Health Insurance Coverage in the United States: 2019

Current Population Reports

By Katherine Keisler-Starkey and Lisa N. Bunch

Issued September 2020

P60-271
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.

Vonda Ashton, Mallory Bane, and Susan S. Gajewski, under the supervision 

of David Watt, all of the Demographic Surveys Division, and Lisa Cheok of 

the Associate Directorate for Demographic Programs, processed the Current 

Population Survey 2020 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.

Donna M. Daily, Chief of the American Community Survey Office, provided overall 

direction for the implementation of the 2019 American Community Survey. 

Nicole Butler, Dameka M. Reese, and Michelle Wiland of the American Community 

Survey Office oversaw the data collection including content, group quarters, and 

self-response. Kenneth B. Dawson, Reyan Azeem, and Arumugam Sutha of the 

Decennial Information Technology Division directed the edit and processing tasks 

for the 2019 American Community Survey 1-year estimates file.

Weiman Zhang, under the supervision of KeTrena Phipps and David V. Hornick, 

of the Demographic Statistical Methods Division, conducted the statistical review 

of all Current Population Survey data.

Sirius Fuller, under the supervision of Michael D. Starsinic and Mark Asiala, all of 

the Decennial Statistical Studies Division, conducted the statistical review of all 

American Community Survey data.

Lisa Cheok of the Associate Directorate for Demographic Programs, provided 

overall direction for the survey implementation. Roberto Cases of the Associate 

Directorate for Demographic Programs, and Charlie Carter and Agatha Jung of 

the Information Technology Directorate prepared and programmed the computerassisted interviewing instrument used to conduct the CPS ASEC.

Alexandra Cockerham and Linda Orsini prepared the maps under the direction of Kevin Hawley, Chief of the Cartographic Products and Services Branch, 

Geography Division.

Additional people within the U.S. Census Bureau also made significant contributions to the preparation of this report. Edward Berchick, Douglas Conway, Katrina 

Crankshaw, Adriana Hernandez-Viver, Matthew Marlay, Amy Steinweg, Jonathan 

Vespa, Susan Walsh, and Natalie Young of the Social, Economic, and Housing 

Statistics Division reviewed the contents.

Faye Brock, Linda Chen, Christine Geter, and Stephen Gibson provided publication management, graphics design and composition, and edito rial review for print 

and electronic media under the direction of Janet Sweeney, Chief of the Graphic 

and Editorial Services Branch, Public Information Office. Linda Vaughn of the 

Census Bureau’s Administrative and Customer Services Division provided printing 

management.

Census Bureau field representatives and telephone interviewers collected the 

data under difficult circumstances. For the Current Population Survey data presented in this report, the additional 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 

Wilbur Ross, 

Secretary

Karen Dunn Kelley, 

Deputy Secretary

U.S. CENSUS BUREAU 

Steven Dillingham,

Director

Health Insurance Coverage in 

the United States: 2019 Issued September 2020

P60-271
Suggested Citation 

Katherine Keisler-Starkey and 

Lisa N. Bunch 

U.S. Census Bureau 

Current Population Reports, 

P60-271, 

Health Insurance Coverage 

in the United States: 2019, 

U.S. Government Publishing Office, 

Washington, DC, 

2020.

U.S. CENSUS BUREAU 

Steven Dillingham, 

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: 2019 iii

Contents TEXT

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

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

Measurement of Health Insurance Coverage in Two Surveys ..... 2

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

CPS ASEC ................................................ 2

Highlights ............................................ 3

Health Insurance Coverage .............................. 4

Health Insurance Coverage in 2019 by Selected Characteristics ... 6

Health Insurance Coverage Over Time ...................... 8

Health Insurance Coverage by Age: 2008–2019 ............... 8

Health Insurance Coverage by Selected Characteristics: 2010, 

2018, and 2019 ............................................ 9

Children Without Health Insurance Coverage ................ 11

Health Insurance Coverage for Adults Aged 19 to 64 by 

Income-to-Poverty Ratio and Medicaid Expansion Status ...... 11

State Estimates of Health Insurance Coverage ................ 14

More Information About Health Insurance Coverage ........... 16

Additional Data and Contacts .......................... 16

State and Local Estimates of Health Insurance Coverage ..... 16

Source and Accuracy of the Estimates ......................... 16

Additional Data and Contacts ............................ 17

Customized Tables .................................. 17

Public-Use Microdata ................................ 17

Census Data API ...................................... 17

Technical Documentation ................................ 17

Comments ........................................... 17

TEXT TABLE

Table 1. Coverage Numbers and Rates by Type of Health Insurance: 

