Health Insurance Coverage in the United States: 2020

Current Population Reports

By Katherine Keisler-Starkey and Lisa N. Bunch

Issued September 2021

P60-274
Acknowledgments Katherine Keisler-Starkey and Lisa N. Bunch prepared this report under the 

direction of Laryssa Mykyta, Chief of the Health and Disability Statistics Branch. 

Sharon Stern, Assistant Division Chief for Employment Characteristics, of the 

Social, Economic, and Housing Statistics Division, provided overall direction.

Mallory Bane and Susan S. Gajewski, under the supervision of David Watt, all of 

the Demographic Systems Division, and Lisa Cheok of the Associate Directorate 

for Demographic Programs, processed the Current Population Survey 2021 

Annual Social and Economic Supplement (CPS ASEC) file.

Andy Chen, Kirk E. Davis, Raymond E. Dowdy, Lan N. Huynh, Chandararith R. 

Phe, and Adam W. Reilly programmed and produced the historical, detailed, and 

publication tables under the direction of Hung X. Pham, Chief of the Tabulation 

and Applications Branch, Demographic Surveys Division.

Weimin Zhang and Emily Hood, under the supervision of KeTrena Phipps and 

David V. Hornick, all of the Demographic Statistical Methods Division, conducted 

the statistical review of the data.

Lisa Cheok of the Associate Directorate for Demographic Programs provided 

overall direction for the survey implementation. Roberto Cases and Zakery 

Peterson of the Associate Directorate for Demographic Programs, and Charlie 

Carter and Agatha Jung of the Information Technology Directorate, prepared 

and programmed the computer-assisted interviewing instrument used to conduct 

the CPS ASEC.

Additional people within the U.S. Census Bureau also made significant contributions to the preparation of this report. Amogh Bandekar, Douglas Conway, John 

Creamer, Katrina Crankshaw, Adriana Hernandez-Viver, Matthew Marlay, Amy 

Steinweg, Jonathan Vespa, Susan Walsh, and Natalie Young, all of the Social, 

Economic, and Housing Statistics Division, and Victoria Udalova of the Associate 

Directorate for Demographic Programs, reviewed the contents. 

Stacey Barber, Faye E. Brock, Linda Chen, and Stephen Gibson provided 

publication management, graphic design and composition, editorial review, 

and 508 compliancy for print and electronic media under the direction of 

Christine E. Geter, Acting Chief of the Graphic and Editorial Services Branch, 

Public Information Office. William A. Burbano and George E. Williams of the 

Administrative and Customer Services Division provided printing management. 

Census Bureau field representatives and telephone interviewers collected the 

data under difficult circumstances. The challenge of obtaining interviews during 

the COVID-19 pandemic increased the difficulty of this task. Without the dedication of field representatives and telephone interviewers, the preparation of this 

report or any report from Census Bureau data would be impossible.
U.S. Department of Commerce 

Gina M. Raimondo, 

Secretary

Don Graves, 

Deputy Secretary

U.S. CENSUS BUREAU 

Ron S. Jarmin,

Acting Director

Health Insurance Coverage in 

the United States: 2020 Issued September 2021

P60-274
Suggested Citation 

Katherine Keisler-Starkey and 

Lisa N. Bunch, 

U.S. Census Bureau 

Current Population Reports, 

P60-274, 

Health Insurance Coverage 

in the United States: 2020, 

U.S. Government Publishing Office, 

Washington, DC, 

September 2021.

U.S. CENSUS BUREAU 

Ron S. Jarmin, 

Acting Director

Ron S. Jarmin,

Deputy Director and Chief Operating Officer

Victoria A. Velkoff,

Associate Director for 

Demographic Programs

David G. Waddington, 

Chief, Social, Economic, and 

Housing Statistics Division
U.S. Census Bureau Health Insurance Coverage in the United States: 2020 iii

Contents TEXT

Introduction ................................................. 1

What Is Health Insurance Coverage? ........................... 1

The Impact of the Coronavirus (COVID-19) Pandemic on the 

Current Population Survey Annual Social Economic Supplement 

(CPS ASEC) ............................................... 2

Health Insurance Coverage by Type and Selected 

Characteristics. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

Highlights ................................................ 2

Selected Social Characteristics ............................. 6

Selected Economic Characteristics ......................... 8

Income-to-Poverty Ratio and Medicaid Expansion Status ..... 9

Health Insurance Coverage by Age and Selected 

Characteristics ......................................... 10

Additional Information About Health Insurance Coverage ........ 12

State and Local Estimates of Health Insurance Coverage ...... 12

Additional Data ........................................... 14

Data.census.gov ...................................... 14

Public-Use Microdata ................................. 14

Census Data API ..................................... 14

Source and Accuracy of the Estimates ......................... 14

Comments ............................................... 15

Appendix A. ................................................ 17

Appendix B. Estimates of Health Insurance Coverage: 

2013 to 2020 .............................................. 27

TABLE

Table 1. Number and Percentage of People by Health Insurance 

Coverage Status and Type: 2018 to 2020 ................ 4
iv Health Insurance Coverage in the United States: 2020 U.S. Census Bureau

FIGURES

Figure 1. Percentage of People by Type of Health Insurance Coverage and Change From 2018 to 2020 .... 5

Figure 2. Percentage of People Uninsured by Age Group: 2018 and 2020 ............................... 5

Figure 3. Health Insurance Coverage by Characteristics: 2018 and 2020 ................................. 7

Figure 4. Health Insurance Coverage and Type by Income-to-Poverty Ratio: 2020 ........................ 9

Figure 5. Uninsured Rate by Poverty Status and Medicaid Expansion of State for Adults Aged 19 to 64: 

2018 and 2020 .......................................................................... 10

Figure 6. Percentage of Children Under the Age of 19 Without Health Insurance Coverage by Selected 

Characteristics: 2018 and 2020 ............................................................ 11

Figure 7. Percentage of Working-Age Adults Without Health Insurance Coverage by Selected 

Characteristics: 2018 and 2020 ............................................................ 13

APPENDIX TABLES

Table A-1. Percentage of People by Health Insurance Coverage Status and Type by Selected Characteristics: 

2018, 2019, and 2020 .................................................................. 17

Table A-2. Health Insurance Coverage Status and Type by Age and Selected Characteristics: 

2018, 2019, and 2020 .................................................................. 20

Table A-3. Health Insurance Coverage Status and Type by Family Type and Family Income-to-Poverty 

Ratio: 2018, 2019, and 2020 ............................................................ 23

APPENDIX FIGURES

Figure B-1. Percentage of People Without Health Insurance Coverage: 2013 to 2020 ..................... 28

Figure B-2. Percentage of People With Private Health Insurance Coverage: 2013 to 2020 .................. 29

Figure B-3. Percentage of People With Public Coverage and Medicaid Coverage: 2013 to 2020 ............ 30

Figure B-4. Percentage of People With Medicaid Coverage by Age Group: 2017 to 2020 .................. 31

Figure B-5. Percentage of People With Health Insurance Coverage at Time of CPS ASEC Interview by 

Type: 2019 and 2021 ................................................................... 32
U.S. Census Bureau Health Insurance Coverage in the United States: 2020 1

Health Insurance Coverage in the United States: 2020

INTRODUCTION

Health insurance is a means for 

financing a person’s health care 

expenses. While the majority of 

people have private health insurance, 

primarily through an employer, many 

others obtain coverage through programs offered by state and federal 

governments. Other individuals do 

not have health insurance coverage 

at all (The “What Is Health Insurance 

Coverage?” text box contains more 

information).

Year to year, the rate of health insurance coverage and the distribution of 

coverage types may change due to 

economic trends, shifts in the demographic composition of the population, and policy changes that affect 

access to care. 

This report presents estimates of 

health insurance coverage in the 

United States in 2020, a year in which 

the nation experienced an economic 

recession related to the COVID-19 

global pandemic. The statistics in 

this report are based on information 

collected in the Current Population 

Survey Annual Social and Economic 

Supplement (CPS ASEC).1

The CPS is the longest-running household survey conducted by the Census 

Bureau. The key purpose of the CPS 

ASEC is to provide timely and detailed 

estimates of economic well-being, of 

which health insurance coverage is 

an important component. The Census 

Bureau has integrated improvements 

to the CPS ASEC as the needs of data 

users and the health insurance environment have changed.

1 The U.S. Census Bureau reviewed this data 

product for unauthorized disclosure of confidential information and approved the disclosure 

avoidance practices applied to this release: 

CBDRB-FY21-POP001-0193. 

The 2020 estimates highlighted in this 

report were collected from February 

2021 to April 2021. Respondents 

were asked to report any health 

insurance coverage they had during 

the previous calendar year (2020). 

People are only considered uninsured 

if they had no coverage at any time 

during the year. As a result, people 

who lost coverage during 2020 are 

not included in the uninsured rate.2

2 The CPS ASEC also includes a measure of 

health insurance coverage held at the time of 

the interview. Although this measure of coverage cannot predict coverage in a given calendar 

year, it offers a snapshot of health insurance 

coverage early in the year when CPS ASEC 

data are collected. More information is available 

in Appendix B: Estimates of Health Insurance 

Coverage 2013–2020, Figure B-5.

What Is Health Insurance Coverage?

Health insurance coverage in the Current Population Survey Annual Social 

and Economic Supplement (CPS ASEC) refers to comprehensive coverage 

at any time during the calendar year for the civilian, noninstitutionalized 

population of the United States.* For reporting purposes, the U.S. Census 

Bureau broadly classifies health insurance coverage as private insurance 

or public insurance. 

Private Coverage

• Employment-based: Plan provided through an employer or union.

• Direct-purchase: Coverage purchased directly from an insurance company, or through a federal or state Marketplace (e.g., healthcare.gov).

• TRICARE: Coverage through TRICARE, formerly known as Civilian 

Health and Medical Program of the Uniformed Services.

Public Coverage

• Medicare: Federal program that helps to pay health care costs for 

people aged 65 and older and for certain people under age 65 with 

long-term disabilities.

• Medicaid: This report uses the term Medicaid to include the specific 

Medicaid government program and other programs for low-income 

individuals administered by the states such as Children’s Health 

Insurance Program (CHIP) and Basic Health Programs.

• CHAMPVA or VA: Civilian Health and Medical Program of the 

Department of Veterans Affairs, as well as care provided by the 

Department of Veterans Affairs and the military.

Additionally, people are considered uninsured if they only had coverage 

through the Indian Health Service (IHS), as IHS coverage is not considered comprehensive.

* Comprehensive health insurance covers basic health care needs. This definition excludes 

single service plans such as accident, disability, dental, vision, or prescription medicine plans.
2 Health Insurance Coverage in the United States: 2020 U.S. Census Bureau

Estimates of health insurance coverage for 2019 were collected between 

February and April of 2020, during 

the first months of the COVID-19 

pandemic. In the middle of the collection period, the Census Bureau 

suspended in-person interviews and 

closed telephone contact centers 

to protect the health and safety of 

staff and respondents. Last year’s 

report included an explanation of 

the impact of the coronavirus pandemic on the CPS ASEC.3 In addition, the Census Bureau produced 

several working papers exploring 

how changes in CPS ASEC data collection in 2020 may have affected 

3 More information is available in the 

“The Impact of the Coronavirus (COVID-19) 

Pandemic on the CPS ASEC” text box in the 

report “Health Insurance Coverage in the United 

States: 2019,” <www.census.gov/content/dam

/Census/library/publications/2020/demo

/p60-271.pdf>.

2019 estimates.4 “The Impact of the 

Coronavirus (COVID-19) Pandemic 

on the Current Population Survey 

Annual Social and Economic 

Supplement (CPS ASEC)” text box 

provides more information. The 

Census Bureau recommends that 

users consider the effect of the 

pandemic on CPS ASEC data collection in interpreting changes in health 

insurance coverage between 2019 

and other years using the CPS ASEC.

4 For additional information related to the 

impact of COVID-19 on the 2020 CPS ASEC, 

refer to Edward R. Berchick, Laryssa Mykyta, and 

Sharon M. Stern, “The Influence of COVID-19-

Related Data Collection Changes on Measuring 

Health Insurance Coverage in the 2020 CPS 

ASEC,” <www.census.gov/library/working

-papers/2020/demo/SEHSD-WP2020-13.html>,

 and Jonathan Rothbaum and C. Adam Bee, 

“Coronavirus Infects Surveys, Too: Nonresponse 

Bias During the Pandemic in the CPS ASEC,” 

<www.census.gov/library/working-papers

/2020/demo/SEHSD-WP2020-10.html>.

Estimates for 2018 were collected in 

2019, prior to the pandemic. In order 

to make the most consistent comparisons, the majority of the estimates in 

this report focus on changes in health 

insurance coverage between 2018, 

prior to the pandemic, and 2020. 

More information presenting the 2020 

coverage estimates in the context 

of a longer time frame is available 

in Appendix B: Estimates of Health 

Insurance Coverage 2013–2020. 

HEALTH INSURANCE COVERAGE 

BY TYPE AND SELECTED 

CHARACTERISTICS 

Highlights

• In 2020, 8.6 percent of people, or 

28.0 million, did not have health 

insurance at any point during the 

year (Table 1 and Figure 1).

The Impact of the Coronavirus (COVID-19) Pandemic on the Current Population Survey Annual Social and 

Economic Supplement (CPS ASEC)

The U.S. Census Bureau administers the CPS ASEC each year between February and April by telephone and 

in-person interviews, with the majority of data collected in March. In 2020, data collection faced extraordinary 

circumstances due to the onset of the COVID-19 pandemic as the Census Bureau suspended in-person interviews and closed both telephone contact centers. The response rate for the CPS basic household survey was 73 

percent in March 2020, about 10 percentage points lower than preceding months and the same period in 2019, 

which were regularly above 80 percent. 

