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.

Over ** million Americans were estimated to be enrolled in the Medicaid program as of 2023. That is a significant increase from around ** million ten years earlier. Medicaid is basically a joint federal and state health program that provides medical coverage to low-income individuals and families. Currently, Medicaid is responsible for ** percent of the nation’s health care bill, making it the third-largest payer behind private insurances and Medicare. From the beginning to ObamacareMedicaid was implemented in 1965 and since then has become the largest source of medical services for Americans with low income and limited resources. The program has become particularly prominent since the introduction of President Obama’s health reform – the Patient Protection and Affordable Care Act - in 2010. Medicaid was largely impacted by this reform, for states now had the opportunity to expand Medicaid eligibility to larger parts of the uninsured population. Thus, the percentage of uninsured in the United States decreased from over ** percent in 2010 to *** percent in 2022. Who is enrolled in Medicaid?Medicaid enrollment is divided mainly into four groups of beneficiaries: children, adults under 65 years of age, seniors aged 65 years or older, and disabled people. Children are the largest group, with a share of approximately ** percent of enrollees. However, their share of Medicaid expenditures is relatively small, with around ** percent. Compared to that, disabled people, accounting for **** percent of total enrollment, were responsible for **** percent of total expenditures. Around half of total Medicaid spending goes to managed care and health plans.

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.

In 2020, around 66.5 percent of the U.S. population had private health insurance coverage. This share slightly decreased to 65.4 percent in 2023. Medicare and Medicaid together provided healthcare coverage to approximately 38 percent of the population in the United States. U.S. population with and without health insurance In 2022, over half of the U.S. population had health insurance coverage through their place of employment, around 54.5 percent. Approximately 35 percent had coverage through some form of government plan in the same year. While still low, the U.S. population without health insurance has decreased slightly from the previous year. A large portion of those without health insurance are between 19 and 25 years of age. Approximately 15 percent of adults in this age group did not have health insurance in 2021. Health expenditure The United States spent approximately 12,555 U.S. dollars per capita on health in 2022 while in comparison, the Canadian government expended some 6,319 U.S. dollars per capita in the same year. However, higher health spending did not equate to a better health system or outcomes and when ranked with other comparable high-income countries, the U.S. came in last on nearly all health performance categories from access of care to health outcomes.

Data on Medicaid coverage among persons under age 65 by selected population characteristics. Please refer to the PDF or Excel version of this table in the HUS 2019 Data Finder (https://www.cdc.gov/nchs/hus/contents2019.htm) for critical information about measures, definitions, and changes over time. SOURCE: NCHS, National Health Interview Survey, health insurance supplements (1984, 1989, 1994-1996). Starting with 1997, data are from the family core and the sample adult questionnaires. Data for level of difficulty are from the 2010 Quality of Life, 2011-2017 Functioning and Disability, and 2018 Sample Adult questionnaires. For more information on the National Health Interview Survey, see the corresponding Appendix entry at https://www.cdc.gov/nchs/data/hus/hus19-appendix-508.pdf.

DQS Medicaid coverage among persons under age 65, by selected characteristics: United States

  Description

Data on Medicaid coverage among people under age 65, in the United States, by selected population characteristics. Data from Health, United States. SOURCE: National Center for Health Statistics, National Health Interview Survey. Search, visualize, and download these and other estimates from over 120 health topics with the NCHS Data Query System (DQS), available from:… See the full description on the dataset page: https://huggingface.co/datasets/HHS-Official/dqs-medicaid-coverage-among-persons-under-age-65-b.

Big “p” policy changes at the state and federal level are certainly important to health equity, such as eligibility for and generosity of Medicaid benefits. Medicaid expansion has significantly expanded the number of people who are eligible for Medicaid and the creation of the health insurance exchanges (Marketplace) under the Affordable Care Act created a very visible avenue through which people can learn that they are eligible. Although many applications are now submitted online, physical access to state, county, and tribal government Medicaid offices still plays a critical role in understanding eligibility, getting help in applying, and navigating required documentation for both initial enrollment and redetermination of eligibility. However, as more government functions have moved online, in-person office locations and/or staff may have been cut to reduce costs, and gentrification has shifted where minoritized, marginalized, and/or low-income populations live, it is unclear if this key local connection point between residents and Medicaid has been maintained. Our objective was to identify and geocode all Medicaid offices in the United States for pairing with other spatial data (e.g., demographics, Medicaid participation, health care use, health outcomes) to investigate policy-relevant research questions. Three coders identified Medicaid office addresses in all 50 states and the District of Columbia by searching state government websites (e.g., Department of Health and Human Services or analogous state agency) during late 2021 and early 2022 for the appropriate Medicaid agency and its office locations, which were then reviewed for accuracy by a fourth coder. Our corpus of Medicaid office addresses was then geocoded using the Census Geocoder from the US Census Bureau (https://geocoding.geo.census.gov/geocoder/) with unresolved addresses investigated and/or manually geocoded using Google Maps. The corpus was updated in August through December 2023 following the end of the COVID-19 public health emergency by a fifth coder as several states closed and/or combined offices during the pandemic. After deduplication (e.g., where multiple counties share a single office) and removal of mailing addresses (e.g., PO Boxes), our dataset includes 3,027 Medicaid office locations. 1 (December 19, 2023) – original version 2 (January 25, 2024) – added related publication (Data in Brief), corrected two records that were missing negative signs in longitude 3 (February 6, 2024) – corrected latitude and longitude for one office (1340 State Route 9, Lake George, NY 12845) 4 (March 4, 2024) – added one office for Vermont after contacting relevant state agency (280 State Road, Waterbury, VT 05671)