2018 and 2019 ................................... 5
iv Health Insurance Coverage in the United States: 2019 U.S. Census Bureau

FIGURES

Figure 1. Percentage of People by Type of Health Insurance Coverage: 2019 ........................ 4

Figure 2. Percentage of People Without Health Insurance Coverage by Selected Characteristics: 2019 .... 7

Figure 3. Percentage of People Without Health Insurance Coverage by Age: 2008 to 2019 ............. 8

Figure 4. Percentage of People by Health Insurance Coverage Type and Selected Characteristics: 2010, 

2018, and 2019 .......................................................................... 10

Figure 5. Percentage of Children Under the Age of 19 Without Health Insurance Coverage by Selected 

Characteristics: 2018 to 2019 .................................................... 12

Figure 6. Uninsured Rate by Poverty Status and Medicaid Expansion of State for Adults Aged 19 to 64: 

2018 to 2019 ............................................................................ 13

Figure 7. Uninsured Rate by State: 2019 ............................................................. 14

Figure 8. Percentage of People Without Health Insurance Coverage by State: 2010, 2018, and 2019 ....... 15

APPENDIX TABLES

Appendix Table 1. Percentage of People by Type of Health Insurance Coverage for Selected Ages 

    and Characteristics Using CPS ASEC Data: 2018 and 2019. . . . . . . . . . . . . . . . . . . . . . . . . . . 18

Appendix Table 2. Percentage of People by Type of Health Insurance Coverage for Selected Ages 

    and Characteristics Using ACS Data: 2018 and 2019 ................................ 19

Appendix Table 3. Percentage of People Without Health Insurance Coverage by State: 2010, 2018, 

    and 2019 ....................................................................... 20
U.S. Census Bureau Health Insurance Coverage in the United States: 2019 1

Introduction

Health Insurance Coverage in the

United States: 2019

Health insurance is a means of 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 the government. Other 

individuals do not have health 

insurance coverage at all (see the 

text box “What Is Health Insurance 

Coverage?”).

Year to year, the prevalence 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 statistics on 

health insurance coverage in the 

United States in 2019 and changes in 

health insurance coverage between 

2018 and 2019.1 The statistics in this 

report are based on information collected in two surveys conducted by 

the U.S. Census Bureau—the Current 

Population Survey Annual Social and 

Economic Supplement (CPS ASEC) 

and the American Community Survey 

(ACS). 

1 The Census Bureau reviewed this data 

product for unauthorized disclosure of confidential information and approved the disclosure 

avoidance practices applied to this release. 

CBDRB-FY20-POP001-0172.

The CPS is the longest-running 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 part. The Census Bureau 

has integrated improvements to the 

CPS ASEC as the needs of data users 

and the health insurance environment 

have changed. This report presents 

estimates of health insurance coverage and type of coverage based on 

the CPS ASEC in 2019.

The 2019 CPS ASEC statistics used 

in this report were collected from 

February 2020 to April 2020. As a 

result of the COVID-19 pandemic, 

some data collection procedures 

What Is Health Insurance Coverage?

Health insurance coverage in the CPS ASEC refers to comprehensive coverage at any time during the calendar 

year.* Health insurance coverage in the ACS refers to comprehensive coverage at the time of interview. For all 

analyses, the population is restricted to the civilian, noninstitutionalized population. For reporting purposes, the 

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 

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.

People were 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.

health care costs for people aged 65 and older and 

for certain people under age 65 with long-term 

disabilities.

• Medicaid: Medicaid, the Children’s Health Insurance 

Program (CHIP), and individual state health plans.

•
2 Health Insurance Coverage in the United States: 2019 U.S. Census Bureau

were altered to protect the health of 

the public and those collecting the 

data (see the text box “The Impact 

of the Coronavirus (COVID-19) 

Pandemic on the CPS ASEC”). The 

Census Bureau has several working 

papers investigating how changes 

in CPS ASEC data collection in 2020 

may have affected published estimates.2 The Census Bureau recommends users consider the impact 

of the pandemic on CPS ASEC data 

collection in interpreting changes in 

health insurance coverage between 

2018 and 2019 using the CPS ASEC.