During collection of the 2021 CPS ASEC, for the safety of both interviewers and respondents, in-person interviews 

were only conducted when telephone interviews could not be done. In March 2021, the response rate for the CPS 

basic household survey improved to about 76 percent, though not quite returning to the prepandemic trend. 

While the response rate improved, it is important to examine how respondents differ from nonrespondents, as this 

difference could affect income and poverty estimates. Using administrative data, Census Bureau researchers have 

documented that the nonrespondents in both 2020 and 2021 are less similar to respondents than in earlier years. 

Of particular interest, for the estimates in this report, are the differences in median income and educational attainment, indicating that respondents in 2020 and 2021 had relatively higher incomes and were more educated than 

nonrespondents. For more details on how these sample differences and the associated nonresponse bias impact 

income and official poverty estimates, refer to <www.census.gov/newsroom/blogs/research-matters/2021/09

/pandemic-affect-survey-response.html>.
U.S. Census Bureau Health Insurance Coverage in the United States: 2020 3

• The percentage of people with

health insurance coverage for all

or part of 2020 was 91.4 (Table 1).

• In 2020, private health insurance

coverage continued to be more

prevalent than public coverage

at 66.5 percent and 34.8 percent,

respectively.5 Of the subtypes

of health insurance coverage,

employment-based insurance

was the most common, covering

54.4 percent of the population

for some or all of the calendar

year, followed by Medicare (18.4

percent), Medicaid (17.8 percent), direct-purchase coverage

(10.5 percent), TRICARE (2.8

percent), and Department of

Veterans Affairs (VA) or Civilian

Health and Medical Program

of the Department of Veterans

Affairs (CHAMPVA) coverage (0.9

percent) (Table 1 and Figure 1).6 

• Between 2018 and 2020, the

rate of private health insurance

coverage decreased by 0.8 percentage points to 66.5 percent,

driven by a 0.7 percentage-point

decline in employment-based

coverage to 54.4 percent (Table

1 and Figure 1).7 

• Between 2018 and 2020, the rate

of public health insurance coverage increased by 0.4 percentage

5 Some people may have more than one 

coverage type during the calendar year. 6 The final category includes CHAMPVA 

coverage and care provided by the VA and the 

military. 7 All comparative statements in this report 

have undergone statistical testing, and unless 

otherwise noted, all comparisons are statistically significant at the 90 percent confidence 

level. Standard errors used in statistical testing 

and margins of errors presented in tables reflect 

the use of replicate weights to account for the 

complex sampling design of the CPS ASEC.

points to 34.8 percent (Table 1 

and Figure 1).8, 9 

• In 2020, 87.0 percent of full-time,

year-round workers had private

insurance coverage, up from

85.1 percent in 2018. In contrast,

those who worked less than fulltime, year-round were less likely

to be covered by private insurance in 2020 than in 2018 (68.5

percent in 2018 and 66.7 percent

in 2020) (Figure 3).10

• More children under the age of 19

in poverty were uninsured in 2020

than in 2018. Uninsured rates

for children under the age of 19

in poverty rose 1.6 percentage

points to 9.3 percent (Figure 6).

This report classifies health insurance 

coverage into three different groups: 

overall coverage, private coverage, 

and public coverage (The “What Is 

Health Insurance?” text box contains 

more information). In the CPS ASEC, 

people are considered to be insured 

if they were covered by any type of 

health insurance for part or all of the 

previous calendar year. People are 

considered uninsured if, for the entire 

year, they were not covered by any 

type of insurance.11

8 This increase was due to growth in the 

number of people aged 65 and older. The 

proportion of the population 65 years and older 

with Medicare coverage decreased between 

2018 and 2020, from 93.9 percent to 93.5 percent. However, the percentage of the U.S. population 65 years and older increased between 

2018 and 2020. 9 Throughout this report, details may not 

sum to totals because of rounding. 10 In this report, a full-time, year-round 

worker is a person who worked 35 or more 

hours per week (full-time) and 50 or more 

weeks during the previous calendar year (yearround). For school personnel, summer vacation 

is counted as weeks worked if they are scheduled to return to their job in the fall. 11 Infants born after the calendar-year reference period are excluded from estimates in 

this report, with the exception of estimates of 

coverage at the time of interview (Appendix B, 

Figure B-5).

In 2020, most people (91.4 percent) 

had health insurance coverage at 

some point during the calendar year 

(Table 1 and Figure 1). More people 

had private health insurance (66.5 

percent) than public coverage (34.8 

percent).

Employment-based insurance was 

the most common subtype of health 

insurance (54.4 percent), followed by 

Medicare (18.4 percent), Medicaid 

(17.8 percent), direct-purchase 

insurance (10.5 percent), TRICARE 

(2.8 percent), and VA/CHAMPVA 

health care (0.9 percent) (Table 1 and 

Figure 1).

The percentage of people covered 

by any type of health insurance in 

2020 was not significantly different than the percentage in 2018. 

Although this result seems counter 

to reports of coverage loss during 

the COVID-19 pandemic, the CPS 

ASEC measures coverage in calendar year 2020 based on whether an 

individual had coverage for all or 

part of the year during 2020. For 

example, a person who held coverage in January 2020, but became 

uninsured later in the year during the 

COVID-19 pandemic, would still be 

considered insured in 2020 using the 

CPS ASEC. Further, individuals losing one type of coverage may also 

purchase or be eligible for another 

type of health coverage. People 

who lose employment-based coverage through job loss might access 

coverage through the Marketplace, 

purchase it directly, or they may 

be eligible for medical assistance 

through federal and state programs 

such as Medicaid. 
4 Health Insurance Coverage in the United States: 2020 U.S. Census Bureau Table 1. Number and Percentage of People by Health Insurance Coverage Status and Type: 2018 to 2020 (Numbers in thousands. Margins of error in thousands or percentage points as appropriate. Population as of March of the following year. Information on confide

nonsampling error, and definitions is available at <https://www2.census.gov /programs-surveys/cps/techdocs/cpsmar21.pdf>) Coverage type 2018 2019 2020 

Number 

Margin of error1 (±) Percent Margin of error1 (±) Number Margin of error1 (±) Percent Margin of error1 (±) Number Margin of error1 (±) Perce

Total ..................... Any health plan ...................  Any private plan2, 3 ................   Employment-based2 ............   Direct-purchase2 ................    Marketplace coverage2 ........   TRICARE2 ......................  Any public plan2, 4. . . . . . . . . . . . . . . . .   Medicare2 ......................   Medicaid2 ......................   VA or CHAMPVA2, 5 .............. Uninsured6 ....................... 323,668 296,206 217,780 178,350 34,846 10,743 8,537 111,330 57,720 57,819 3,217 27,462 133 641 1,222 1,283 647 428 508 962 401 891 182 630 X 91.5 67.3 55.1 10.8 3.3 2.6 34.4 17.8 17.9 1.0 8.5 X0.2 0.4 0.4 0.2 0.1 0.2 0.3 0.1 0.3 0.1 0.2 324,550 298,438 220,848 183,005 33,170 9,716 8,534 110,687 58,779 55,851 3,221 26,111 132 688 1,121 1,142 776 417 522 967 409 927 188 657 X 92.0 68.0 56.4 10.2 3.0 2.6 34.1 18.1 17.2 1.0 8.0 X0.2 0.3 0.4 0.2 0.1 0.2 0.3 0.1 0.3 0.1 0.2 325,638 297,680 216,532 177,175 34,041 10,804 9,183 113,337 59,844 57,921 2,979 27,957 153 638 1,166 1,070 653 439 579 923 393 893 175 612 

965

1

3

11

* Changes between the estimates are statistically different from zero at the 90 percent confidence level. X Not applicable. Z Rounds to zero. 1 A margin of error (MOE) is a measure of an estimate’s variability. The larger the MOE in relation to the size of the estimate, the less reliable the estimate. This number, when added to 

the 90 percent confidence interval. MOEs shown in this table are based on standard errors calculated using replicate weights. 2 The estimates by type of coverage are not mutually exclusive; people can be covered by more than one type of health insurance during the year. 3 Private health insurance includes coverage provided through an employer or union, coverage purchased directly, or TRICARE. 4 Public health insurance coverage includes Medicaid, Medicare, CHAMPVA (Civilian Health and Medical Program of the Department of Veterans Affairs), and care provided by the Dep

5 Includes CHAMPVA, as well as care provided by the Department of Veterans Affairs and the military. 6 In the CPS ASEC, individuals are considered to be uninsured if they do not have health insurance coverage for the entire calendar year. Source: U.S. Census Bureau, Current Population Survey, 2019 to 2021 Annual Social and Economic Supplement (CPS ASEC).
U.S. Census Bureau Health Insurance Coverage in the United States: 2020 5

* Denotes a statistically signficant change between 2018 and 2020 at the 90 percent confidence level.

Z Rounds to zero.

1

 Includes CHAMPVA (Civilian Health Medical Program of the Department of Veterans Aairs), as well as care provided by 

the Department of Veterans Aairs (VA) and the military.

Note: The estimates by type of coverage are not mutually exclusive: people can be covered by more than one type of health insurance 

during the year. Information on confidentiality protection, sampling error, nonsampling error, and definitions in the Current Population 

Survey is available at <https://www2.census.gov/programs-surveys/cps/techdocs/cpsmar21.pdf>.

Source: U.S. Census Bureau, Current Population Survey, 2019 and 2021 Annual Social and Economic Supplement (CPS ASEC).

Figure 1.

Percentage of People by Type of Health Insurance Coverage and Change From 2018 to 2020

 VA and CHAMPVA1

 Medicaid

 Medicare

Any Public Plan

 TRICARE

 Marketplace

 Direct-purchase

 Employment-based

Any Private Plan

With health insurance

Uninsured

Type of Coverage in 2020 Change: 2018 to 2020

(Population as of March of the following year)

No statistical change between years

8.6 +0.1

–0.1

*–0.8

*–0.7

*–0.3

 Z

*+0.2

*+0.4

*+0.5

 –0.1

*–0.1

91.4

66.5

54.4

10.5

3.3

2.8

34.8

18.4

17.8

0.9

Figure 2.

Percentage of People Uninsured by Age Group: 2018 and 2020

(Population as of March of the following year)

2018

5.5 5.6

14.3 14.4

12.5 12.4

9.3 9.6

13.9 14.2

0.9 1.0

2020

 

Note: There were no significant changes between 2018 and 2020 at the 90 percent confidence level. Information on confidentiality protection, 

sampling error, nonsampling error, and definitions in the Current Population Survey is available at <https://www2.census.gov/programs-surveys

/cps/techdocs/cpsmar21.pdf>.

Source: U.S. Census Bureau, Current Population Survey, 2019 and 2021 Annual Social and Economic Supplement (CPS ASEC).

Under age 19 Aged 19 to 25 Aged 26 to 34 Aged 35 to 44 Aged 45 to 64 Aged 65 or older 
6 Health Insurance Coverage in the United States: 2020 U.S. Census Bureau

Between 2018 and 2020, of the 

subtypes of private health insurance, employment-based coverage and direct-purchase insurance 

decreased, while TRICARE increased. 

The percentage of people covered 

by employment-based insurance and 

direct-purchase insurance decreased 

by 0.7 percentage points to 54.4 

percent and by 0.3 percentage points 

to 10.5 percent, respectively, in 2020. 

TRICARE coverage increased by 0.2 

percentage points to 2.8 percent in 

2020 (Table 1 and Figure 1). 

Additionally, the percentage of 

people covered by a public health 

insurance plan increased between 

2018 and 2020 to 34.8 percent (Table 

1 and Figure 1). Of the three subtypes of public health insurance, only 

the Medicare rate increased between 

2018 and 2020. The percentage 

of people covered by Medicare 

increased by 0.5 percentage points 

to 18.4 percent in 2020. This increase 

in coverage was partly due to growth 

in the number of people aged 65 and 

older. The Medicaid rate in 2020 was 

17.8 percent, which was not statistically different from 2018.

Age is associated with the likelihood 

that a person has health insurance 

coverage. Older adults (those over 

the age of 65) and children (those 

under the age of 19) are more likely 

to have health insurance coverage 

than those aged 19 to 64, in part 

because their age makes them eligible for certain public health insurance programs. Medicare provides 

health coverage benefits for most 

adults aged 65 and older. Children 

under the age of 19 may qualify for 

coverage through Medicaid or the 

Children’s Health Insurance Program 

(CHIP), and young adults may receive 

coverage through a parent or guardian’s plan until the age of 26.12

In 2020, 1.0 percent of adults aged 

65 and older were uninsured for the 

entire calendar year, while 5.6 percent of children under the age of 19 

were uninsured in the same period. 

Among working-age adults, the age 

group with the largest percentage 

uninsured for the entirety of calendar year 2020 was those aged 19 to 

25 (14.4 percent), followed by those 

aged 26 to 34 (14.2 percent), adults 

aged 35 to 44 (12.4 percent), and 

those aged 45 to 64 (9.6 percent) 

(Figure 2).13 Between 2018 and 2020, 

there were no significant changes in 

the uninsured rate by age groups.

Selected Social Characteristics

The CPS ASEC can also be used to 

look at the prevalence and type of 

health insurance coverage across 

certain social and economic characteristics, as well as changes in coverage across race and Hispanic origin 

groups. 

Overall, Hispanics had the highest uninsured rate (18.3 percent) 

in 2020, followed by Blacks (10.4 

percent), Asians (5.9 percent), and 

12 CHIP is a public program that provides 

health insurance to children in families with 

income too high to qualify for Medicaid, but 

who are likely unable to afford private health 

insurance. 13 In 2020, the uninsured rate of individuals 

aged 19 to 25 was not statistically different from 

the uninsured rate of individuals aged 26 to 34.

non-Hispanic Whites (5.4 percent) 

(Table A-1).14, 15, 16

In 2020, Blacks had the highest 

rate of public coverage (41.4 percent) followed by Hispanics (35.9 

percent), non-Hispanic Whites 

(33.8 percent), and Asians (27.0 

percent). In the same year, nonHispanic Whites had the highest rate 

of private coverage (73.9 percent), 

followed by Asians (72.4 percent), 

Blacks (54.6 percent), and Hispanics 

(49.9 percent) (Figure 3).