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, 27 percent of Hispanic people in non-Medicaid expansion states were uninsured, this was almost double in comparison to 15 percent in Medicaid expansion states. In general, most ethnic groups are more likely to be uninsured in non-Medicaid expansion states compared to expansion states. This statistic shows the share of population by ethnicity without health insurance in the United States in 2021, by state Medicaid expansion status.

Data on Medicaid coverage among people under age 65, in the United States, by selected population characteristics. Data from Health, United States. SOURCE: National Center for Health Statistics, National Health Interview Survey. Search, visualize, and download these and other estimates from over 120 health topics with the NCHS Data Query System (DQS), available from: https://www.cdc.gov/nchs/dataquery/index.htm.

Although the American Community Survey (ACS) produces population, demographic and housing unit estimates, the decennial census is the official source of population totals for April 1st of each decennial year. In between censuses, the Census Bureau's Population Estimates Program 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..Information about the American Community Survey (ACS) can be found on the ACS website. Supporting documentation including code lists, subject definitions, data accuracy, and statistical testing, and a full list of ACS tables and table shells (without estimates) can be found on the Technical Documentation section of the ACS website.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, 2018-2022 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..When information is missing or inconsistent, the Census Bureau logically assigns an acceptable value using the response to a related question or questions. If a logical assignment is not possible, data are filled using a statistical process called allocation, which uses a similar individual or household to provide a donor value. The "Allocated" section is the number of respondents who received an allocated value for a particular subject..The 2018-2022 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 2020 Census 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.

The number of older individuals – those aged 65 and older – enrolled in the Medicaid health insurance program was projected to be 6.4 million in 2020. Enrollment is expected to increase year-on-year and is forecast to reach eight million by 2027.

Which enrollment group is the largest? The percentage of people covered by Medicaid has notably increased since 2000, and enrollment has accelerated in recent years due to the program’s expansion under the Affordable Care Act. The elderly represent the smallest enrollment group, and this looks set to continue in the coming years. The number of disabled enrollees is projected to grow to nearly twelve million, while children are expected to remain the largest enrollment group.

Combining Medicaid and Medicare Aged individuals can qualify for Medicaid based on their low-income or via another eligibility pathway, such as receiving Supplemental Security Income. Some seniors may also qualify for both Medicaid and Medicare, and these dual-eligible beneficiaries receive a comprehensive range of medical support. Medicare is a health insurance program primarily aimed at individuals aged 65 and older – this group accounted for around 85 percent of all Medicare enrollees in 2019.

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.

Centers for Medicare & Medicaid Services - Nursing HomesThis feature layer, utilizing data from the Centers for Medicare & Medicaid Services (CMS), displays the locations of nursing homes in the U.S. Nursing homes provide a type of residential care. They are a place of residence for people who require constant nursing care and have significant deficiencies with activities of daily living. Per CMS, "Nursing homes, which include Skilled Nursing Facilities (SNFs) and Nursing Facilities (NFs), are required to be in compliance with Federal requirements to receive payment under the Medicare or Medicaid programs. The Secretary of the United States Department of Health & Human Services has delegated to the CMS and the State Medicaid Agency the authority to impose enforcement remedies against a nursing home that does not meet Federal requirements." This layer includes currently active nursing homes, including number of certified beds, address, and other information.Bridgepoint Sub-Acute and Rehab Capitol HillData downloaded: August 1, 2024Data source: Provider InformationData modification: This dataset includes only those facilities with addresses that were appropriately geocoded.For more information: Nursing homes including rehab servicesFor feedback, please contact: ArcGIScomNationalMaps@esri.comCenters for Medicare & Medicaid ServicesPer USA.gov, "The Centers for Medicare and Medicaid Services (CMS) provides health coverage to more than 100 million people through Medicare, Medicaid, the Children’s Health Insurance Program, and the Health Insurance Marketplace. The CMS seeks to strengthen and modernize the Nation’s health care system, to provide access to high quality care and improved health at lower costs."

In 2022, approximately 63 million people in the U.S. were covered by Medicaid, which provides medical coverage to low-income families. This statistic depicts the number of people in the United States covered by Medicaid from 1990 to 2023.

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.

