response rates) can be found on the American Community Survey website in the Methodology section..Source: U.S. Census Bureau, 2017-2021 American Community Survey 5-Year Estimates.Data are based on a sample and are subject to sampling variability. The degree of uncertainty for an estimate arising from sampling variability is represented through the use of a margin of error. The value shown here is the 90 percent margin of error. The margin of error can be interpreted roughly as providing a 90 percent probability that the interval defined by the estimate minus the margin of error and the estimate plus the margin of error (the lower and upper confidence bounds) contains the true value. In addition to sampling variability, the ACS estimates are subject to nonsampling error (for a discussion of nonsampling variability, see ACS Technical Documentation). The effect of nonsampling error is not represented in these tables..Logical coverage edits applying a rules-based assignment of Medicaid, Medicare and military health coverage were added as of 2009 -- please see https://www.census.gov/library/working-papers/2010/demo/coverage_edits_final.html for more details. Select geographies of 2008 data comparable to the 2009 and later tables are available at https://www.census.gov/data/tables/time-series/acs/1-year-re-run-health-insurance.html. The health insurance coverage category names were modified in 2010. See https://www.census.gov/topics/health/health-insurance/about/glossary.html#par_textimage_18 for a list of the insurance type definitions..Beginning in 2017, selected variable categories were updated, including age-categories, income-to-poverty ratio (IPR) categories, and the age universe for certain employment and education variables. See user note entitled "Health Insurance Table Updates" for further details..The 2017-2021 American Community Survey (ACS) data generally reflect the March 2020 Office of Management and Budget (OMB) delineations of metropolitan and micropolitan statistical areas. In certain instances, the names, codes, and boundaries of the principal cities shown in ACS tables may differ from the OMB delineation lists due to differences in the effective dates of the geographic entities..Estimates of urban and rural populations, housing units, and characteristics reflect boundaries of urban areas defined based on Census 2010 data. As a result, data for urban and rural areas from the ACS do not necessarily reflect the results of ongoing urbanization..Explanation of Symbols:- The estimate could not be computed because there were an insufficient number of sample observations. For a ratio of medians estimate, one or both of the median estimates falls in the lowest interval or highest interval of an open-ended distribution. For a 5-year median estimate, the margin of error associated with a median was larger than the median itself.N The estimate or margin of error cannot be displayed because there were an insufficient number of sample cases in the selected geographic area. (X) The estimate or margin of error is not applicable or not available.median- The median falls in the lowest interval of an open-ended distribution (for example "2,500-")median+ The median falls in the highest interval of an open-ended distribution (for example "250,000+").** The margin of error could not be computed because there were an insufficient number of sample observations.*** The margin of error could not be computed because the median falls in the lowest interval or highest interval of an open-ended distribution.***** A margin of error is not appropriate because the corresponding estimate is controlled to an independent population or housing estimate. Effectively, the corresponding estimate has no sampling error and the margin of error may be treated as zero.