14 Federal surveys give respondents the 

option of reporting more than one race. 

Therefore, two basic ways of defining a race 

group are possible. A group, such as Asian, may 

be defined as those who reported Asian and no 

other race (the race-alone or single-race concept) or as those who reported Asian, regardless of whether they also reported another race 

(the race-alone-or-in-combination concept). The 

body of this report (text, figures, and tables) 

shows data using the first approach (race 

alone). Use of the single-race population does 

not imply that it is the preferred method of presenting or analyzing data. The Census Bureau 

uses a variety of approaches. Data for American 

Indians and Alaska Natives, Native Hawaiians 

and Other Pacific Islanders, and those reporting 

two or more races are not shown separately. 

In this report, the term “non-Hispanic White” 

refers to people who are not Hispanic and 

who reported White and no other race. The 

Census Bureau uses non-Hispanic Whites as the 

comparison group for other race groups and 

Hispanics.

Because Hispanic people may be any race, 

data in this report for Hispanic people overlap with data for racial groups. Of those who 

reported only one race, 16.0 percent of White 

householders, 5.3 percent of Black householders, and 2.7 percent of Asian householders 

also reported being Hispanic. 

Data users should exercise caution when 

interpreting aggregate results for the Hispanic 

population and for race groups because these 

populations consist of many distinct groups that 

differ in socioeconomic characteristics, culture, 

and recency of immigration. Data were first collected for Hispanic people in 1972. 15 The small sample size of the Asian population and the fact that the CPS ASEC does not 

use separate population controls for weighting 

the Asian sample to national totals contributes 

to the large variances surrounding estimates 

for this group. As a result, the CPS ASEC may 

be unable to detect statistically significant differences between some estimates for the Asian 

population. 16 In 2020, the uninsured rate of non-Hispanic 

Whites was not statistically different from the 

uninsured rate of Asians.
U.S. Census Bureau Health Insurance Coverage in the United States: 2020 7

 Total

Race and Hispanic Origin1

White, not Hispanic

Black

Asian

Hispanic (any race)

Income-to-Poverty Ratio

Poverty universe2

Below 100% of poverty

Between 100% and

399% of poverty

At or above 400% of

poverty

Work Experience

 Aged 15 to 64

All workers

Worked full-time, 

year-round

Worked less than 

full-time, year-round

Did not work

Marital Status

Aged 19 to 64

Married

Not married

Medicaid Expansion Status3

Expansion state

Nonexpansion state

Figure 3.

Health Insurance Coverage by Characteristics: 2018 and 2020

(Population as of March of the following year)

1 Federal surveys give respondents the option of reporting more than one race. This figure shows data using the race-alone concept. 

For example, “Asian” refers to people who reported Asian and no other race.

2 The poverty universe excludes unrelated individuals under the age of 15 such as foster children.

3 Medicaid expansion status as of January 1, 2020, for 2020 data. Medicaid expansion status as of January 1, 2018, for 2018 data. 

Expansion states on or before January 1, 2018, include AK, AR, AZ, CA, CO, CT, DC, DE, HI, IA, IL, IN, KY, LA, MA, MD, MI, MN, MT, ND, NH, NJ, 

NM, NV, NY, OH, OR, PA, RI, VT, WA, and WV. After January 1, 2018, and on or before January 1, 2020, ID, ME, UT, and VA 

expanded Medicaid. More information is available at <www.medicaid.gov/state-overviews/index.html>.

Note: The estimates by type of coverage are not mutually exclusive: people can be covered by more than one type of health insurance 

during the year. Information on confidentiality protection, sampling error, nonsampling error, and definitions in the Current Population 

Survey is available at <https://www2.census.gov/programs-surveys/cps/techdocs/cpsmar21.pdf>.

Source: U.S. Census Bureau, Current Population Survey, 2019 and 2021 Annual Social and Economic Supplement (CPS ASEC).

Percent 

 2018 2020 2018 2020

Public Private

0 10 20 30 40 50 60 70 80 90 100

No statistical change between years
8 Health Insurance Coverage in the United States: 2020 U.S. Census Bureau

Non-Hispanic Whites experienced 

changes in health insurance status 

between 2018 and 2020. Specifically, 

private coverage decreased by 0.9 

percentage points to 73.9 percent, 

and public coverage increased by 0.6 

percentage points to 33.8 percent 

in 2020. In contrast, there was no 

significant change in either private or 

public coverage between 2018 and 

2020 for Hispanics of any race, Blacks, 

or Asians.

Selected Economic Characteristics

For many adults aged 15 to 64, health 

insurance coverage is related to work 

status such as working full-time, yearround, working less than full-time, 

year-round, or not working at all during the calendar year. Workers were 

more likely than nonworkers to be 

covered by private health insurance. 

In 2020, 87.0 percent of full-time, 

year-round workers were covered 

through a private insurance plan, 

compared with 66.7 percent of those 

working less than full-time, yearround. Those who did not work were 

the least likely to have private health 

insurance coverage, at 52.2 percent 

(Figure 3 and Table A-2).

Overall, between 2018 and 2020, 

workers' private coverage declined 

by approximately 0.7 percentage 

points. However, this decrease was 

not equal across all types of workers. 

For example, the percentage of fulltime, year-round workers with private 

coverage increased by 1.9 percentage points, while private insurance 

coverage rates for those who worked 

less than full-time, year-round 

decreased by 1.9 percentage points. 

There was no statistical change in 

private coverage for nonworkers 

between 2018 and 2020.

Rates of public coverage followed a 

different pattern. Nonworkers were 

more likely than those working less 

than full-time, year-round to have 

public coverage (39.1 percent of nonworkers versus 20.9 percent of less 

than full-time, year-round workers). 

Full-time, year-round workers were 

the least likely to have public coverage, at 6.1 percent. In 2020, public 

insurance coverage rates decreased 

by 1.0 percentage point for full-time, 

year-round workers and 1.0 percentage point for nonworkers compared 

to 2018. 

Many adults obtain health insurance 

coverage through their spouses, 

and, therefore, health insurance 

coverage is related to marital status. 

Adults aged 19 to 64 who were not 

married were less likely to have private health insurance than married 

adults (63.6 percent and 82.1 percent, respectively). There were no 

changes in private or public health 

insurance rates between 2018 and 

2020 for either married or unmarried 

people (Figure 3 and Table A-2).17

Health insurance coverage and type 

is also associated with family incometo-poverty ratio, which provides 

a measure of a family’s economic 

resources.18 Family resources may 

determine the ability to afford private 

health insurance, and families below 

certain income-to-poverty thresholds may qualify for public health 

insurance options. Figure 4 shows 

the public coverage rate, private 

coverage rate, and uninsured rate for 

individuals based on their family’s 

income-to-poverty ratio in 2020.

17 Unmarried people include those who were 

never married, as well as those who are widowed, divorced, or separated. For estimates of 

health coverage for each of these groups, refer 

to Appendix Table A-2. 18 The Office of Management and Budget 

(OMB) determined the official definition of poverty in Statistical Policy Directive 14. Appendix 

B of the report, “Income and Poverty in the 

United States: 2020,” provides a more detailed 

description of how the Census Bureau calculates 

poverty. More information is available at 

<www.census.gov/content/dam/Census 

/library/publications/2021/demo/p60-273.pdf>.

For private insurance, those living 

in poverty are the least likely to have 

private insurance (23.2 percent), and 

each group with a higher incometo-poverty ratio has a higher rate of 

private insurance. Those living at or 

above 400 percent of the poverty 

line are the most likely to have private health insurance (88.2 percent) 

(Figure 4).

In contrast, those living in poverty are 

the most likely to have public insurance (64.3 percent), while those living 

at or above 400 percent of the poverty line are the least likely to have 

public health insurance (19.1 percent). The percentage of people with 

public insurance decreases as the 

income-to-poverty ratio increases.

As the income-to-poverty ratio 

increases, the percentage of uninsured declines. Those in poverty have 

the highest rate of people uninsured 

for the full calendar year (17.2 percent), while those living at or above 

400 percent of the poverty line have 

the lowest rate of people uninsured for all of 2020 (3.4 percent). 

Other income-to-poverty groups fall 

between these rates, and those with 

higher income-to-poverty ratios are 

less likely to be uninsured.

Changes in health insurance coverage by type were not distributed 

equally across income-to-poverty 

ratio groups. For example, people 

with an income-to-poverty ratio 

between 100 and 399 percent and 

those at or above 400 percent of 

poverty increased their rates of public insurance use between 2018 and 

2020 (by 2.2 percentage points and 

0.6 percentage points, respectively) 

(Figure 3). 

In contrast, between 2018 and 2020, 

rates of private insurance decreased 

for people with an income-to-poverty 

ratio between 100 and 399 percent 
U.S. Census Bureau Health Insurance Coverage in the United States: 2020 9

of poverty and those at or above 400 

percent of poverty (by 2.9 percentage points and 1.0 percentage point, 

respectively). However, those in poverty saw an increase in private health 

coverage by 1.3 percentage points 

(Figure 3). 

Income-to-Poverty Ratio and 

Medicaid Expansion Status 

The Patient Protection and 

Affordable Care Act provided the 

option for states to expand Medicaid 

eligibility to adults whose income-topoverty ratio fell under 138 percent 

of the poverty line.19 As of January 

1, 2020, 35 states and the District of 

Columbia had expanded Medicaid 

19 In 2020, the Medicaid income eligibility threshold for adults under the age of 65 in 

the District of Columbia was 221 percent of 

the poverty line. More information is available 

in “Medicaid and CHIP Eligibility, Enrollment, 

and Cost Sharing Policies as of January 2020: 

Findings From a 50-state Survey,” 

<https://files.kff.org/attachment/Report 

-Medicaid-and-CHIP-Eligibility,-Enrollment-and

-Cost-Sharing-Policies-as-of-January-2020.pdf>.

eligibility (“expansion states”); 15 

states had not expanded Medicaid 

eligibility (“non-expansion states”).20

The uninsured rate in 2020 varied by 

state Medicaid expansion status. In 

2020, among adults aged 19 to 64, 

those in expansion states had lower 

20 The 35 states and the District of Columbia 

that expanded Medicaid eligibility on or before 

January 1, 2020, include AK, AR, AZ, CA, CO, 

CT, DC, DE, HI, IA, ID, IL, IN, KY, LA, MA, MD, 

ME, MI, MN, MT, ND, NH, NJ, NM, NV, NY, OH, 

OR, PA, RI, UT, VA, VT, WA, and WV. More information is available at <www.medicaid.gov 

/state-overviews/index.html>.

Figure 4.

Health Insurance Coverage and Type by Income-to-Poverty Ratio: 2020 

66.6

23.2

39.6

60.3

72.0

88.2

34.7

64.3

56.9

38.8

29.4

19.1

8.6

17.2

13.3

11.9

3.4

8.9

(Population as of March of the following year)

1 The poverty universe excludes unrelated individuals under the age of 15 such as foster children.

Note: The estimates by type of coverage are not mutually exclusive; people can be covered by more than one type of health insurance 

during the year. Information on confidentiality protection, sampling error, nonsampling error, and definitions is available

at <https://www2.census.gov/programs-surveys/cps/techdocs/cpsmar21.pdf>.

Source: U.S. Census Bureau, Current Population Survey, 2021 Annual Social and Economic Supplement (CPS ASEC).

Private

At or above 400% of poverty

Between 300% and 399% of poverty

Between 200% and 299% of poverty

Between 100% and 199% of poverty

Below 100% of poverty

Poverty universe1

Uninsured

At or above 400% of poverty

Between 300% and 399% of poverty

Between 200% and 299% of poverty

Between 100% and 199% of poverty

Below 100% of poverty

Poverty universe1

Public

At or above 400% of poverty

Between 300% and 399% of poverty

Between 200% and 299% of poverty

Between 100% and 199% of poverty

Below 100% of poverty

Poverty universe1
10 Health Insurance Coverage in the United States: 2020 U.S. Census Bureau

uninsured rates (8.9 percent) than 

those in nonexpansion states (17.6 

percent) (Figure 5).

Further, the relationship between 

poverty status, health insurance 

coverage in 2020, and the change 

in coverage between 2018 and 2020 

may be related to an individual’s 

state of residence and whether that 

state expanded Medicaid eligibility 

(Figure 5).

Uninsured rates were lower for all 

income-to-poverty groups in expansion states than in nonexpansion 

states. For people in families living in 

poverty in nonexpansion states, there 

was a 2.6 percentage-point increase 

in the uninsured rate, to 38.1 percent 

between 2018 and 2020, while there 

was no statistically significant change 

in the uninsured rate for those in 

poverty in expansion states.21 Among 

people with family income between 

100 and 399 percent of poverty, 23.0 

percent of people in nonexpansion 

states did not have health insurance 

for the full year, representing a 1.8 

percentage-point increase in the percentage of uninsured from 2018. For 

the same group in expansion states, 

there was a 1.1 percentage-point 

21 Between 2018 and 2020, the change in 

the uninsured rate of people in poverty living in 

expansion states was not statistically different 

from the change in the uninsured rate of people 

in poverty living in nonexpansion states.

increase in the percentage of uninsured to 13.8 percent. For all other 

income-to-poverty groups, there was 

no significant change in the uninsured 

rate between 2018 and 2020.

Health Insurance Coverage by Age 

and Selected Characteristics

In 2020, 5.6 percent of children under 

the age of 19 did not have health 

insurance coverage, which was not 

statistically different from 2018 

(Figure 6). Examining coverage by 

children’s characteristics reveals that 

changes in health insurance coverage between 2018 and 2020 did not 

occur equally across groups. 

* Denotes a statistically significant change between 2018 and 2020 at the 90 percent confidence level.

Z Rounds to zero.