The ACS is an ongoing survey that 

collects comprehensive information 

on social, economic, and housing 

topics. Due to its large sample size, 

the ACS provides estimates at many 

levels of geography. In response to 

legislative needs by partner federal 

agencies, the ACS added questions 

on health insurance in 2008. This 

report presents estimates of yearto-year change and the difference 

between health insurance coverage 

in 2010 and 2019 based on the ACS. 

The use of both surveys provides 

a more complete picture of health 

insurance coverage in the United 

States in 2019.

Measurement of Health Insurance 

Coverage in Two Surveys

The CPS ASEC and the ACS both ask 

whether people have health insurance coverage and, if so, about the 

type of health coverage they have. 

The two surveys differ in the question wording, the reference period for 

health insurance estimates, and when 

2 For additional information related to the 

impact of COVID-19 on the 2020 CPS ASEC, 

see Berchick, Edward R., 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 Rothbaum, Jonathan 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>.

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

The 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. This year, data collection faced 

extraordinary circumstances. On March 11, 2020, the World Health 

Organization declared that global coronavirus cases had reached pandemic levels. As the United States began to grapple with the implications 

of the COVID-19 pandemic for the nation, interviewing for the March 

CPS began (the official start date was March 15). In order to protect the 

health and safety of Census Bureau staff and respondents, the survey 

suspended in-person interviews and closed both Computer-Assisted 

Telephone Interviewing (CATI) contact centers on March 20. For the rest 

of March and through April, the Census Bureau continued to attempt 

all interviews by phone. For those whose first month in the survey was 

March or April, the Census Bureau used vendor-provided telephone numbers associated with the sample address. 

While the Census Bureau went to great lengths to complete interviews 

by telephone, the response rate for the CPS basic household survey was 

73 percent in March 2020, about 10 percentage points lower than in preceding months and the same period in 2019, which were regularly above 

80 percent. Further, as the Bureau of Labor Statistics stated in their FAQs 

accompanying the April 3 release of the March Employment Situation, 

“Response rates for households normally more likely to be interviewed 

in person were particularly low. The response rate for households entering the sample for their first month was over 20 percentage points lower 

than in recent months, and the rate for those in the fifth month was over 

10 percentage points lower.” 

The change from conducting first interviews in person to making first 

contacts by telephone only is a contributing factor to the lower response 

rates. Further, it is likely that the characteristics of people for whom a 

telephone number was found may be systematically different from the 

people for whom the Census Bureau was unable to obtain a telephone 

number. While the Census Bureau creates weights designed to adjust for 

nonresponse and to control weighted counts to independent population 

estimates by age, sex, race, and Hispanic origin, the magnitude of the 

increase in (and differential nature of) nonresponse related to the pandemic likely reduced their efficacy.1 Using administrative data, Census 

Bureau researchers have documented that the nonrespondents in 2020 

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 had relatively higher income and were more educated than nonrespondents. For 

more details, see <www.census.gov/newsroom/blogs/random

-samplings/2020/09/pandemic-affect-survey-response.html>. 

1 For more information about the design of the survey, see Technical Paper 77, 

<https://www2.census.gov/programs-surveys/cps/methodology/CPS-Tech-Paper-77.pdf>.
U.S. Census Bureau Health Insurance Coverage in the United States: 2019 3

and how the data are collected.3 Key 

differences between the surveys are 

summarized below.

In the CPS ASEC, which is conducted between February and April, 

respondents answer questions about 

whether they had health insurance 

coverage at any time in the previous calendar year. People are considered “uninsured” only if they had 

no health insurance coverage at any 

time during the previous calendar 

year. In contrast, the ACS is collected 

continuously throughout the calendar year. The survey asks if a person 

is currently covered by any of a list 

of types of health insurance. People 

are considered uninsured in the ACS 

if they report that they do not have 

health coverage at the time that they 

answered the survey.