Although the American Community Survey (ACS) produces population, demographic and housing unit estimates, it is the Census Bureau's Population Estimates Program that produces and disseminates the official estimates of the population for the nation, states, counties, cities, and towns and estimates of housing units for states and counties..Supporting documentation on code lists, subject definitions, data accuracy, and statistical testing can be found on the American Community Survey website in the Technical Documentation section.Sample size and data quality measures (including coverage rates, allocation rates, and response rates) can be found on the American Community Survey website in the Methodology section..Source: U.S. Census Bureau, 2017-2021 American Community Survey 5-Year Estimates.Data are based on a sample and are subject to sampling variability. The degree of uncertainty for an estimate arising from sampling variability is represented through the use of a margin of error. The value shown here is the 90 percent margin of error. The margin of error can be interpreted roughly as providing a 90 percent probability that the interval defined by the estimate minus the margin of error and the estimate plus the margin of error (the lower and upper confidence bounds) contains the true value. In addition to sampling variability, the ACS estimates are subject to nonsampling error (for a discussion of nonsampling variability, see ACS Technical Documentation). The effect of nonsampling error is not represented in these tables..Logical coverage edits applying a rules-based assignment of Medicaid, Medicare and military health coverage were added as of 2009 -- please see https://www.census.gov/library/working-papers/2010/demo/coverage_edits_final.html for more details. Select geographies of 2008 data comparable to the 2009 and later tables are available at https://www.census.gov/data/tables/time-series/acs/1-year-re-run-health-insurance.html. The health insurance coverage category names were modified in 2010. See https://www.census.gov/topics/health/health-insurance/about/glossary.html#par_textimage_18 for a list of the insurance type definitions..Beginning in 2017, selected variable categories were updated, including age-categories, income-to-poverty ratio (IPR) categories, and the age universe for certain employment and education variables. See user note entitled "Health Insurance Table Updates" for further details..The 2017-2021 American Community Survey (ACS) data generally reflect the March 2020 Office of Management and Budget (OMB) delineations of metropolitan and micropolitan statistical areas. In certain instances, the names, codes, and boundaries of the principal cities shown in ACS tables may differ from the OMB delineation lists due to differences in the effective dates of the geographic entities..Estimates of urban and rural populations, housing units, and characteristics reflect boundaries of urban areas defined based on Census 2010 data. As a result, data for urban and rural areas from the ACS do not necessarily reflect the results of ongoing urbanization..Explanation of Symbols:- The estimate could not be computed because there were an insufficient number of sample observations. For a ratio of medians estimate, one or both of the median estimates falls in the lowest interval or highest interval of an open-ended distribution. For a 5-year median estimate, the margin of error associated with a median was larger than the median itself.N The estimate or margin of error cannot be displayed because there were an insufficient number of sample cases in the selected geographic area. (X) The estimate or margin of error is not applicable or not available.median- The median falls in the lowest interval of an open-ended distribution (for example "2,500-")median+ The median falls in the highest interval of an open-ended distribution (for example "250,000+").** The margin of error could not be computed because there were an insufficient number of sample observations.*** The margin of error could not be computed because the median falls in the lowest interval or highest interval of an open-ended distribution.***** A margin of error is not appropriate because the corresponding estimate is controlled to an independent population or housing estimate. Effectively, the corresponding estimate has no sampling error and the margin of error may be treated as zero.

Although the American Community Survey (ACS) produces population, demographic and housing unit estimates, it is the Census Bureau's Population Estimates Program that produces and disseminates the official estimates of the population for the nation, states, counties, cities, and towns and estimates of housing units for states and counties..Supporting documentation on code lists, subject definitions, data accuracy, and statistical testing can be found on the American Community Survey website in the Technical Documentation section.Sample size and data quality measures (including coverage rates, allocation rates, and response rates) can be found on the American Community Survey website in the Methodology section..Source: U.S. Census Bureau, 2021 American Community Survey 1-Year Estimates.Data are based on a sample and are subject to sampling variability. The degree of uncertainty for an estimate arising from sampling variability is represented through the use of a margin of error. The value shown here is the 90 percent margin of error. The margin of error can be interpreted roughly as providing a 90 percent probability that the interval defined by the estimate minus the margin of error and the estimate plus the margin of error (the lower and upper confidence bounds) contains the true value. In addition to sampling variability, the ACS estimates are subject to nonsampling error (for a discussion of nonsampling variability, see ACS Technical Documentation). The effect of nonsampling error is not represented in these tables..Beginning in 2017, selected variable categories were updated, including age-categories, income-to-poverty ratio (IPR) categories, and the age universe for certain employment and education variables. See user note entitled "Health Insurance Table Updates" for further details..The 2021 American Community Survey (ACS) data generally reflect the March 2020 Office of Management and Budget (OMB) delineations of metropolitan and micropolitan statistical areas. In certain instances the names, codes, and boundaries of the principal cities shown in ACS tables may differ from the OMB delineations due to differences in the effective dates of the geographic entities..Estimates of urban and rural populations, housing units, and characteristics reflect boundaries of urban areas defined based on Census 2010 data. As a result, data for urban and rural areas from the ACS do not necessarily reflect the results of ongoing urbanization..Explanation of Symbols:- The estimate could not be computed because there were an insufficient number of sample observations. For a ratio of medians estimate, one or both of the median estimates falls in the lowest interval or highest interval of an open-ended distribution. For a 5-year median estimate, the margin of error associated with a median was larger than the median itself.N The estimate or margin of error cannot be displayed because there were an insufficient number of sample cases in the selected geographic area. (X) The estimate or margin of error is not applicable or not available.median- The median falls in the lowest interval of an open-ended distribution (for example "2,500-")median+ The median falls in the highest interval of an open-ended distribution (for example "250,000+").** The margin of error could not be computed because there were an insufficient number of sample observations.*** The margin of error could not be computed because the median falls in the lowest interval or highest interval of an open-ended distribution.***** A margin of error is not appropriate because the corresponding estimate is controlled to an independent population or housing estimate. Effectively, the corresponding estimate has no sampling error and the margin of error may be treated as zero.