1

 Medicaid expansion status as of January 1, 2020, for 2020 data. Medicaid expansion status as of January 1, 2018, for 2018 data. 

Expansion states on or before January 1, 2018, include AK, AR, AZ, CA, CO, CT, DC, DE, HI, IA, IL, IN, KY, LA, MA, MD, MI, MN, MT, ND, NH, NJ, 

NM, NV, NY, OH, OR, PA, RI, VT, WA, and WV. After January 1, 2018, and on or before January 1, 2020, ID, ME, UT, and VA expanded Medicaid. 

More information is available at <www.medicaid.gov/state-overviews/index.html>.

Note: Information on confidentiality protection, sampling error, nonsampling error, and definitions, is available 

at <https://www2.census.gov/programs-surveys/cps/techdocs/cpsmar21.pdf>. 

Source: U.S. Census Bureau, Current Population Survey, 2019 and 2021 Annual Social and Economic Supplement (CPS ASEC).

Figure 5.

Uninsured Rate by Poverty Status and Medicaid Expansion of State for Adults Aged 19 to 64: 

2018 and 2020

Percentage-Point Change in Uninsured Rate Between 2018 and 2020

16.9 16.7

2.6*

1.8*

Z

0.9*

–0.1

1.1*

0.2 0.3

12.7 13.8

35.6 38.1

21.2 23.0

16.7 17.6

6.2 6.3

3.5 3.7

8.6 8.9

At or above Total*

400% of 

poverty

Between 

100% and

399% of 

poverty*

Below 

100% of 

poverty*

At or above Total

400% 

of poverty

Between

 100% and 

399% 

of poverty*

Below 

100% of 

poverty

2018 2020 Expansion States1

2018 2020 Nonexpansion States1

(Population as of March of the following year, adults aged 19 to 64)
U.S. Census Bureau Health Insurance Coverage in the United States: 2020 11

Figure 6.

Percentage of Children Under the Age of 19 Without Health Insurance Coverage by Selected 

Characteristics: 2018 and 2020 

2020 

2018 5.6

5.5

 5.6

5.5

 7.0

6.7

 5.2

5.1

 7.7

 7.7

 4.9

 4.8

 4.0

3.9

 8.5

7.9

 4.4

3.8

 3.3

 3.6

 2.2

 2.6

 3.8

 4.2

 7.6

 8.6

 2.8

 4.1

 9.3

7.8

 9.5

8.7

 17.8

15.9

 6.0

4.6

 20.9

 18.3

(Population as of March of the following year, children under age 19)

* Denotes a statistically significant change between 2018 and 2020 at the 90 percent confidence level. 

1 The poverty universe excludes unrelated individuals under the age of 15 such as foster children.

2 Federal surveys give respondents the option of reporting more than one race. This figure shows data using the race-alone concept. 

For example, “Asian” refers to people who reported Asian and no other race.

3 Medicaid expansion status as of January 1, 2020, for 2020 data. Medicaid expansion status as of January 1, 2018, for 2018 data.

Expansion states on or before January 1, 2018, include AK, AR, AZ, CA, CO, CT, DC, DE, HI, IA, IL, IN, KY, LA, MA, MD, MI, MN, MT, ND, 

NH, NJ, NM, NV, NY, OH, OR, PA, RI, VT, WA, and WV. After January 1, 2018, and on or before January 1, 2020, ID, ME, UT, and VA 

expanded Medicaid. More information is available at <www.medicaid.gov/state-overviews/index.html>.

Note: Information on confidentiality protection, sampling error, nonsampling error, and definitions is available at 

<https://www2.census.gov/programs-surveys/cps/techdocs/cpsmar21.pdf>.

Source: U.S. Census Bureau, Current Population Survey, 2019 and 2021 Annual Social and Economic Supplement (CPS ASEC).

Nonexpansion state

Expansion state

Medicaid Expansion Status3

West

South

Midwest

Northeast

Region

Noncitizen

Naturalized citizen

Foreign-born

Native-born citizen

Nativity

Hispanic (any race)

Asian*

Black*

White, not Hispanic

Race and Hispanic Origin2

At or above 400% of poverty*

Between 100% and 399% of poverty

Below 100% of poverty*

Poverty universe1

Income-to-Poverty Ratio

Total
12 Health Insurance Coverage in the United States: 2020 U.S. Census Bureau

Among children living in poverty, 9.3 

percent did not have health insurance 

at any time in 2020, representing an 

increase of 1.6 percentage points 

since 2018. For children in families 

at or above 400 percent of poverty, 

the uninsured rate decreased by 0.4 

percentage points, to 2.2 percent. In 

2020, 7.0 percent of children between 

100 and 399 percent of poverty did 

not have health insurance, which is 

not statistically different from 2018. 

In both years, the percentage of 

children without health insurance 

coverage decreased as the incometo-poverty ratio increased.

The percentage of non-Hispanic 

White children without health insurance coverage was not statistically 

different in 2020 compared with 

2018. However, the uninsured rate 

decreased for Asian children (by 1.4 

percentage points) and increased 

for Black children (by 1.4 percentage points), to 2.8 percent and 6.0 

percent, respectively. In 2020, 9.5 

percent of Hispanic children were 

uninsured, which is not statistically 

different from 2018.

In 2020, 5.2 percent of children born 

in the United States were uninsured. 

However, among foreign-born children, 17.8 percent were uninsured, 

including 7.6 percent of children 

who were naturalized citizens and 

20.9 percent of children who were 

not citizens.22

Health insurance rates for children 

varied by region as well.23 For example, 7.7 percent of children living in 

the South were uninsured, while the 

uninsured rates for children in the 

22 In 2020, the uninsured rate of native-born 

children under the age of 19 was not statistically 

different from the uninsured rate of naturalized 

citizen children. 23 For information about how the Census 

Bureau classifies regions, refer to 

<https://www2.census.gov/geo/pdfs/maps 

-data/maps/reference/us_regdiv.pdf>.

Northeast (3.3 percent), Midwest 

(4.4 percent), and West (4.9 percent) 

were lower.24

Health insurance rates varied for children who lived in expansion states 

compared to those who lived in 

nonexpansion states (4.0 percent and 

8.5 percent, respectively).

Health insurance outcomes for 

working -age adults aged 19 to 64 

may differ from those in other age 

groups because they do not qualify 

for certain programs, such as CHIP, 

and only qualify for Medicare under 

limited circumstances. In 2020, 11.9 

percent of working-age adults (aged 

19 to 64) did not have health insurance coverage, which was not statistically different from 2018 (Figure 7). 

The uninsured rate for noncitizen 

adults aged 19 to 64 increased 2.2 

percentage points between 2018 

and 2020. In 2020, 33.8 percent of 

working-age noncitizens did not have 

health insurance, which is higher than 

foreign-born adults (22.9 percent), 

naturalized citizen adults (10.7 percent), and native-born adults (9.6 

percent).

The uninsured rate decreased by 1.1 

percentage points for working-age 

adults who worked full-time, yearround, from 9.5 percent in 2018 to 

8.4 percent in 2020. However, the 

uninsured rate increased by 1.8 

percentage points for working-age 

adults who worked less than fulltime, year-round to 16.4 percent.

Among working-age adults in 2020, 

those who were separated (20.2 percent), never married (16.0 percent), 

divorced (13.2 percent), or widowed 

(12.1 percent) were more likely to be 

24 In 2020, the uninsured rate of children 

living in the West was not statistically different 

from the uninsured rate of children living in the 

Midwest.

uninsured than those who were married (8.5 percent).25

Health insurance rates for workingage adults also varied by region. For 

example, 11.3 percent of adults living 

in the West in 2020 were uninsured, 

a 0.8 percentage-point increase from 

2018. There was no significant change 

in uninsured rates for working-age 

adults in other regions.

ADDITIONAL INFORMATION 

ABOUT HEALTH INSURANCE 

COVERAGE

State and Local Estimates of Health 

Insurance Coverage

Since the CPS ASEC produces thorough and timely estimates of income, 

poverty, and health insurance, the 

Census Bureau recommends that 

people use it as the data source for 

national estimates. However, the 

Census Bureau also publishes annual 

estimates of health insurance coverage by state and other smaller 

geographic units based on data collected in the American Community 

Survey (ACS). Single-year estimates 

are available for geographic units 

with populations of 65,000 or more. 

Five-year estimates are available for 

all geographic units, including census 

tracts and block groups. 

Due to the impact of the pan demic 

on data collection, the standard 

1-year estimates from the 2020 

ACS will not be released. However, 

the Census Bureau plans to release 

experimental estimates developed 

from the 2020 ACS 1-year data later 

this year in the form of a limited 

number of data tables for limited 

geographies. 

25 In 2020, the uninsured rate of divorced 

adults aged 19 to 64 was not statistically different from the uninsured rate of widowed adults 

aged 19 to 64.
U.S. Census Bureau Health Insurance Coverage in the United States: 2020 13

Nonexpansion state*

Expansion state

Medicaid Expansion Status2

West*

South

Midwest

Northeast

Region

Never married

Separated

Divorced

Widowed

Married

Marital Status

Did not work

Worked less than full-time, full-year*

Worked full-time, full-year*

All workers

Work Experience

Noncitizen*

Naturalized citizen

Foreign-born

Native-born

Nativity

Hispanic (any race)

Asian

Black

White, not Hispanic

Race and Hispanic Origin1

Total 11.9

11.7

7.7

7.6

9.6

9.3

11.1

10.8

 8.5

8.3

 13.2

13.0

 20.2

19.9

16.0

16.0

6.6

 6.8

 8.9

 8.6

 17.6

16.7

 8.6

 7.9

 11.3

 10.6

 16.4

 16.8

 12.1

 13.7

 16.4

14.6

8.4

 9.5

 22.9

22.3

 33.8

31.6

 10.7

 11.2

 14.7

 15.0

 14.3

13.5

 24.9

24.6

 7.7

 8.6

2020 

2018

Figure 7.

Percentage of Working-Age Adults Without Health Insurance Coverage 

by Selected Characteristics: 2018 and 2020 

(Population as of March of the following year, adults aged 19 to 64)

* Denotes a statistically significant change between 2018 and 2020 at the 90 percent confidence level.

1 Federal surveys give respondents the option of reporting more than one race. This figure shows data using the race-alone concept. 

For example, “Asian” refers to people who reported Asian and no other race.

2 Medicaid expansion status as of January 1, 2020, for 2020 data. Medicaid expansion status as of January 1, 2018, for 2018 data. 

Expansion states on or before January 1, 2018, include AK, AR, AZ, CA, CO, CT, DC, DE, HI, IA, IL, IN, KY, LA, MA, MD, MI, MN, MT, ND, 

NH, NJ, NM, NV, NY, OH, OR, PA, RI, VT, WA, and WV. After January 1, 2018, and on or before January 1, 2020, ID, ME, UT, and VA 

expanded Medicaid. More information is available at <www.medicaid.gov/state-overviews/index.html>.

Note: Information on confidentiality protection, sampling error, nonsampling error, and definitions is available

at <https://www2.census.gov/programs-surveys/cps/techdocs/cpsmar21.pdf>. 

Source: U.S. Census Bureau, Current Population Survey, 2019 and 2021 Annual Social and Economic Supplement (CPS ASEC).
14 Health Insurance Coverage in the United States: 2020 U.S. Census Bureau

The Census Bureau’s Small Area 

Health Insurance Estimates (SAHIE) 

program also produces single-year 

estimates of health insurance for all 

states and all counties. These estimates are based on statistical models 

using data from a variety of sources, 

including current surveys, administrative records, and annual population estimates. In general, SAHIE 

estimates have lower variances than 

ACS estimates but are released later 

because they incorporate these additional data into their models. 

Small Area Health Insurance Estimates 

are available at <www.census.gov 

/programs-surveys/sahie.html>. The 

most recent estimates are for 2019.

Additional Data 

The CPS ASEC is used to produce 

additional health insurance coverage 

tables. These tables are available on 

the Census Bureau’s Health Insurance 

Web site. The Web site may be 

accessed through the Census Bureau’s 

home page at <www.census.gov> or 

directly at <www.census.gov/data

/tables/2021/demo/health-insurance 

/p60-274.html>.

For assistance with health insurance 

data, contact the Census Bureau 

Customer Services Center at 

1-800-923-8282 (toll-free), or

search your topic of interest using

the Census Bureau’s “Question and

Answer Center” found at

<https://ask.census.gov>.

Data.census.gov 

Data.census.gov is the new platform 

to access data and digital content 

from the Census Bureau. It is the 

official source of data for the Census 

Bureau’s most popular surveys and 

programs such as the ACS, Decennial 

Census, Economic Census, and more. 

Through the centralized experience 

on data.census.gov, data users of all 

skill levels can search pre made tables 

or create custom statis tics from 

Public Use Microdata files. 

The Census Bureau created easy 

ways to visualize, customize, and 

download data through a single 

plat form on data.census.gov in 

response to user feedback. To learn 

more about data.census.gov, check 

out the release notes at 

<https://www2.census.gov/data 

/api-documentation/data-census 

-gov-release-notes.pdf>.

In addition to the pretabulated 

detailed and historical tables 

available online, data users of all skill 

levels can create custom statistics 

from Public Use Microdata files using 

the Microdata Access Tool (MDAT) 

available at <https://data.census.gov 

/mdat>. The MDAT provides data 

users the ability to create customized 

tables using public-use data from the 

CPS ASEC.

Public-Use Microdata

Microdata for the CPS ASEC are 

available online at <www.census.gov 

/data/datasets/time-series/demo 

/cps/cps-asec.html>. Technical 

methods have been applied to CPS 

microdata to avoid disclosing the 

identities of individuals from whom 

data were collected.

Census Data API

The Census Data Application 

Programming Interface (API) gives 

the public access to pretabulated data 

from various Census Bureau data programs. It is an efficient way to query 

data directly from Census Bureau 

servers with many advantages, including the ability to easily download 

target variables and geographies and 

immediately access the most current 

data. Users can find which datasets 

are currently available via API online 

at <www.census.gov/data

/developers/data-sets.html>.