The CPS ASEC and the ACS also 

differ in terms of interview mode, or 

how the data are collected. The CPS 

ASEC is conducted by interviewers, 

either with a personal visit or over 

the telephone. For the ACS, although 

some respondents complete the 

survey with an interviewer, the majority of people respond for themselves 

using an Internet questionnaire or a 

mailed paper form. 

The CPS ASEC underwent a twostage redesign in recent years, 

including changes to the questionnaire in 2014 and to post-survey 

collection processing methods in 

2019.4 Evidence suggests that the 

redesign addressed known limitations 

to CPS ASEC health coverage measures and improved health insurance 

3 For additional information on measurement 

of health insurance coverage in the CPS ASEC 

and the ACS, see <www.census.gov/topics

/health/health-insurance/guidance.html>. 4 For more information on the survey redesign, see Berchick, Edward R., Jessica C. Barnett, 

and Rachel D Upton, “Health Insurance Coverage 

in the United States: 2018,” Appendix A, Current 

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

Washington DC, 2019, <www.census.gov/content

/dam/Census/library/publications/2019/demo

/p60-267.pdf>.

measurement.5 The 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 and 

the uninsured. The Census Bureau 

generally recommends the CPS ASEC 

be used for national statistics and the 

ACS be used for small populations, 

subnational geographies, and comparisons over a longer time period 

(from 2008 to 2019). 

This report describes health insurance coverage at the national level 

using the CPS ASEC. It primarily uses 

the ACS 1-year estimates to examine coverage for key populations 

and to compare changes in coverage between 2018 and 2019. ACS 

1-year estimates data were collected 

during 2019 and, thus, data collection occurred before the COVID-19 

pandemic. The use of both surveys 

provides a more complete picture 

of health insurance coverage in the 

United States in 2019.

Highlights 

• In 2019, 8.0 percent of people, or 

26.1 million, did not have health 

insurance at any point during 

the year, according to the CPS 

ASEC (Figure 1 and Table 1).6

The percentage of people with 

health insurance coverage for all 

5 Jackson, H. and E. 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 

<https://doi.org/10.1177/0046958020923554> 

and Berchick, E. R. and H. M. Jackson, “Health 

Insurance Coverage in the 2017 CPS ASEC 

Research File,” SEHSD Working Paper WP2019-

01, 2019, <www.census.gov/content/dam

/Census/library/working-papers/2019/demo

/sehsd-wp2019-01.pdf>. 6 Infants born after the end of the calendar 

year are excluded from estimates of health 

coverage in the previous calendar year in the 

CPS ASEC. These infants were not yet born and, 

therefore, neither had coverage nor were uninsured during the previous calendar year.

or part of 2019 was 92.0 percent 

(Table 1).7

• Private health insurance coverage was more prevalent than 

public coverage, covering 68.0 

and 34.1 percent of the population at some point during the 

year, respectively (see the text 

box “What Is Health Insurance 

Coverage?”).8 Employment-based 

insurance was the most common 

subtype (Figure 1 and Table 1).

• In 2019, 9.2 percent of people, 

or 29.6 million, were not covered 

by health insurance at the time of 

interview, according to the ACS, 

up from 8.9 percent and 28.6 million (Table 1).9

• In 2019, the percentage of 

people with employer-provided 

coverage at the time of interview 

was slightly higher than in 2018, 

from 55.2 percent in 2018 to 55.4 

percent in 2019.10, 11

• The percentage of people with 

Medicaid coverage at the time 

of interview decreased to 19.8 

percent in 2019, down from 20.5 

percent in 2018 (Table 1). 

• Between 2018 and 2019, the percentage of people without health 

insurance coverage decreased 

in one state and increased in 19 

states (Figure 8).

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 and ACS. 8 Some people may have more than one 

coverage type during the calendar year. 9 The CPS ASEC and the ACS have different sampling frames. To ensure consistency 

between surveys, the ACS analysis throughout this report includes only the civilian 

noninstitutionalized population. For additional 

information, see <www.census.gov/programs

-surveys/acs/>. 10 Estimates in this highlight and the remaining 

highlights come from the ACS 1-year estimates. 11 Throughout this report, details may not 

sum to totals because of rounding.
4 Health Insurance Coverage in the United States: 2019 U.S. Census Bureau

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. For information on confidentiality protection, sampling error, nonsampling error, and definitions in the Current Population 

Survey, see <https://www2.census.gov/programs-surveys/cps/techdocs/cpsmar20.pdf>.