Although the American Community Survey (ACS) produces population, demographic and housing unit estimates, it is the Census Bureau's Population Estimates Program that produces and disseminates the official estimates of the population for the nation, states, counties, cities, and towns and estimates of housing units for states and counties..Supporting documentation on code lists, subject definitions, data accuracy, and statistical testing can be found on the American Community Survey website in the Technical Documentation section.Sample size and data quality measures (including coverage rates, allocation rates, and response rates) can be found on the American Community Survey website in the Methodology section..Source: U.S. Census Bureau, 2021 American Community Survey 1-Year Estimates.Data are based on a sample and are subject to sampling variability. The degree of uncertainty for an estimate arising from sampling variability is represented through the use of a margin of error. The value shown here is the 90 percent margin of error. The margin of error can be interpreted roughly as providing a 90 percent probability that the interval defined by the estimate minus the margin of error and the estimate plus the margin of error (the lower and upper confidence bounds) contains the true value. In addition to sampling variability, the ACS estimates are subject to nonsampling error (for a discussion of nonsampling variability, see ACS Technical Documentation). The effect of nonsampling error is not represented in these tables..Logical coverage edits applying a rules-based assignment of Medicaid, Medicare and military health coverage were added as of 2009 -- please see https://www.census.gov/library/working-papers/2010/demo/coverage_edits_final.html for more details. Select geographies of 2008 data comparable to the 2009 and later tables are available at https://www.census.gov/data/tables/time-series/acs/1-year-re-run-health-insurance.html. The health insurance coverage category names were modified in 2010. See https://www.census.gov/topics/health/health-insurance/about/glossary.html#par_textimage_18 for a list of the insurance type definitions..Beginning in 2017, selected variable categories were updated, including age-categories, income-to-poverty ratio (IPR) categories, and the age universe for certain employment and education variables. See user note entitled "Health Insurance Table Updates" for further details..The 2021 American Community Survey (ACS) data generally reflect the March 2020 Office of Management and Budget (OMB) delineations of metropolitan and micropolitan statistical areas. In certain instances the names, codes, and boundaries of the principal cities shown in ACS tables may differ from the OMB delineations due to differences in the effective dates of the geographic entities..Estimates of urban and rural populations, housing units, and characteristics reflect boundaries of urban areas defined based on Census 2010 data. As a result, data for urban and rural areas from the ACS do not necessarily reflect the results of ongoing urbanization..Explanation of Symbols:- The estimate could not be computed because there were an insufficient number of sample observations. For a ratio of medians estimate, one or both of the median estimates falls in the lowest interval or highest interval of an open-ended distribution. For a 5-year median estimate, the margin of error associated with a median was larger than the median itself.N The estimate or margin of error cannot be displayed because there were an insufficient number of sample cases in the selected geographic area. (X) The estimate or margin of error is not applicable or not available.median- The median falls in the lowest interval of an open-ended distribution (for example "2,500-")median+ The median falls in the highest interval of an open-ended distribution (for example "250,000+").** The margin of error could not be computed because there were an insufficient number of sample observations.*** The margin of error could not be computed because the median falls in the lowest interval or highest interval of an open-ended distribution.***** A margin of error is not appropriate because the corresponding estimate is controlled to an independent population or housing estimate. Effectively, the corresponding estimate has no sampling error and the margin of error may be treated as zero.

In 2021, 13 percent of AIAN children and 25 percent of AIAN adults aged between 19 and 64 years were uninsured, the highest share of uninsured among all ethnic groups. White and Asian Americans were less likely to be uninsured in comparison to other ethnic groups. This statistic shows the share of population by age and ethnicity without health insurance in the United States in 2021.