SOURCE AND ACCURACY OF 

THE ESTIMATES 

The estimates in this report are 

from the CPS ASEC. The CPS is the 

longest-running survey conducted 

by the Census Bureau. The CPS is 

a household survey primarily used 

to collect employment data. The 

sample universe for the basic CPS 

consists of the resident civilian, 

noninstitutionalized population of 

the United States. People in institutions, such as prisons, long-term care 

hospitals, and nursing homes, are 

not eligible to be interviewed in the 

CPS. Students living in dormitories 

are included in the estimates only if 

information about them is reported in 

an interview at their parents’ home. 

Since the CPS is a household survey, 

people who are homeless and not 

living in shelters are not included in 

the sample.

The CPS ASEC collects data in 

February, March, and April each year, 

asking detailed questions categorizing income into over 50 sources. The 

key purpose of the CPS ASEC is to 

provide timely and comprehensive 

estimates of income, poverty, and 

health insurance and to measure 

change in these national-level estimates. The CPS ASEC is the official 

source of national poverty estimates 

calculated in accordance with the 

Office of Management and Budget’s 

Statistical Policy Directive 14.26 

The CPS ASEC collects data in the 50 

states and the District of Columbia; 

these data do not represent residents 

of Puerto Rico or U.S. Island Areas.27

The 2021 CPS ASEC sample consists 

of about 90,800 addresses. The CPS 

ASEC includes military personnel 

who live in a household with at least 

one other civilian adult, regardless 

of whether they live off post or on 

post. All other armed forces personnel are excluded. The estimates in 

26 The OMB determined the official definition of poverty in Statistical Policy Directive 14. 

Appendix B of the report, “Income and Poverty 

in the United States: 2020,” provides a more 

detailed description of how the Census Bureau 

calculates poverty. More information is available 

at <www.census.gov/content/dam/Census 

/library/publications/2021/demo/p60-273.pdf>.

27 U.S. Island Areas include American Samoa, 

Guam, the Commonwealth of the Northern 

Mariana Islands, and the Virgin Islands of the 

United States.
U.S. Census Bureau Health Insurance Coverage in the United States: 2020 15

this report are controlled to March 

2021 independent national population estimates by age, sex, race, and 

Hispanic origin. Beginning with 2010, 

population estimates are based on 

2010 Census population counts and 

are updated annually taking into 

account births, deaths, emigration, 

and immigration. 

The estimates in this report (which 

may be shown in text, figures, and 

tables) are based on responses from 

a sample of the population and may 

differ from actual values because of 

sampling variability or other factors. 

As a result, apparent differences 

between the estimates for two or 

more groups may not be statistically 

significant. All comparative statements have undergone statistical 

testing and are statistically significant at the 90 percent confidence 

level unless otherwise noted. In this 

report, the variances of estimates 

were calculated using the Successive 

Difference Replication (SDR) method.

Beginning with the 2011 CPS ASEC 

report, the standard errors and 

confidence intervals displayed in 

tables were calculated using the SDR 

method, unless otherwise noted. In 

previous years, the standard errors 

of CPS ASEC estimates were calculated using the generalized variance 

function (GVF) approach. Under 

this approach, generalized variance 

parameters were used in formulas 

provided in the source and accuracy statement to estimate standard 

errors. Further information on replicate weights, standard errors, income 

top-coding and data swapping on 

the public-use file, and changes to 

the CPS ASEC data file is available at 

<https://www2.census.gov/programs 

-surveys/cps/techdocs/cpsmar21

.pdf>.

Comments

The Census Bureau welcomes the 

comments and advice of data and 

report users. If you have suggestions 

or comments on the health insurance 

coverage report, please write to:

Sharon Stern 

Assistant Division Chief, Employment 

 Characteristics 

Social, Economic, and Housing 

 Statistics Division 

U.S. Census Bureau 

Washington, DC 20233-8500

or e-mail 

<sharon.m.stern@census.gov>.

APPENDIX A. 

Table A-1. 

Percentage of People by Health Insurance Coverage Status and Type by Selected Characteristics: 

2018, 2019, and 2020

(Numbers in thousands. Population as of March of the following year. Information on confidentiality protection, sampling error, 

nonsampling error, and definitions is available at <https://www2.census.gov/programs-surveys/cps/techdocs/cpsmar21.pdf>)

Characteristic

Total

Number

Any health insurance

Uninsured4

Percent

Margin of 

error1 (±)

Private health 

insurance2

Public health 

insurance3

Percent

Margin of 

error1 (±) Percent

Margin of 

error1 (±) Percent

Margin of 

error1 (±)

2020 Total .........

Race5 and Hispanic Origin

325,638 91.4 0.2 66.5 0.4 34.8 0.3 8.6 0.2

White ...................... 247,763 91.7 0.2 68.6 0.4 34.3 0.3 8.3 0.2

 White, not Hispanic ........ 194,230 94.6 0.2 73.9 0.4 33.8 0.4 5.4 0.2

Black ....................... 43,427 89.6 0.6 54.6 1.0 41.4 0.8 10.4 0.6

Asian ...................... 20,125 94.1 0.6 72.4 1.2 27.0 1.1 5.9 0.6

Hispanic (any race) ..........

Age

61,160 81.7 0.7 49.9 0.9 35.9 0.7 18.3 0.7

Under age 65 ............... 269,802 89.8 0.2 70.0 0.4 22.6 0.3 10.2 0.2

 Under age 196 ............. 76,156 94.4 0.3 62.2 0.6 35.1 0.6 5.6 0.3

 Aged 19 to 64 ............. 193,646 88.1 0.3 73.0 0.4 17.7 0.3 11.9 0.3

  Aged 19 to 257 .......... 29,269 85.6 0.6 69.4 0.9 18.2 0.8 14.4 0.6

  Aged 26 to 34 ........... 40,916 85.8 0.6 70.4 0.8 18.2 0.6 14.2 0.6

  Aged 35 to 44 ........... 42,004 87.6 0.5 73.7 0.7 16.3 0.6 12.4 0.5

  Aged 45 to 64 ........... 81,457 90.4 0.3 75.3 0.5 18.0 0.4 9.6 0.3

Aged 65 and older ...........

Nativity

55,836 99.0 0.1 49.6 0.8 93.6 0.3 1.0 0.1

Native-born ................. 280,839 93.1 0.2 68.2 0.4 35.4 0.3 6.9 0.2

Foreign-born ............... 44,799 80.7 0.7 55.8 0.9 30.9 0.7 19.3 0.7

 Naturalized citizen ......... 22,667 91.7 0.5 63.8 1.0 36.8 0.9 8.3 0.5

 Not a citizen ..............

Region

22,132 69.4 1.2 47.5 1.3 24.9 1.0 30.6 1.2

Northeast .................. 54,771 95.2 0.4 69.1 0.9 37.8 0.9 4.8 0.4

Midwest .................... 67,436 93.8 0.4 71.7 0.8 33.5 0.7 6.2 0.4

South ...................... 125,396 88.2 0.4 63.4 0.6 33.6 0.5 11.8 0.4

West .......................

State Medicaid Expansion 

Status8

Lived in Medicaid expansion 

78,035 91.8 0.3 65.0 0.7 35.7 0.6 8.2 0.3

state ......................

Did not live in Medicaid 

211,948 93.6 0.2 67.9 0.5 36.1 0.4 6.4 0.2

expansion state ............ 113,690 87.4 0.4 63.8 0.6 32.5 0.5 12.6 0.4

Footnotes provided at end of table.

U.S. Census Bureau Health Insurance Coverage in the United States: 2020 17
Table A-1. 

Percentage of People by Health Insurance Coverage Status and Type by Selected Characteristics: 

2018, 2019, and 2020—Con.

(Numbers in thousands. Population as of March of the following year. Information on confidentiality protection, sampling error, 

nonsampling error, and definitions is available at <https://www2.census.gov/programs-surveys/cps/techdocs/cpsmar21.pdf>)

Characteristic

Total

Number

Any health insurance

Uninsured4

Percent

Margin of 

error1 (±)

Private health 

insurance2

Public health 

insurance3

Percent

Margin of 

error1 (±) Percent

Margin of 

error1 (±) Percent

Margin of 

error1 (±)

2019 Total ..........

Race5 and Hispanic Origin

324,550 92.0 0.2 68.0 0.3 34.1 0.3 8.0 0.2

White ...................... 247,869 92.2 0.2 70.1 0.4 33.5 0.3 7.8 0.2

 White, not Hispanic ........ 194,518 94.8 0.2 75.2 0.4 33.0 0.4 5.2 0.2

Black ....................... 42,991 90.4 0.5 55.2 0.9 41.8 0.9 9.6 0.5

Asian ...................... 19,905 93.8 0.7 74.4 1.1 25.2 0.9 6.2 0.7

Hispanic (any race) ..........

Age

60,517 83.3 0.7 51.6 0.9 35.8 0.8 16.7 0.7

Under age 65 ............... 269,908 90.5 0.2 71.4 0.4 22.0 0.3 9.5 0.2

 Under age 196 ............. 76,636 94.8 0.3 63.6 0.7 34.3 0.7 5.2 0.3

 Aged 19 to 64 ............. 193,272 88.9 0.3 74.4 0.4 17.2 0.3 11.1 0.3

  Aged 19 to 257 .......... 29,605 85.8 0.7 70.8 0.8 17.2 0.7 14.2 0.7

  Aged 26 to 34 ........... 40,511 86.7 0.5 71.5 0.7 17.8 0.6 13.3 0.5

  Aged 35 to 44 ........... 41,412 88.6 0.5 75.6 0.7 15.6 0.6 11.4 0.5

  Aged 45 to 64 ........... 81,744 91.2 0.3 76.7 0.5 17.6 0.5 8.8 0.3

Aged 65 and older ...........

Nativity

54,642 98.9 0.1 51.6 0.7 93.8 0.3 1.1 0.1

Native-born ................. 279,653 93.5 0.2 69.7 0.4 34.6 0.3 6.5 0.2

Foreign-born ............... 44,897 82.2 0.7 57.7 0.8 30.8 0.7 17.8 0.7

 Naturalized citizen ......... 22,750 91.3 0.6 64.0 1.1 36.6 1.0 8.7 0.6

 Not a citizen ..............

Region

22,147 72.9 1.1 51.3 1.2 24.9 1.0 27.1 1.1

Northeast .................. 55,080 95.3 0.4 70.8 0.9 35.9 0.9 4.7 0.4

Midwest .................... 67,486 94.3 0.4 73.2 0.7 33.5 0.8 5.7 0.4

South ...................... 124,084 89.0 0.4 65.0 0.6 32.8 0.5 11.0 0.4

West .......................

State Medicaid Expansion 

Status8

Lived in Medicaid expansion 

77,900 92.4 0.4 66.5 0.8 35.4 0.7 7.6 0.4

state ......................

Did not live in Medicaid 

205,888 94.0 0.2 69.3 0.4 35.6 0.4 6.0 0.2

expansion state ............ 118,661 88.4 0.4 65.9 0.6 31.6 0.5 11.6 0.4

Footnotes provided at end of table.

18 Health Insurance Coverage in the United States: 2020 U.S. Census Bureau
Table A-1. 

Percentage of People by Health Insurance Coverage Status and Type by Selected Characteristics: 

2018, 2019, and 2020—Con.

(Numbers in thousands. Population as of March of the following year. Information on confidentiality protection, sampling error, 

nonsampling error, and definitions is available at <https://www2.census.gov/programs-surveys/cps/techdocs/cpsmar21.pdf>)

Characteristic

Total

Number

Any health insurance

Uninsured4

Percent

Margin of 

error1 (±)

Private health 

insurance2

Public health 

insurance3

Percent

Margin of 

error1 (±) Percent

Margin of 

error1 (±) Percent

Margin of 

error1 (±)

    2018 Total ..........

Race5 and Hispanic Origin

323,668 91.5 0.2 67.3 0.4 34.4 0.3 8.5 0.2

White ...................... 247,472 91.8 0.2 69.3 0.4 33.8 0.3 8.2 0.2

 White, not Hispanic ........ 194,679 94.6 0.2 74.8 0.4 33.2 0.3 5.4 0.2

Black ....................... 42,758 90.3 0.5 55.4 1.1 41.2 0.9 9.7 0.5

Asian ...................... 19,770 93.2 0.6 73.1 1.3 26.1 1.1 6.8 0.6

Hispanic (any race) ..........

Age

59,925 82.2 0.6 49.6 1.0 36.5 0.8 17.8 0.6

Under age 65 ............... 270,881 90.0 0.2 70.2 0.4 22.8 0.3 10.0 0.2

 Under age 196 ............. 77,333 94.5 0.3 61.8 0.7 35.7 0.7 5.5 0.3

 Aged 19 to 64 ............. 193,548 88.3 0.3 73.5 0.4 17.6 0.3 11.7 0.3

  Aged 19 to 257 .......... 29,297 85.7 0.6 69.9 0.9 18.3 0.7 14.3 0.6

  Aged 26 to 34 ........... 40,768 86.1 0.5 71.3 0.8 17.5 0.6 13.9 0.5

  Aged 35 to 44 ........... 41,027 87.5 0.5 73.7 0.6 16.2 0.5 12.5 0.5

  Aged 45 to 64 ........... 82,455 90.7 0.3 75.8 0.5 18.1 0.4 9.3 0.3

Aged 65 and older ..........

Nativity

52,788 99.1 0.1 52.4 0.7 94.1 0.3 0.9 0.1

Native-born ................. 277,848 93.2 0.2 69.1 0.4 34.9 0.3 6.8 0.2

Foreign-born ............... 45,820 81.1 0.6 56.0 0.9 31.2 0.7 18.9 0.6

 Naturalized citizen ......... 22,296 91.2 0.6 64.0 1.0 36.4 1.0 8.8 0.6

 Not a citizen ..............