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

Figure 1.

Percentage of People by Type of Health Insurance Coverage: 2019

 VA and CHAMPVA

 Medicaid

 Medicare

Any public plan

 TRICARE

 Direct-purchase

 Employment-based

Any private plan

With health insurance 

Uninsured

2019 Type of Coverage

(Population as of March 2020)

8.0

92.0

68.0

56.4

10.2

2.6

34.1

18.1

17.2

1.0

• All states and the District of 

Columbia had a lower uninsured 

rate in 2019 than in 2010.

Health Insurance Coverage

This report classifies health insurance 

coverage into three categories: 

overall coverage, private coverage, 

and public coverage (see the text 

box “What Is Health Insurance 

Coverage?”). 

Most people (92.0 percent) had health 

insurance coverage at some point 

during 2019 (Figure 1 and Table 1). 

That is, 8.0 percent of people, or 26.1 

million, were uninsured for the entire 

calendar year. More people had private health insurance (68.0 percent) 

than public coverage (34.1 percent).12

Employment-based insurance was 

the most common subtype of health 

insurance, with 56.4 percent of people 

holding this type of coverage in 2019. 

About 10.2 percent of people held 

direct-purchase health coverage, and 

12 See the text box “What Is Health Insurance 

Coverage?” for definitions of private and public 

coverage. Some people may have more than one 

coverage type during the calendar year.

2.6 percent were covered through 

TRICARE. Of the two most common 

types of public coverage, Medicare 

covered more people than Medicaid 

(18.1 percent compared with 17.2 

percent, respectively). About 1.0 percent of people were covered through 

VA or CHAMPVA health care (Table 1 

and Figure 1).13

The ACS also provides estimates 

of health insurance coverage at the 

national level. As a result of the differences between the CPS ASEC and the 

ACS discussed above, the estimates 

of health insurance coverage are not 

expected to be the same in both 

surveys. 

The ACS found that 90.8 percent of 

the population had health insurance 

coverage at the time of interview 

in 2019, and the CPS ASEC found 

92.0 percent had coverage at some 

point during 2019. The relationships 

among coverage types in the ACS 

13 The final category includes CHAMPVA 

(Civilian Health and Medical Program of the 

Department of Veterans Affairs) coverage and 

care provided by the Department of Veterans 

Affairs and the military.

are consistent with those reported 

in the CPS ASEC. For example, more 

people had private health insurance 

(67.4 percent) than public coverage 

(35.4 percent) at the time of interview.14 Employment-based insurance 

was the most common subtype of 

health insurance coverage held at 

the time of interview in 2019 (55.4 

percent), followed by Medicaid (19.8 

percent), Medicare (18.1 percent), 

direct-purchase insurance (13.1 

percent), TRICARE (2.7 percent), 

and VA or CHAMPVA health care (2.2 

percent) (Table 1).15

The two surveys find different yearto-year changes in overall coverage 

and for some types of coverage. 

For instance, the CPS ASEC found 

health insurance coverage statistically increased between 2018 and 

2019, driven by employment-based 

health insurance. In contrast, the ACS 

showed the overall coverage rate 

14 Some people may have more than one coverage type at the time of the interview. 15 The ACS estimates for Medicare and 

TRICARE are not significantly different than 

the CPS estimates for Medicare and TRICARE, 

respectively.
U.S. Census Bureau Health Insurance Coverage in the United States: 2019 5

Table 1. 

Coverage Numbers and Rates by Type of Health Insurance: 2018 and 2019

(Numbers in thousands. Margins of error in thousands or percentage points as appropriate. CPS ASEC population as of March of the following year. 