Although the American Community Survey (ACS) produces population, demographic and housing unit estimates, it is the Census Bureau's Population Estimates Program that produces and disseminates the official estimates of the population for the nation, states, counties, cities, and towns and estimates of housing units for states and counties..Supporting documentation on code lists, subject definitions, data accuracy, and statistical testing can be found on the American Community Survey website in the Technical Documentation section.Sample size and data quality measures (including coverage rates, allocation rates, and response rates) can be found on the American Community Survey website in the Methodology section..Source: U.S. Census Bureau, 2017-2021 American Community Survey 5-Year Estimates.Data are based on a sample and are subject to sampling variability. The degree of uncertainty for an estimate arising from sampling variability is represented through the use of a margin of error. The value shown here is the 90 percent margin of error. The margin of error can be interpreted roughly as providing a 90 percent probability that the interval defined by the estimate minus the margin of error and the estimate plus the margin of error (the lower and upper confidence bounds) contains the true value. In addition to sampling variability, the ACS estimates are subject to nonsampling error (for a discussion of nonsampling variability, see ACS Technical Documentation). The effect of nonsampling error is not represented in these tables..Logical coverage edits applying a rules-based assignment of Medicaid, Medicare and military health coverage were added as of 2009 -- please see https://www.census.gov/library/working-papers/2010/demo/coverage_edits_final.html for more details. Select geographies of 2008 data comparable to the 2009 and later tables are available at https://www.census.gov/data/tables/time-series/acs/1-year-re-run-health-insurance.html. The health insurance coverage category names were modified in 2010. See https://www.census.gov/topics/health/health-insurance/about/glossary.html#par_textimage_18 for a list of the insurance type definitions..Beginning in 2017, selected variable categories were updated, including age-categories, income-to-poverty ratio (IPR) categories, and the age universe for certain employment and education variables. See user note entitled "Health Insurance Table Updates" for further details..The 2017-2021 American Community Survey (ACS) data generally reflect the March 2020 Office of Management and Budget (OMB) delineations of metropolitan and micropolitan statistical areas. In certain instances, the names, codes, and boundaries of the principal cities shown in ACS tables may differ from the OMB delineation lists due to differences in the effective dates of the geographic entities..Estimates of urban and rural populations, housing units, and characteristics reflect boundaries of urban areas defined based on Census 2010 data. As a result, data for urban and rural areas from the ACS do not necessarily reflect the results of ongoing urbanization..Explanation of Symbols:- The estimate could not be computed because there were an insufficient number of sample observations. For a ratio of medians estimate, one or both of the median estimates falls in the lowest interval or highest interval of an open-ended distribution. For a 5-year median estimate, the margin of error associated with a median was larger than the median itself.N The estimate or margin of error cannot be displayed because there were an insufficient number of sample cases in the selected geographic area. (X) The estimate or margin of error is not applicable or not available.median- The median falls in the lowest interval of an open-ended distribution (for example "2,500-")median+ The median falls in the highest interval of an open-ended distribution (for example "250,000+").** The margin of error could not be computed because there were an insufficient number of sample observations.*** The margin of error could not be computed because the median falls in the lowest interval or highest interval of an open-ended distribution.***** A margin of error is not appropriate because the corresponding estimate is controlled to an independent population or housing estimate. Effectively, the corresponding estimate has no sampling error and the margin of error may be treated as zero.

SELECTED ECONOMIC CHARACTERISTICS HEALTH INSURANCE COVERAGE - DP03 Universe - Civilian noninstitutionalized population Survey-Program - American Community Survey 5-year estimates Years - 2020, 2021, 2022 Health insurance coverage in the ACS and other Census Bureau surveys define coverage to include plans and programs that provide comprehensive health coverage. Plans that provide insurance only for specific conditions or situations such as cancer and long-term care policies are not considered comprehensive health coverage. Likewise, other types of insurance like dental, vision, life, and disability insurance are not considered comprehensive health insurance coverage.