Region

23,524 71.4 1.0 48.4 1.1 26.2 1.0 28.6 1.0

Northeast .................. 55,266 94.9 0.5 69.4 0.9 36.9 0.8 5.1 0.5

Midwest .................... 67,458 94.3 0.4 72.8 0.8 33.3 0.7 5.7 0.4

South ...................... 123,391 87.9 0.4 64.2 0.6 33.1 0.4 12.1 0.4

West .......................

State Medicaid Expansion 

Status8

Lived in Medicaid expansion 

77,553 92.3 0.4 65.9 0.8 35.6 0.7 7.7 0.4

state ......................

Did not live in Medicaid 

197,396 93.8 0.2 68.4 0.5 36.1 0.4 6.2 0.2

expansion state ............ 126,273 88.0 0.4 65.6 0.6 31.8 0.4 12.0 0.4

1

 A margin of error (MOE) is a measure of an estimate’s variability. The larger the MOE in relation to the size of the estimate, the less reliable the estimate. This number, when added to and subtracted from the estimate, forms the 90 percent confidence interval. MOEs shown in this table are based on 

standard errors calculated using replicate weights. 2 Private health insurance includes coverage provided through an employer or union, coverage purchased directly, or TRICARE.

3 Public health insurance coverage includes Medicaid, Medicare, CHAMPVA (Civilian Health and Medical Program of the Department of Veterans Affairs), 

and care provided by the Department of Veterans Affairs and the military. 4 Individuals are considered to be uninsured if they do not have health insurance coverage for the entire calendar year.

5 Federal surveys give respondents the option of reporting more than one race. Therefore, two basic ways of defining a race group are possible. A 

group, such as Asian, may be defined as those who reported Asian and no other race (the race-alone or single-race concept) or as those who reported 

Asian regardless of whether they also reported another race (the race-alone-or-in-combination concept). This table shows data using the first approach 

(race alone). The use of the single-race population does not imply that it is the preferred method of presenting or analyzing data. The Census Bureau uses 

a variety of approaches. Data for American Indians and Alaska Natives, Native Hawaiians and Other Pacific Islanders, and those reporting two or more races 

are not shown separately. 6 Children under the age of 19 are eligible for Medicaid/CHIP.

7 This age group is of special interest because of the Affordable Care Act’s dependent coverage provision. Individuals aged 19 to 25 may be eligible to 

be a dependent on a parent’s health insurance plan. 8 Medicaid expansion status as of January 1, 2020, 2019, and 2018, respectively. Expansion states on or before January 1, 2018, include AK, AR, AZ, 

CA, CO, CT, DC, DE, HI, IA, IL, IN, KY, LA, MA, MD, MI, MN, MT, ND, NH, NJ, NM, NV, NY, OH, OR, PA, RI, VT, WA, and WV. After Jan 1, 2018, and on or before 

January 1, 2019, VA expanded Medicaid. After January 1, 2019, and on or before January 1, 2020, ID, ME, and UT expanded Medicaid. For more information, 

refer to <www.medicaid.gov/state-overviews/index.html>. 

Note: The estimates by type of coverage are not mutually exclusive; people can be covered by more than one type of health insurance during the year.

Source: U.S. Census Bureau, Current Population Survey, 2019, 2020, and 2021 Annual Social and Economic Supplement (CPS ASEC).

U.S. Census Bureau Health Insurance Coverage in the United States: 2020 19
Table A-2. 

Health Insurance Coverage Status and Type by Age and Selected Characteristics: 2018, 2019, and 

2020

(Numbers in thousands. Population as of March of the following year. Information on confidentiality protection, sampling error, 

nonsampling error, and definitions is available at <https://www2.census.gov/programs-surveys/cps/techdocs/cpsmar21.pdf>)

Characteristic

Total

Number

Any health insurance

Uninsured4

Percent

Margin of 

error1 (±)

Private health 

insurance2

Public health 

insurance3

Percent

Margin of 

error1 (±) Percent

Margin of 

error1 (±) Percent

Margin of 

error1 (±)

2020

Total, 15 to 64 years 

old ...............

Disability Status5

210,421 88.5 0.3 72.5 0.4 18.8 0.3 11.5 0.3

 With disability ............. 15,134 91.0 0.7 45.5 1.2 52.9 1.2 9.0 0.7

 With no disability ..........

Work Experience

194,199 88.2 0.3 74.4 0.4 16.2 0.3 11.8 0.3

All workers .................

 Worked full-time, 

154,502 89.0 0.3 79.8 0.4 11.4 0.3 11.0 0.3

 year-round ..............

 Worked less than full-time, 

99,588 91.6 0.3 87.0 0.3 6.1 0.2 8.4 0.3

 year-round ..............

Did not work at least one 

54,913 84.3 0.5 66.7 0.7 20.9 0.5 15.7 0.5

week ......................

Total, 19 to 64 years 

55,920 87.1 0.4 52.2 0.7 39.1 0.7 12.9 0.4

old ...............

Marital Status

193,646 88.1 0.3 73.0 0.4 17.7 0.3 11.9 0.3

Married6 .................... 98,821 91.5 0.3 82.1 0.4 12.3 0.4 8.5 0.3

Widowed ................... 3,304 87.9 1.5 60.1 2.4 32.6 2.4 12.1 1.5

Divorced ................... 18,486 86.8 0.7 65.0 1.0 24.9 0.9 13.2 0.7

Separated .................. 3,738 79.8 1.9 53.0 2.3 29.7 2.0 20.2 1.9

Never married ...............

Total, 26 to 64 years 

69,297 84.0 0.5 63.9 0.6 22.1 0.5 16.0 0.5

old ...............

Educational Attainment

164,377 88.5 0.3 73.7 0.4 17.6 0.3 11.5 0.3

No high school diploma ......

High school graduate 

13,758 68.1 1.4 35.4 1.2 35.4 1.3 31.9 1.4

(includes equivalency) ...... 43,850 83.9 0.6 61.5 0.7 25.8 0.7 16.1 0.6

Some college, no degree ..... 23,885 89.3 0.6 72.6 0.8 20.4 0.8 10.7 0.6

Associate degree ............ 17,799 91.0 0.6 77.7 0.9 16.5 0.8 9.0 0.6

Bachelor’s degree ...........

Graduate or professional 

41,047 94.1 0.4 87.5 0.5 8.8 0.4 5.9 0.4

degree .................... 24,039 96.5 0.4 92.3 0.5 5.8 0.5 3.5 0.4

Footnotes provided at end of table.

20 Health Insurance Coverage in the United States: 2020 U.S. Census Bureau
Table A-2. 

Health Insurance Coverage Status and Type by Age and Selected Characteristics: 2018, 2019, and 

2020—Con.

(Numbers in thousands. Population as of March of the following year. Information on confidentiality protection, sampling error, 

nonsampling error, and definitions is available at <https://www2.census.gov/programs-surveys/cps/techdocs/cpsmar21.pdf>)

Characteristic

Total

Number

Any health insurance

Uninsured4

Percent

Margin of 

error1 (±)

Private health 

insurance2

Public health 

insurance3

Percent

Margin of 

error1 (±) Percent

Margin of 

error1 (±) Percent

Margin of 

error1 (±)

2019

    Total, 15 to 64 years 

    old ...............

Disability Status5

210,228 89.3 0.3 73.9 0.4 18.2 0.3 10.7 0.3

 With disability ............. 15,056 91.6 0.6 47.3 1.3 52.4 1.3 8.4 0.6

 With no disability ..........

Work Experience

194,194 89.1 0.3 75.8 0.4 15.6 0.3 10.9 0.3

All workers .................

 Worked full-time, 

157,181 89.8 0.3 80.8 0.3 11.2 0.3 10.2 0.3

 year-round ..............

 Worked less than full-time, 

112,803 91.1 0.3 85.8 0.3 7.0 0.2 8.9 0.3

 year-round ..............

Did not work at least one 

44,379 86.6 0.5 68.2 0.7 21.6 0.6 13.4 0.5

week ......................

    Total, 19 to 64 years 

53,047 87.8 0.5 53.2 0.7 39.1 0.7 12.2 0.5

    old ...............

Marital Status

193,272 88.9 0.3 74.4 0.4 17.2 0.3 11.1 0.3

Married6 .................... 100,795 92.4 0.3 83.4 0.4 12.2 0.4 7.6 0.3

Widowed ................... 3,319 86.5 1.7 56.5 2.5 33.5 2.3 13.5 1.7

Divorced ................... 18,290 88.0 0.7 67.4 1.0 23.6 0.9 12.0 0.7

Separated .................. 3,802 81.0 1.8 51.8 2.2 31.4 1.9 19.0 1.8

Never married ...............

    Total, 26 to 64 years 

67,065 84.3 0.5 65.1 0.6 21.3 0.5 15.7 0.5

    old ...............

Educational Attainment

163,666 89.4 0.3 75.1 0.4 17.2 0.3 10.6 0.3

No high school diploma ......

High school graduate 

13,733 71.5 1.3 38.9 1.3 35.9 1.4 28.5 1.3

(includes equivalency) ...... 43,630 85.1 0.5 64.2 0.7 24.2 0.7 14.9 0.5

Some college, no degree ..... 24,315 89.8 0.6 73.7 0.8 19.7 0.8 10.2 0.6

Associate degree ............ 17,998 91.6 0.7 79.3 0.9 15.8 0.8 8.4 0.7

Bachelor’s degree ...........

Graduate or professional 

40,563 94.7 0.4 87.6 0.6 9.1 0.4 5.3 0.4

degree .................... 23,428 96.8 0.4 93.2 0.5 5.4 0.4 3.2 0.4

Footnotes provided at end of table.

U.S. Census Bureau Health Insurance Coverage in the United States: 2020 21
Table A-2. 

Health Insurance Coverage Status and Type by Age and Selected Characteristics: 2018, 2019, and 

2020—Con.

(Numbers in thousands. Population as of March of the following year. Information on confidentiality protection, sampling error, 

nonsampling error, and definitions is available at <https://www2.census.gov/programs-surveys/cps/techdocs/cpsmar21.pdf>)

Characteristic

Total

Number

Any health insurance

Uninsured4

Percent

Margin of 

error1 (±)

Private health 

insurance2

Public health 

insurance3

Percent

Margin of 

error1 (±) Percent

Margin of 

error1 (±) Percent

Margin of 

error1 (±)

2018

Total, 15 to 64 years 

old ...............

Disability Status5

210,794 88.7 0.3 72.8 0.4 18.8 0.3 11.3 0.3

 With disability ............. 15,438 90.4 0.7 44.7 1.2 53.9 1.1 9.6 0.7

 With no disability ..........

Work Experience

194,434 88.5 0.3 74.9 0.4 16.0 0.3 11.5 0.3

All workers .................

 Worked full-time, 

155,221 89.3 0.3 80.5 0.4 11.1 0.2 10.7 0.3

 year-round ..............

 Worked less than full-time, 

111,950 90.5 0.3 85.1 0.4 7.2 0.2 9.5 0.3

 year-round ..............

Did not work at least one 

43,271 86.2 0.5 68.5 0.7 21.3 0.6 13.8 0.5

week ......................

Total, 19 to 64 years 

55,573 86.9 0.4 51.3 0.8 40.2 0.7 13.1 0.4

old ...............

Marital Status

193,548 88.3 0.3 73.5 0.4 17.6 0.3 11.7 0.3

Married6 .................... 101,805 91.7 0.3 82.3 0.4 12.6 0.3 8.3 0.3

Widowed ................... 3,385 86.3 1.6 55.6 2.2 34.9 2.2 13.7 1.6

Divorced ................... 18,683 87.0 0.7 64.7 1.0 25.3 1.0 13.0 0.7

Separated .................. 4,200 80.1 2.0 52.4 2.3 29.7 1.8 19.9 2.0

Never married ...............

Total, 26 to 64 years 

65,475 84.0 0.5 64.7 0.6 21.6 0.5 16.0 0.5

old ...............

Educational Attainment

164,250 88.7 0.3 74.2 0.4 17.5 0.3 11.3 0.3

No high school diploma ......

High school graduate 

15,197 71.0 1.2 37.0 1.2 36.9 1.3 29.0 1.2

(includes equivalency) ...... 44,573 85.1 0.5 64.3 0.7 24.4 0.6 14.9 0.5

Some college, no degree ..... 24,977 89.3 0.6 73.8 0.8 19.3 0.7 10.7 0.6

Associate degree ............ 17,735 91.0 0.6 78.7 0.8 15.8 0.7 9.0 0.6

Bachelor’s degree ...........

Graduate or professional 

39,255 93.8 0.3 87.2 0.5 8.5 0.4 6.2 0.3

degree .................... 22,514 96.6 0.4 92.9 0.5 5.7 0.4 3.4 0.4

1

 A margin of error (MOE) is a measure of an estimate’s variability. The larger the MOE in relation to the size of the estimate, the less reliable the estimate. 

This number, when added to and subtracted from the estimate, forms the 90 percent confidence interval. MOEs shown in this table are based on standard 

errors calculated using replicate weights. 2 Private health insurance includes coverage provided through an employer or union, coverage purchased directly, or TRICARE.

3 Public health insurance coverage includes Medicaid, Medicare, CHAMPVA (Civilian Health and Medical Program of the Department of Veterans Affairs), 

and care provided by the Department of Veterans Affairs and the military. 4 Individuals are considered to be uninsured if they do not have health insurance coverage for the entire calendar year.

5 The sum of those with and without a disability does not equal the total because disability status is not defined for individuals in the U.S. armed forces. 

6 The combined category “married” includes three individual categories: “married, civilian spouse present,” “married, U.S. armed forces spouse present,” 

and “married, spouse absent.” 

Note: The estimates by type of coverage are not mutually exclusive; people can be covered by more than one type of health insurance during the year.

Source: U.S. Census Bureau, Current Population Survey, 2019, 2020, and 2021 Annual Social and Economic Supplement (CPS ASEC).