Objective: A one third reduction of premature deaths from non-communicable diseases by 2030 is a target of the United Nations Sustainable Development Goal for Health. Unlike in other developed nations, premature mortality in the United States (US) is increasing. The state of Oklahoma suffers some of the greatest rates in the US of both all-cause mortality and overdose deaths. Medicaid opioids are associated with overdose death at the patient level, but the impact of this exposure on population all-cause mortality is unknown. The objective of this study was to look for an association between Medicaid spending, as proxy measure for Medicaid opioid exposure, and all-cause mortality rates in the 45–54-year-old American Indian/Alaska Native (AI/AN45-54) and non-Hispanic white (NHW45-54) populations.Methods: All-cause mortality rates were collected from the US Centers for Disease Control & Prevention Wonder Detailed Mortality database. Annual per capita (APC) Medicaid spending, and APC Medicare opioid claims, smoking, obesity, and poverty data were also collected from existing databases. County-level multiple linear regression (MLR) analyses were performed. American Indian mortality misclassification at death is known to be common, and sparse populations are present in certain counties; therefore, the two populations were examined as a combined population (AI/NHW45-54), with results being compared to NHW45-54 alone.Results: State-level simple linear regressions of AI/NHW45-54 mortality and APC Medicaid spending show strong, linear correlations: females, coefficient 0.168, (R2 0.956; P < 0.0001; CI95 0.15, 0.19); and males, coefficient 0.139 (R2 0.746; P < 0.0001; CI95 0.10, 0.18). County-level regression models reveal that AI/NHW45-54 mortality is strongly associated with APC Medicaid spending, adjusting for Medicare opioid claims, smoking, obesity, and poverty. In females: [R2 0.545; (F)P < 0.0001; Medicaid spending coefficient 0.137; P < 0.004; 95% CI 0.05, 0.23]. In males: [R2 0.719; (F)P < 0.0001; Medicaid spending coefficient 0.330; P < 0.001; 95% CI 0.21, 0.45].Conclusions: In Oklahoma, per capita Medicaid spending is a very strong risk factor for all-cause mortality in the combined AI/NHW45-54 population, after controlling for Medicare opioid claims, smoking, obesity, and poverty.

Although the American Community Survey (ACS) produces population, demographic and housing unit estimates, for 2020, the 2020 Census provides the official counts of the population and housing units for the nation, states, counties, cities, and towns. For 2016 to 2019, the Population Estimates Program provides estimates of the population for the nation, states, counties, cities, and towns and intercensal housing unit estimates for the nation, 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, 2016-2020 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 2016-2020 American Community Survey (ACS) data generally reflect the September 2018 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.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 2022, just under four in ten Medicaid/CHIP enrollees were White, non-Hispanic. In comparison, roughly three-quarters of Medicare beneficiaries were White. The Affordable Care Act (ACA) Medicaid expansion in 2014, has helped reduce racial disparities in access to healthcare in the United States.

Medicaid eligibility

Medicaid provides health coverage to certain low-income individuals, families, children, pregnant women, the elderly, and persons with disabilities. Each state has its own Medicaid eligibility criteria in accordance with federal guidelines. As a result, Medicaid eligibility and benefits differ widely from state to state. Medicaid expansion provision under the Affordable Care Act (ACA) allows states to provide coverage for low-income adults by expanding eligibility for Medicaid to 138 percent of the federal poverty line (FPL).

Medicaid coverage gap

Uninsured individuals who live in states that have chosen not to expand Medicaid under the Affordable Care Act (ACA) are referred to as being in the Medicaid coverage gap. As of January 2021, 12 states have not adopted the Medicaid expansion provision under the Affordable Care Act (ACA). More than two million uninsured adults fall into this coverage gap, and among them, more than 60 percent are people of color.

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, 2018 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. The 2008 data table in American FactFinder does not incorporate these edits. Therefore, the estimates that appear in these tables are not comparable to the estimates in the 2009 and later tables. 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..When information is missing or inconsistent, the Census Bureau logically assigns an acceptable value using the response to a related question or questions. If a logical assignment is not possible, data are filled using a statistical process called allocation, which uses a similar individual or household to provide a donor value. The "Allocated" section is the number of respondents who received an allocated value for a particular subject..While the 2018 American Community Survey (ACS) data generally reflect the July 2015 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:..An "**" entry in 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..An "-" entry in the estimate column indicates that 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, or the margin of error associated with a median was larger than the median itself..An "-" following a median estimate means the median falls in the lowest interval of an open-ended distribution..An "+" following a median estimate means the median falls in the upper interval of an open-ended distribution..An "***" entry in the margin of error column indicates that the median falls in the lowest interval or upper interval of an open-ended distribution. A statistical test is not appropriate..An "*****" entry in the margin of error column indicates that the estimate is controlled. A statistical test for sampling variability is not appropriate. .An "N" entry in the estimate and margin of error columns indicates that data for this geographic area cannot be displayed because the number of sample cases is too small..An "(X)" means that the estimate is not applicable or not available....