Medicare is an important public health insurance scheme for U.S. adults aged 65 years and over. As of 2023, an estimated 18.9 percent of the U.S. population was covered by Medicare, an increase from the previous year. As of 2021, California, Florida, and Texas had the largest number of adults aged 65 years and older. The Medicare program Medicare has two primary parts: Medicare Part A covers hospital care and Medicare Part B covers medical and preventative services. Both parts of Medicare are available to those aged 65 years and older under certain conditions. Medicare premiums are variable and depend on the enrollee’s income. Despite a majority of the Medicare enrollees being above the federal poverty line, there are still several programs in place to help cover the costs of healthcare for the elderly. Opinions on elderly care in the U.S. It is estimated that about 23 percent of Medicare enrollees are in fair/poor health. But there are lots of questions about who should pay for or help with elderly care long-term. In a recent survey of U.S. adults, about half of the respondents said that health insurance companies should pay for elderly care. However, a majority of adults also supported a long-term government sponsored health plan like Medicaid. The issue is still hotly debated and politicized in the United States.

Table from the American Community Survey (ACS) B27011 health insurance coverage status and type by employment status. These are multiple, nonoverlapping vintages of the 5-year ACS estimates of population and housing attributes starting in 2015 shown by the corresponding census tract vintage. Also includes the most recent release annually.King County, Washington census tracts with nonoverlapping vintages of the 5-year American Community Survey (ACS) estimates starting in 2010. Vintage identified in the "ACS Vintage" field.The census tract boundaries match the vintage of the ACS data (currently 2010 and 2020) so please note the geographic changes between the decades. Tracts have been coded as being within the City of Seattle as well as assigned to neighborhood groups called "Community Reporting Areas". These areas were created after the 2000 census to provide geographically consistent neighborhoods through time for reporting U.S. Census Bureau data. This is not an attempt to identify neighborhood boundaries as defined by neighborhoods themselves.Vintages: 2015, 2020, 2021, 2022, 2023ACS Table(s): B27011Data downloaded from: Census Bureau's Explore Census Data The United States Census Bureau's American Community Survey (ACS):About the SurveyGeography & ACSTechnical DocumentationNews & UpdatesThis ready-to-use layer can be used within ArcGIS Pro, ArcGIS Online, its configurable apps, dashboards, Story Maps, custom apps, and mobile apps. Data can also be exported for offline workflows. Please cite the Census and ACS when using this data.Data Note from the Census:Data are based on a sample and are subject to sampling variability. The degree of uncertainty for an estimate arising from sampling variability is represented through the use of a margin of error. The value shown here is the 90 percent margin of error. The margin of error can be interpreted as providing a 90 percent probability that the interval defined by the estimate minus the margin of error and the estimate plus the margin of error (the lower and upper confidence bounds) contains the true value. In addition to sampling variability, the ACS estimates are subject to nonsampling error (for a discussion of nonsampling variability, see Accuracy of the Data). The effect of nonsampling error is not represented in these tables.Data Processing Notes:Boundaries come from the US Census TIGER geodatabases, specifically, the National Sub-State Geography Database (named tlgdb_(year)_a_us_substategeo.gdb). Boundaries are updated at the same time as the data updates (annually), and the boundary vintage appropriately matches the data vintage as specified by the Census. These are Census boundaries with water and/or coastlines erased for cartographic and mapping purposes. For census tracts, the water cutouts are derived from a subset of the 2020 Areal Hydrography boundaries offered by TIGER. Water bodies and rivers which are 50 million square meters or larger (mid to large sized water bodies) are erased from the tract level boundaries, as well as additional important features. For state and county boundaries, the water and coastlines are derived from the coastlines of the 2020 500k TIGER Cartographic Boundary Shapefiles. These are erased to more accurately portray the coastlines and Great Lakes. The original AWATER and ALAND fields are still available as attributes within the data table (units are square meters). The States layer contains 52 records - all US states, Washington D.C., and Puerto RicoCensus tracts with no population that occur in areas of water, such as oceans, are removed from this data service (Census Tracts beginning with 99).Percentages and derived counts, and associated margins of error, are calculated values (that can be identified by the "_calc_" stub in the field name), and abide by the specifications defined by the American Community Survey.Field alias names were created based on the Table Shells file available from the American Community Survey Summary File Documentation page.Negative values (e.g., -4444...) have been set to null, with the exception of -5555... which has been set to zero. These negative values exist in the raw API data to indicate the following situations:The margin of error column indicates that either no sample observations or too few sample observations were available to compute a standard error and thus the margin of error. A statistical test is not appropriate.Either no sample observations or too few sample observations were available to compute an estimate, or a ratio of medians cannot be calculated because one or both of the median estimates falls in the lowest interval or upper interval of an open-ended distribution.The median falls in the lowest interval of an open-ended distribution, or in the upper interval of an open-ended distribution. A statistical test is not appropriate.The estimate is controlled. A statistical test for sampling variability is not appropriate.The data for this geographic area cannot be displayed because the number of sample cases is too small.