22 Health Insurance Coverage in the United States: 2020 U.S. Census Bureau
Table A-3. 

Health Insurance Coverage Status and Type by Family Type and Family Income-to-Poverty Ratio: 

2018, 2019, and 2020

(Numbers in thousands. Population as of March of the following year. Information on confidentiality protection, sampling error, 

nonsampling error, and definitions is available at <https://www2.census.gov/programs-surveys/cps/techdocs/cpsmar21.pdf>)

Characteristic

Total

Number

Any health insurance

Uninsured4

Percent

Margin of 

error1 (±)

Private health 

insurance2

Public health 

insurance3

Percent

Margin of 

error1 (±) Percent

Margin of 

error1 (±) Percent

Margin of 

error1 (±)

2020 Total ..........

Household Relationship

325,638 91.4 0.2 66.5 0.4 34.8 0.3 8.6 0.2

Married couple family .........

 With children under 18 

193,596 93.6 0.2 74.8 0.4 29.4 0.4 6.4 0.2

 years .....................

Unmarried male reference 

106,005 92.6 0.3 75.5 0.6 20.4 0.6 7.4 0.3

 person ...................

 With children under 18 

42,018 86.9 0.6 58.9 0.9 36.6 0.8 13.1 0.6

 years .....................

Unmarried female reference 

10,891 86.2 1.4 54.7 1.9 35.4 1.8 13.8 1.4

person .....................

 With children under 18 

72,338 90.3 0.4 50.2 0.7 50.3 0.6 9.7 0.4

 years ..................... 31,937 89.3 0.7 41.7 1.1 52.2 1.1 10.7 0.7

Unrelated subfamilies ......... 1,017 86.5 3.8 51.3 6.0 38.3 5.2 13.5 3.8

Secondary individuals .........

Income-to-Poverty Ratio

16,670 82.8 0.9 61.3 1.3 25.7 1.0 17.2 0.9

Total, poverty universe ........

Below 100 percent of 

325,156 91.4 0.2 66.6 0.4 34.7 0.3 8.6 0.2

poverty ....................

Below 138 percent of 

37,156 82.8 0.8 23.2 0.9 64.3 1.0 17.2 0.8

poverty ....................

Between 100 and 199 percent 

56,337 83.9 0.6 25.3 0.7 64.6 0.8 16.1 0.6

of poverty ..................

Between 200 and 299 percent 

52,336 86.7 0.6 39.6 0.9 56.9 0.8 13.3 0.6

of poverty ..................

Between 300 and 399 percent 

50,389 88.1 0.5 60.3 0.9 38.8 0.8 11.9 0.5

of poverty ..................

At or above 400 percent of 

41,655 91.1 0.6 72.0 0.9 29.4 0.8 8.9 0.6

poverty ....................

Footnotes provided at end of table.

143,620 96.6 0.2 88.2 0.3 19.1 0.3 3.4 0.2

U.S. Census Bureau Health Insurance Coverage in the United States: 2020 23
Table A-3. 

Health Insurance Coverage Status and Type by Family Type and Family Income-to-Poverty Ratio: 2018, 

2019, and 2020—Con.

(Numbers in thousands. Population as of March of the following year. Information on confidentiality protection, sampling error, 

nonsampling error, and definitions is available at <https://www2.census.gov/programs-surveys/cps/techdocs/cpsmar21.pdf>)

Characteristic

Total

Number

Any health insurance

Uninsured4

Percent

Margin of 

error1 (±)

Private health 

insurance2

Public health 

insurance3

Percent

Margin of 

error1 (±) Percent

Margin of 

error1 (±) Percent

Margin of 

error1 (±)

2019 Total ...........

Household Relationship

324,550 92.0 0.2 68.0 0.3 34.1 0.3 8.0 0.2

Married couple family .........

 With children under 18 

197,994 93.9 0.2 75.8 0.4 28.9 0.4 6.1 0.2

 years .....................

Unmarried male reference 

109,323 93.0 0.4 76.4 0.7 19.7 0.6 7.0 0.4

 person ...................

 With children under 18 

40,246 88.0 0.6 61.2 0.8 35.7 0.8 12.0 0.6

 years .....................

Unmarried female reference 

10,244 86.8 1.3 55.2 1.9 36.0 1.8 13.2 1.3

person .....................

 With children under 18 

69,641 91.1 0.4 51.4 0.7 50.4 0.7 8.9 0.4

 years ..................... 30,494 91.2 0.7 42.9 1.2 53.2 1.2 8.8 0.7

Unrelated subfamilies ......... 941 90.6 3.6 58.5 6.0 38.2 6.2 9.4 3.6

Secondary individuals .........

Income-to-Poverty Ratio

15,728 81.4 1.0 62.1 1.2 23.4 1.1 18.6 1.0

Total, poverty universe ........

Below 100 percent of 

324,048 92.0 0.2 68.1 0.3 34.0 0.3 8.0 0.2

poverty ....................

Below 138 percent of 

33,879 84.1 0.8 22.9 0.9 66.6 1.0 15.9 0.8

poverty ....................

Between 100 and 199 percent 

52,816 84.6 0.6 25.2 0.8 65.9 0.8 15.4 0.6

of poverty ..................

Between 200 and 299 percent 

51,349 85.9 0.6 39.9 1.0 55.5 1.0 14.1 0.6

of poverty ..................

Between 300 and 399 percent 

48,924 89.0 0.5 63.0 0.9 37.3 0.9 11.0 0.5

of poverty ..................

At or above 400 percent of 

43,078 91.7 0.5 72.6 0.8 29.5 0.8 8.3 0.5

poverty ....................

Footnotes provided at end of table.

146,818 97.0 0.2 88.8 0.3 19.2 0.3 3.0 0.2

24 Health Insurance Coverage in the United States: 2020 U.S. Census Bureau
Table A-3. 

Health Insurance Coverage Status and Type by Family Type and Family Income-to-Poverty Ratio: 2018, 

2019, and 2020—Con.

(Numbers in thousands. Population as of March of the following year. Information on confidentiality protection, sampling error, 

nonsampling error, and definitions is available at <https://www2.census.gov/programs-surveys/cps/techdocs/cpsmar21.pdf>)

Characteristic

Total

Number

Any health insurance

Uninsured4

Percent

Margin of 

error1 (±)

Private health 

insurance2

Public health 

insurance3

Percent

Margin of 

error1 (±) Percent

Margin of 

error1 (±) Percent

Margin of 

error1 (±)

2018 Total ...........

Household Relationship

323,668 91.5 0.2 67.3 0.4 34.4 0.3 8.5 0.2

Married couple family .........

 With children under 18 

195,914 93.6 0.2 75.3 0.4 29.1 0.4 6.4 0.2

 years .....................

Unmarried male reference 

109,341 92.6 0.4 75.1 0.7 20.9 0.6 7.4 0.4

 person ...................

 With children under 18 

40,495 87.2 0.6 59.0 0.8 36.9 0.7 12.8 0.6

 years .....................

Unmarried female reference 

10,398 87.2 1.1 53.0 1.8 38.2 1.6 12.8 1.1

person .....................

 With children under 18 

70,093 90.6 0.4 51.3 0.7 50.1 0.7 9.4 0.4

 years ..................... 31,462 90.2 0.6 43.3 1.1 51.4 1.2 9.8 0.6

Unrelated subfamilies ......... 1,069 86.9 3.4 50.0 5.1 42.4 4.6 13.1 3.4

Secondary individuals .........

Income-to-Poverty Ratio

16,097 81.5 1.0 61.6 1.2 23.8 1.0 18.5 1.0

Total, poverty universe ........

Below 100 percent of 

323,172 91.5 0.2 67.3 0.4 34.3 0.3 8.5 0.2

poverty ....................

Below 138 percent of 

38,056 83.7 0.6 22.0 0.8 66.8 0.9 16.3 0.6

poverty ....................

Between 100 and 199 percent 

58,204 84.4 0.6 24.7 0.7 65.8 0.7 15.6 0.6

of poverty ..................

Between 200 and 299 percent 

55,302 86.4 0.6 41.6 0.9 54.4 0.8 13.6 0.6

of poverty ..................

Between 300 and 399 percent 

50,632 89.2 0.5 64.4 0.8 36.2 0.8 10.8 0.5

of poverty ..................

At or above 400 percent of 

43,624 91.9 0.4 75.1 0.8 27.7 0.7 8.1 0.4

poverty .................... 135,559 96.6 0.2 89.2 0.3 18.5 0.3 3.4 0.2

1

 A margin of error (MOE) is a measure of an estimate’s variability. The larger the MOE in relation to the size of the estimate, the less reliable the estimate. This number, when added to and subtracted from the estimate, forms the 90 percent confidence interval. MOEs shown in this table are based on 

standard errors calculated using replicate weights. 2 Private health insurance includes coverage provided through an employer or union, coverage purchased directly, or TRICARE.

3 Public health insurance coverage includes Medicaid, Medicare, CHAMPVA (Civilian Health and Medical Program of the Department of Veterans Affairs), 

and care provided by the Department of Veterans Affairs and the military. 4 Individuals are considered to be uninsured if they do not have health insurance coverage for the entire calendar year.

Note: The estimates by type of coverage are not mutually exclusive; people can be covered by more than one type of health insurance during the year.

Source: U.S. Census Bureau, Current Population Survey, 2019, 2020, and 2021 Annual Social and Economic Supplement (CPS ASEC).

U.S. Census Bureau Health Insurance Coverage in the United States: 2020 25

U.S. Census Bureau Health Insurance Coverage in the United States: 2020 27

APPENDIX B. 

ESTIMATES OF HEALTH INSURANCE COVERAGE: 2013 TO 2020

The Current Population Survey 

Annual Social and Economic 

Supplement (CPS ASEC) is used to 

produce official estimates of income 

and poverty, and it serves as the 

most widely-cited source of estimates on health insurance coverage 

and the uninsured. 

SURVEY REDESIGN

The Census Bureau has consistently 

sought to improve measurement 

of health insurance coverage. The 

CPS ASEC underwent a two-stage 

redesign in recent years, including 

changes to the questionnaire incorporated over the period of 2014 to 

2016, followed by changes to postsurvey collection processing methods 

in 2019.1 Evidence suggests that the 

redesign effectively addressed known 

limitations to CPS ASEC health coverage and improved health insurance 

coverage measurement.2

In consideration of these and previous changes in survey design, 

researchers should use caution when 

comparing results over time. Due 

to the differences in measurement, 

1 For more information on the survey redesign, refer to Appendix A in Edward R. Berchick, 

Jessica C. Barnett, and Rachel D. Upton, “Health 

Insurance Coverage in the United States: 2018,” 

Current Population Reports, P60-267, U.S. Census 

Bureau, Washington, DC, 2019. 2 Heide Jackson and Edward R. Berchick, 

“Improvements in Uninsurance Estimates 

for Fully Imputed Cases in the Current 

Population Survey Annual Social and Economic 

Supplement,” Inquiry: The Journal of Health 

Care Organization, Provision, and Financing, 

2020, and E. R. Berchick and H. M. Jackson, 

“Health Insurance Coverage in the 2017 CPS 

ASEC Research File,” <www.census.gov/library 

/working-papers/2019/demo/SEHSD-WP2019 

-01.html>.

health insurance estimates for calendar year 2013 through 2017 are 

not directly comparable to previous years. Estimates for calendar 

years 2018 and beyond may be 

compared with each other and with 

2017 estimates from the 2018 CPS 

ASEC Bridge File or 2016 estimates 

from the 2017 CPS ASEC Research 

File. Although it is not appropriate 

to directly compare 2018 estimates 

with earlier years processed with the 

legacy system, it is helpful to examine the estimates in this report in the 

context of a longer time period to 

better understand the changes that 

occurred in health coverage in 2020.

RECENT CHANGES IN 

THE HEALTH INSURANCE 

LANDSCAPE 

Changes in health coverage over 

time reflect economic trends, demographic shifts, and changes in federal 

and state policy. Several such policy 

changes are related to the Patient 

Protection and Affordable Care Act 

(ACA). 

Many of the provisions of the ACA 

went into effect in 2014, including 

the establishment of health insurance 

marketplaces (e.g., healthcare.gov) 

and the optional expansion of 

Medicaid eligibility. Over the following years, some states took the 

opportunity to expand Medicaid 

eligibility. The first year, 24 states and 

the District of Columbia expanded 

eligibility. By 2020, all but 15 states 

had expanded Medicaid eligibility. 

As a result, many people, particularly adults aged 19 to 64, may have 

become eligible for coverage options 

under the ACA. Based on family 

income, some people may have 

qualified for subsidies or tax credits 

to help pay for premiums associated 

with health insurance plans. In addition, people with lower income may 

have become eligible for Medicaid 

coverage if they resided in one of the 

states (or the District of Columbia) 

that expanded Medicaid eligibility.

Notably, some provisions of the ACA 

no longer apply. For example, as of 

2019 the individual mandate penalty 

requiring individuals to be covered 

by health insurance or pay a tax 

penalty was cancelled at the federal 

level, although several states and the 

District of Columbia have state health 

insurance coverage mandates. 