This layer shows Health Insurance Coverage. This is shown by state boundaries. This service is updated annually to contain the most currently released American Community Survey (ACS) 5-year data, and contains estimates and margins of error. There are also additional calculated attributes related to this topic, which can be mapped or used within analysis.
This layer is symbolized to show percent uninsured. To see the full list of attributes available in this service, go to the "Data" tab, and choose "Fields" at the top right. Current Vintage: 2015-2019ACS Table(s): B27010, DP03Data downloaded from: Census Bureau's API for American Community Survey Date of API call: February 10, 2021National Figures: data.census.gov The United States Census Bureau's American Community Survey (ACS): About the SurveyGeography & ACSTechnical Documentation News & UpdatesThis ready-to-use layer can be used within ArcGIS Pro, ArcGIS Online, its configurable apps, dashboards, Story Maps, custom apps, and mobile apps. Data can also be exported for offline workflows. Please cite the Census and ACS when using this data.Data Note from the Census:Data are based on a sample and are subject to sampling variability. The degree of uncertainty for an estimate arising from sampling variability is represented through the use of a margin of error. The value shown here is the 90 percent margin of error. The margin of error can be interpreted as providing a 90 percent probability that the interval defined by the estimate minus the margin of error and the estimate plus the margin of error (the lower and upper confidence bounds) contains the true value. In addition to sampling variability, the ACS estimates are subject to nonsampling error (for a discussion of nonsampling variability, see Accuracy of the Data). The effect of nonsampling error is not represented in these tables. Data Processing Notes: Boundaries come from the US Census TIGER geodatabases. Boundaries are updated at the same time as the data updates (annually), and the boundary vintage appropriately matches the data vintage as specified by the Census. These are Census boundaries with water and/or coastlines clipped for cartographic purposes. For census tracts, the water cutouts are derived from a subset of the 2010 AWATER (Area Water) boundaries offered by TIGER. For state and county boundaries, the water and coastlines are derived from the coastlines of the 500k TIGER Cartographic Boundary Shapefiles. The original AWATER and ALAND fields are still available as attributes within the data table (units are square meters). The States layer contains 52 records - all US states, Washington D.C., and Puerto RicoCensus tracts with no population that occur in areas of water, such as oceans, are removed from this data service (Census Tracts beginning with 99).Percentages and derived counts, and associated margins of error, are calculated values (that can be identified by the "_calc_" stub in the field name), and abide by the specifications defined by the American Community Survey.Field alias names were created based on the Table Shells file available from the American Community Survey Summary File Documentation page.Margin of error (MOE) values of -555555555 in the API (or "*****" (five asterisks) on data.census.gov) are displayed as 0 in this dataset. The estimates associated with these MOEs have been controlled to independent counts in the ACS weighting and have zero sampling error. So, the MOEs are effectively zeroes, and are treated as zeroes in MOE calculations. Other negative values on the API, such as -222222222, -666666666, -888888888, and -999999999, all represent estimates or MOEs that can't be calculated or can't be published, usually due to small sample sizes.
All of these are rendered in this dataset as null (blank) values.