The economic shock related to the 

COVID-19 global pandemic also may 

have affected health insurance coverage in the United States in 2020. The 

Families First Coronavirus Response 

Act required states, as a condition of 

receiving increased Medicaid funding, 

to provide continuous coverage for 

those enrolled in Medicaid. A recent 

Centers for Medicare & Medicaid 

Services report showed that Medicaid 

enrollment increased dramatically 

in 2020, after declines in enrollment 

from 2017 to 2019. Specifically, 

annual Medicaid enrollment during 

the period February 2020 through 

January 2021 increased from 34.0 

million to 40.2 million among adults 

aged 19 and older; Medicaid and the 
28 Health Insurance Coverage in the United States: 2020 U.S. Census Bureau

Children’s Health Insurance Program 

enrollment increased from 35.0 million to 38.3 million for children under 

the age of 19.3, 4

The coronavirus pandemic and the 

related stay-at-home orders during 

the spring of 2020 also affected how 

the Census Bureau collected data for 

the CPS ASEC. The edition of this 

report released in September 2020 

provides an overview of the issues.5 In 

addition, the Census Bureau produced 

3 Appendices A and B of the December 2020 

and January 2021 Medicaid and CHIP Enrollment 

Trends Snapshot are available at <www.medicaid

.gov/medicaid/national-medicaid-chip-program 

-information/downloads/december-2020-january 

-2021-medicaid-chip-enrollment-trend-snapshot 

.pdf>. 4 Throughout this appendix, details may not 

sum to totals because of rounding. 5 “The Impact of the Coronavirus (COVID-19) 

Pandemic on the CPS ASEC” text box in the 

“Health Insurance Coverage in the United States: 

2019,” report is available at <www.census.gov

/content/dam/Census/library/publications/2020 

/demo/p60-271.pdf>.

several working papers exploring how 

changes in CPS ASEC data collection in 2020 may have affected 2019 

estimates. These analyses revealed 

that the 2020 CPS ASEC sample differed from the previous year with 

respect to a number of characteristics 

that are correlated with health insurance coverage. For example, the 2020 

CPS ASEC sample was older, more 

educated, and more likely to have 

a disability than the 2019 sample.6

Researchers should consider the 

effect of the pandemic on CPS ASEC 

6 Additional information related to the impact 

of COVID-19 on the 2020 CPS ASEC is available 

in Edward R. Berchick, Laryssa Mykyta, and 

Sharon M. Stern, “The Influence of COVID-19-

Related Data Collection Changes on Measuring 

Health Insurance Coverage in the 2020 CPS 

ASEC,” <www.census.gov/library/working

-papers/2020/demo/SEHSD-WP2020-13.html>, 

and Jonathan Rothbaum and C. Adam Bee, 

“Coronavirus Infects Surveys, Too: Nonresponse 

Bias During the Pandemic in the CPS ASEC,” 

<www.census.gov/library/working-papers

/2020/demo/SEHSD-WP2020-10.html>.

data collection in interpreting changes 

in health insurance coverage between 

2019 and other years using the CPS 

ASEC. As a result, no comparisons 

between calendar year coverage in 

2019 (collected in 2020) and other 

survey years are reported in this 

Appendix.

Estimates of health insurance 

coverage: 2013 to 2020 

Uninsured Rates 

Figure B-1 shows the percentage of 

people without health insurance coverage from 2013 to 2017, under the 

legacy processing system, and from 

2017 to 2020, using the updated processing system. The uninsured rate 

declined from 2013 to 2014, when 

many provisions of the ACA went 

into effect and continued to decline 

Figure B-1.

Percentage of People Without Health Insurance Coverage: 2013 to 2020 

(Numbers in percent. Population as of March of the following year)

Note: Information on confidentiality protection, sampling error, nonsampling error, and definitions is available at 

<https://www2.census.gov/programs-surveys/cps/techdocs/cpsmar21.pdf>.

Source: U.S. Census Bureau, Current Population Survey, 2018 Annual Social and Economic Supplement Bridge File and 2014 to 

2021 Annual Social and Economic Supplement (CPS ASEC). 

13.3

10.4

9.1 8.8 8.8

8.5 8.0 8.6 7.9

Legacy processing system 

Updated processing system 

Recession

0

5

10

15

20

25

30

2013 2014 2015 2016 2017 2018 2019 2020
U.S. Census Bureau Health Insurance Coverage in the United States: 2020 29

through 2016.7 The uninsured rate for 

2017 was lower under the updated 

processing system than under the 

legacy system. However, the percentage of uninsured increased between 

2017 and 2018 by 0.5 percentage 

points to 8.5 percent. 

In 2020, the uninsured rate was 8.6 

percent, 0.6 percentage points higher 

than the uninsured rate in 2017, but 

not significantly different from the 

rate in 2018. The CPS ASEC only 

includes people who had no coverage at all during calendar year 2020 

7 There was no significant change in the 

uninsured rate between 2016 and 2017 using 

the legacy processing system.

as uninsured. Therefore, people losing health insurance coverage in 2020

are not considered uninsured in 2020.

Private health insurance coverage 

The percentage of people with private health insurance coverage from 

2013 to 2020 is presented in Figure 

B-2.8 As shown, there was an increase

in private coverage rates between

2013 and 2015, coincident with the

implementation of the ACA, followed

8 Private coverage includes employersponsored insurance, insurance purchased 

directly by an individual, through a broker or 

the Marketplace (such as healthcare.gov). The 

updated processing system further includes 

TRICARE as private coverage.

by a leveling of private coverage 

between 2015 and 2017. 

Using the updated processing 

system, there was no statistically 

significant change in the private coverage rate between 2017 and 2018. 

However, between 2018 and 2020, 

the percentage of people with private health insurance coverage at any 

point during the year declined 0.8 

percentage points to 66.5 percent. 

Public coverage

Figure B-3 shows the percentage 

of people with public coverage and 

Medicaid coverage in the CPS ASEC 

from 2013 to 2020. Using the legacy 

Recession

0

50

55

60

65

70

75

80

2013 2014 2015 2016 2017 2018 2019 2020

Figure B-2.

Percentage of People With Private Health Insurance Coverage: 2013 to 2020 

(Numbers in percent. Population as of March of the following year)

Note: Information on confidentiality protection, sampling error, nonsampling error, and definitions is available at 

<https://www2.census.gov/programs-surveys/cps/techdocs/cpsmar21.pdf>.

Source: U.S. Census Bureau, Current Population Survey, 2018 Annual Social and Economic Supplement Bridge File and 2014 to 

2021 Annual Social and Economic Supplement (CPS ASEC). 

64.1

66.0 67.2 67.5 67.2

67.3 68.0

66.5

67.7

Legacy processing system 

Updated processing system 
30 Health Insurance Coverage in the United States: 2020 U.S. Census Bureau

processing system, public coverage 

increased from 2013 to 2017.9 Public 

coverage rates were lower in 2017 

using the updated processing system 

compared to the legacy processing 

system. However, TRICARE is defined 

as private coverage in the updated 

processing system and not as public 

coverage as in the legacy system. 

Although public coverage rates 

declined between 2017 to 2018 using 

the updated processing system, the 

9 Under the legacy processing system, public 

coverage increased annually, except for 2015 to 

2016, which was not a significant change.

percentage of people holding public 

coverage increased by 0.4 percentage 

points to 34.8 percent between 2018 

and 2020. 

As with public coverage, the percentage of people with Medicaid coverage 

declined between 2017 and 2018 by 

0.7 percentage points to 17.9 percent 

under the updated processing system. 

Although there was no significant 

difference in Medicaid coverage rates 

reported in the CPS ASEC between 

2018 and 2020, the lack of change 

masks a 0.4 percentage-point increase 

in the percentage of working-age 

adults aged 19 to 64 covered by 

Medicaid during this same time. 

Working-age adults may have been 

more vulnerable to losing coverage 

during the COVID-19 pandemic than 

other age groups (Figure B-4).10

Current Coverage, or Coverage at 

Time of the CPS ASEC Interview

The redesigned CPS ASEC also 

includes a measure of current coverage, health insurance coverage 

10 There was no significant change in the 

Medicaid coverage rate for children under the 

age of 19 or for percentage of adults aged 65 

and older between 2018 and 2020.

Recession

0

10

15

20

25

30

35

40

2013 2014 2015 2016 2017 2018 2019 2020

Figure B-3.

Percentage of People With Public Coverage and Medicaid Coverage: 2013 to 2020 

(Numbers in percent. Population as of March of the following year)

Note: Information on confidentiality protection, sampling error, nonsampling error, and definitions is available at 

<https://www2.census.gov/programs-surveys/cps/techdocs/cpsmar21.pdf>.

Source: U.S. Census Bureau, Current Population Survey, 2018 Annual Social and Economic Supplement Bridge File and 2014 

to 2021 Annual Social and Economic Supplement (CPS ASEC). 

17.5

19.5

34.6

19.6

37.7 37.1 36.5

19.4 19.3

18.5 17.9 17.2 17.8

34.4 34.1 34.8 34.8

37.3

Public coverage legacy processing system 

Medicaid coverage legacy processing system 

Medicaid coverage updated processing system 

Public coverage updated processing system 
U.S. Census Bureau Health Insurance Coverage in the United States: 2020 31

held at the time of the CPS ASEC 

interview. Although this measure of 

coverage cannot predict coverage 

in a given calendar year, it offers a 

snapshot of health insurance coverage early in the year, when CPS ASEC 

data are collected. A discussion of 

differences between the primary 

measure of health insurance coverage 

(calendar year coverage) and current 

coverage measured at the time of 

the interview in the CPS ASEC were 

discussed in the Research Matters 

blog, “Current Coverage, CalendarYear Coverage: Two Measures, Two 

Concepts,” published in 2019.11 

Figure B-5 illustrates the change in 

current coverage at the time of the 

2019 CPS ASEC interview in early 

2019, before the pandemic and 

11 Sharon Stern, “Current Coverage, CalendarYear Coverage: Two Measures, Two Concepts,” 

<www.census.gov/newsroom/blogs/research 

-matters/2019/09/current-coverage.html>.

pandemic-related changes to data 

collection, and at the time of the CPS 

ASEC interview in early 2021. 

As shown in Figure B-5, a decline in 

private coverage over the period was 

partly offset by an increase in the percentage of people covered by public 

insurance programs. As a result, the 

percentage of uninsured in early 2021 

(9.1 percent), when the CPS ASEC was 

collected, was not statistically different 

from the uninsured rate in early 2019.

* Denotes a statistically significant change from between 2017 and 2018, or 2018 and 2020. Users should consider the effect of the pandemic

on 2020 CPS ASEC data collection in interpreting changes in health insurance coverage between 2019 and other years using the CPS ASEC.

As a result, no comparisons between calendar year coverage in 2019 (collected in 2020) and other survey years are reported here.

1 The percentage of children under 19 with Medicaid coverage in 2020 is statistically different from the percentage of children under 19 with 

Medicaid coverage in 2017. 

Note: Information on confidentiality protection, sampling error, nonsampling error, and definitions is available 

at <https://www2.census.gov/programs-surveys/cps/techdocs/cpsmar21.pdf>.

Source: U.S. Census Bureau, Current Population Survey 2018 Annual Social and Economic Supplement Bridge File and 2019 to 2021 Annual 

Social and Economic Supplement (CPS ASEC).

Figure B-4.

Percentage of People With Medicaid Coverage by Age Group: 2017 to 2020 

36.5

35.3*

33.8 34.8

6.6 6.0 6.4 6.3

3.5

14.6 13.8 14.0* 14.4*

Under age 191 Aged 19 to 64 Aged 65 and older

(Numbers in percent. Population as of March of the following year)

2017 2018 2019 2020 2017 2018 2019 2020 2017 2018 2019 2020
32 Health Insurance Coverage in the United States: 2020 U.S. Census Bureau

Figure B-5.

Percentage of People With Health Insurance Coverage at Time of CPS ASEC Interview 

by Type: 2019 and 2021 

 2021 

2019

90.9

90.9

65.2

 66.2

52.9

 54.0

10.1

10.3

0.9

1.0

9.1

9.1

2.8

2.6

 34.8

34.0

 18.6

18.0

 17.6

17.2

(Numbers in percent. Population as of March of the calendar year)

* Denotes a statistically significant change between 2019 and 2021 at the 90 percent confidence level.

1 Includes CHAMPVA (Civilian Health Medical Program of the Department of Veterans Aairs), as well as care provided by the

Department of Veterans Aairs (VA) and the military.

Note: The estimates by type of coverage are not mutually exclusive: people can be covered by more than one type of health

insurance during the year. Information on confidentiality protection, sampling error, nonsampling error, and definitions is available

at <https://www2.census.gov/programs-surveys/cps/techdocs/cpsmar21.pdf>.

Source: U.S. Census Bureau, Current Population Survey, 2019 and 2021 Annual Social and Economic Supplement (CPS ASEC).

Uninsured

VA or CHAMPVA*, 

1

Medicaid*

Medicare*

Public coverage*

TRICARE*

Direct purchase

Employment-based*

Private coverage*

Any coverage

Consistent with calendar year 

coverage, private coverage in early 

2021 declined 1.0 percentage point 

to 65.2 percent, from early 2019 

before the COVID-19 pandemic. This 

decrease in private coverage was 

partly driven by a 1.1 percentagepoint drop in coverage through 

employer-sponsored insurance to 

52.9 percent, as many individuals 

may have lost their jobs and their 

coverage during the pandemic.12, 13

In contrast, by early 2021, 34.8 

percent of people were covered 

through public insurance programs, 

12 There was no statistical difference 

between the percent change in private coverage 

and the percent change in employment-based 

coverage between early 2019 and early 2021. 13 For more information regarding job losses 

during the COVID-19 pandemic, refer to Ryan 

Ansell and John P. Mullins, "COVID-19 Ends 

Longest Employment Recovery and Expansion 

in CES History, Causing Unprecedented Job 

Losses in 2020," Monthly Labor Review, 

U.S. Bureau of Labor Statistics, June 2021, 

<https://doi.org/10.21916/mlr.2021.13>. 

representing an increase of 0.9 percentage points. Between early 2019 

and early 2021, Medicaid coverage 

increased by 0.4 percentage points to 

17.6 percent, consistent with reports 

of increased enrollment. In early 

2021, 18.6 percent of people were 

covered under Medicare, representing an increase of 0.6 percentage 

points since 2019.14

14 Between 2019 and 2021, there was no statistical difference between the percent change 

in public coverage and Medicaid; public coverage and Medicare; or Medicaid and Medicare.

Health Insurance Coverage in the United States: 2020 P60-274 Current Population Reports U.S. Census Bureau

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