Although the American Community Survey (ACS) produces population, demographic and housing unit estimates, it is the Census Bureau's Population Estimates Program that produces and disseminates the official estimates of the population for the nation, states, counties, cities, and towns and estimates of housing units for states and counties..Supporting documentation on code lists, subject definitions, data accuracy, and statistical testing can be found on the American Community Survey website in the Technical Documentation section.Sample size and data quality measures (including coverage rates, allocation rates, and response rates) can be found on the American Community Survey website in the Methodology section..Source: U.S. Census Bureau, 2017-2021 American Community Survey 5-Year Estimates.Data are based on a sample and are subject to sampling variability. The degree of uncertainty for an estimate arising from sampling variability is represented through the use of a margin of error. The value shown here is the 90 percent margin of error. The margin of error can be interpreted roughly as providing a 90 percent probability that the interval defined by the estimate minus the margin of error and the estimate plus the margin of error (the lower and upper confidence bounds) contains the true value. In addition to sampling variability, the ACS estimates are subject to nonsampling error (for a discussion of nonsampling variability, see ACS Technical Documentation). The effect of nonsampling error is not represented in these tables..Logical coverage edits applying a rules-based assignment of Medicaid, Medicare and military health coverage were added as of 2009 -- please see https://www.census.gov/library/working-papers/2010/demo/coverage_edits_final.html for more details. Select geographies of 2008 data comparable to the 2009 and later tables are available at https://www.census.gov/data/tables/time-series/acs/1-year-re-run-health-insurance.html. The health insurance coverage category names were modified in 2010. See https://www.census.gov/topics/health/health-insurance/about/glossary.html#par_textimage_18 for a list of the insurance type definitions..Beginning in 2017, selected variable categories were updated, including age-categories, income-to-poverty ratio (IPR) categories, and the age universe for certain employment and education variables. See user note entitled "Health Insurance Table Updates" for further details..The 2017-2021 American Community Survey (ACS) data generally reflect the March 2020 Office of Management and Budget (OMB) delineations of metropolitan and micropolitan statistical areas. In certain instances, the names, codes, and boundaries of the principal cities shown in ACS tables may differ from the OMB delineation lists due to differences in the effective dates of the geographic entities..Estimates of urban and rural populations, housing units, and characteristics reflect boundaries of urban areas defined based on Census 2010 data. As a result, data for urban and rural areas from the ACS do not necessarily reflect the results of ongoing urbanization..Explanation of Symbols:- The estimate could not be computed because there were an insufficient number of sample observations. For a ratio of medians estimate, one or both of the median estimates falls in the lowest interval or highest interval of an open-ended distribution. For a 5-year median estimate, the margin of error associated with a median was larger than the median itself.N The estimate or margin of error cannot be displayed because there were an insufficient number of sample cases in the selected geographic area. (X) The estimate or margin of error is not applicable or not available.median- The median falls in the lowest interval of an open-ended distribution (for example "2,500-")median+ The median falls in the highest interval of an open-ended distribution (for example "250,000+").** The margin of error could not be computed because there were an insufficient number of sample observations.*** The margin of error could not be computed because the median falls in the lowest interval or highest interval of an open-ended distribution.***** A margin of error is not appropriate because the corresponding estimate is controlled to an independent population or housing estimate. Effectively, the corresponding estimate has no sampling error and the margin of error may be treated as zero.

In 2021, 18 percent of Americans in Medicaid non-expansion states were uninsured, this was twice the share of uninsured people in Medicaid expansion states. Individual-market health insurance coverage was higher among Americans in non-expansion states. In general, health insurance coverage was higher among Americans residing in Medicaid expansion states compared to non-expansion states between 2013 and 2021.

The percentage of Americans covered by the Medicaid public health insurance plan increased from 17.8 percent in 2020 to around 18.9 percent in 2023. However, the percentage of those insured through Medicaid remains lower than the peak of 19.6 percent in 2015. The expansion of Medicaid The Affordable Care Act (ACA) provided the option for states to expand Medicaid eligibility to people whose income was below a particular threshold. The ACA’s major coverage expansion came into force in 2014, and the number of individuals estimated to be enrolled in Medicaid has since surpassed 75 million. More than 28 million children were enrolled in the program in 2018, representing 38 percent of overall Medicaid enrollment. State Medicaid coverage Initially, the ACA mandated that all state Medicaid programs would have to be extended to provide medical coverage to nearly all low-income groups. However, the Supreme Court rejected that part of the act in 2012, leaving the door open for states to make their own decision on whether they expand their plans. As of September 2021, 39 states plus the District of Columbia have adopted the Medicaid expansion.

In 2023, **** percent of the U.S. population had employment-based health insurance coverage. This statistic depicts the percentage of the U.S. population with employment-based health insurance from 1987 to 2023.

In 2022, health spending in the United States reached approximately 4.6 trillion U.S. dollars, and private insurance accounted for around 29 percent of that figure. However, public health insurance, which includes the Medicare and Medicaid programs, combined for a share of around 39 percent. The rising costs of health care coverage U.S. national health expenditure continues to increase and is projected to exceed four trillion U.S. dollars in 2021. Hospital care and physician services have been the leading spending categories for several years and combined for more than half of all health spending in 2021. In the same year, federal and state governments made up 61 percent of national health expenditures, with the federal government’s share accounting for 27 percent. The differences between Medicare and Medicaid Medicare and Medicaid were both signed into U.S. law by President Johnson in 1965. Medicare is a health insurance program solely funded by the federal government. The plan was primarily created for all Americans aged 65 and older, regardless of their income. Medicaid is administered at a state level in accordance with some core federal requirements, but both fund the program. The plan provides health care to millions of Americans, and some states have expanded the Medicaid program to cover nearly all low-income adults under the age of 65.

Although the American Community Survey (ACS) produces population, demographic and housing unit estimates, it is the Census Bureau's Population Estimates Program that produces and disseminates the official estimates of the population for the nation, states, counties, cities, and towns and estimates of housing units for states and counties..Supporting documentation on code lists, subject definitions, data accuracy, and statistical testing can be found on the American Community Survey website in the Technical Documentation section.Sample size and data quality measures (including coverage rates, allocation rates, and response rates) can be found on the American Community Survey website in the Methodology section..Source: U.S. Census Bureau, 2017-2021 American Community Survey 5-Year Estimates.Data are based on a sample and are subject to sampling variability. The degree of uncertainty for an estimate arising from sampling variability is represented through the use of a margin of error. The value shown here is the 90 percent margin of error. The margin of error can be interpreted roughly as providing a 90 percent probability that the interval defined by the estimate minus the margin of error and the estimate plus the margin of error (the lower and upper confidence bounds) contains the true value. In addition to sampling variability, the ACS estimates are subject to nonsampling error (for a discussion of nonsampling variability, see ACS Technical Documentation). The effect of nonsampling error is not represented in these tables..Logical coverage edits applying a rules-based assignment of Medicaid, Medicare and military health coverage were added as of 2009 -- please see https://www.census.gov/library/working-papers/2010/demo/coverage_edits_final.html for more details. Select geographies of 2008 data comparable to the 2009 and later tables are available at https://www.census.gov/data/tables/time-series/acs/1-year-re-run-health-insurance.html. The health insurance coverage category names were modified in 2010. See https://www.census.gov/topics/health/health-insurance/about/glossary.html#par_textimage_18 for a list of the insurance type definitions..Beginning in 2017, selected variable categories were updated, including age-categories, income-to-poverty ratio (IPR) categories, and the age universe for certain employment and education variables. See user note entitled "Health Insurance Table Updates" for further details..The Hispanic origin and race codes were updated in 2020. For more information on the Hispanic origin and race code changes, please visit the American Community Survey Technical Documentation website..The 2017-2021 American Community Survey (ACS) data generally reflect the March 2020 Office of Management and Budget (OMB) delineations of metropolitan and micropolitan statistical areas. In certain instances, the names, codes, and boundaries of the principal cities shown in ACS tables may differ from the OMB delineation lists due to differences in the effective dates of the geographic entities..Estimates of urban and rural populations, housing units, and characteristics reflect boundaries of urban areas defined based on Census 2010 data. As a result, data for urban and rural areas from the ACS do not necessarily reflect the results of ongoing urbanization..Explanation of Symbols:- The estimate could not be computed because there were an insufficient number of sample observations. For a ratio of medians estimate, one or both of the median estimates falls in the lowest interval or highest interval of an open-ended distribution. For a 5-year median estimate, the margin of error associated with a median was larger than the median itself.N The estimate or margin of error cannot be displayed because there were an insufficient number of sample cases in the selected geographic area. (X) The estimate or margin of error is not applicable or not available.median- The median falls in the lowest interval of an open-ended distribution (for example "2,500-")median+ The median falls in the highest interval of an open-ended distribution (for example "250,000+").** The margin of error could not be computed because there were an insufficient number of sample observations.*** The margin of error could not be computed because the median falls in the lowest interval or highest interval of an open-ended distribution.***** A margin of error is not appropriate because the corresponding estimate is controlled to an independent population or housing estimate. Effectively, the corresponding estimate has no sampling error and the margin of error may be treated as zero.