ACS population as of July of the calendar year. For information on confidentiality protection, sampling error, nonsampling error, and definitions, see 

<https://www2.census.gov/programs-surveys/cps/techdocs/cpsmar20.pdf> and <https://www2.census.gov/programs-surveys/acs/tech_docs/accuracy

/ACS_Accuracy_of_Data_2019.pdf>)

Coverage type

2018 2019 Change 

(2019 less 

Number 2018)

Margin of 

error1 (±) Percent

Margin of 

error1 (±) Number

Margin of 

error1 (±) Percent

Margin of 

error1 (±)

CPS ASEC2

    Total . . . . . . . . . . . . . . . . . 323,668 133 X X 324,550 132 X X X

Any health plan . . . . . . . . . . . . . . . 296,206 641 91.5 0.2 298,438 689 92.0 0.2 *0.4

 Any private plan3, 4 . . . . . . . . . . . 217,780 1,222 67.3 0.4 220,848 1,121 68.0 0.3 *0.8

  Employment-based3. . . . . . . . . 178,350 1,283 55.1 0.4 183,005 1,142 56.4 0.4 *1.3

  Direct-purchase3. . . . . . . . . . . . . 34,846 647 10.8 0.2 33,170 776 10.2 0.2 *–0.5

   Marketplace coverage3. . . . . 10,743 428 3.3 0.1 9,716 417 3.0 0.1 *–0.3

  TRICARE3. . . . . . . . . . . . . . . . . . . 8,537 508 2.6 0.2 8,534 522 2.6 0.2 Z

 Any public plan3, 5 . . . . . . . . . . . 111,330 962 34.4 0.3 110,687 967 34.1 0.3 –0.3

  Medicare3. . . . . . . . . . . . . . . . . . . 57,720 401 17.8 0.1 58,779 408 18.1 0.1 *0.3

  Medicaid3. . . . . . . . . . . . . . . . . . . 57,819 891 17.9 0.3 55,851 927 17.2 0.3 *–0.7

  VA or CHAMPVA3, 6. . . . . . . . . . . 3,217 182 1.0 0.1 3,221 188 1.0 0.1 Z

Uninsured2 . . . . . . . . . . . . . . . . . . . 27,462 630 8.5 0.2 26,111 657 8.0 0.2 *–0.4

ACS2

    Total . . . . . . . . . . . . . . . . . 322,249 15 X X 323,121 18 X X X

Any health plan . . . . . . . . . . . . . . . 293,684 178 91.1 0.1 293,482 210 90.8 0.1 *–0.3

 Any private plan3, 4 . . . . . . . . . . . 217,623 404 67.5 0.1 217,812 446 67.4 0.1 –0.1

  Employment-based3. . . . . . . . . 177,740 354 55.2 0.1 178,919 404 55.4 0.1 *0.2

  Direct-purchase3. . . . . . . . . . . . . 43,191 184 13.4 0.1 42,302 179 13.1 0.1 *–0.3

  TRICARE3. . . . . . . . . . . . . . . . . . . 8,767 79 2.7 Z 8,782 88 2.7 Z Z

 Any public plan3, 5 . . . . . . . . . . . 114,750 205 35.6 0.1 114,315 222 35.4 0.1 *–0.2

  Medicare3. . . . . . . . . . . . . . . . . . . 56,869 63 17.6 Z 58,327 59 18.1 Z *0.4

  Medicaid3. . . . . . . . . . . . . . . . . . . 65,965 234 20.5 0.1 64,077 247 19.8 0.1 *–0.6

  VA or CHAMPVA3, 6. . . . . . . . . . . 7,477 44 2.3 Z 7,247 57 2.2 Z *–0.1

Uninsured2 . . . . . . . . . . . . . . . . . . . 28,566 183 8.9 0.1 29,639 210 9.2 0.1 *0.3

* 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 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 In the CPS ASEC, individuals are considered to be uninsured if they do not have health insurance coverage for the entire calendar year. In the ACS, individuals are considered 

uninsured if they are uninsured at the time of interview.

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

4 Private health insurance includes coverage provided through an employer or union, coverage purchased directly, or TRICARE.

5 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.

6 Includes CHAMPVA, as well as care provided by the Department of Veterans Affairs and the military. 

Source: U.S. Census Bureau, Current Population Survey, 2019 and 2020 Annual Social and Economic Supplement (CPS ASEC), 2018 and 2019 American Community Surveys 

(ACS), 1-Year Estimates.
6 Health Insurance Coverage in the United States: 2019 U.S. Census Bureau

decreased between 2018 and 2019. An 

increase in employment-based coverage at the time of interview in the ACS 

was offset by decreases in direct purchase, Medicaid, VA, and CHAMPVA 

coverage. Both surveys found that 

Medicare coverage increased and 

Medicaid coverage declined between 

2018 and 2019.16 Direct-purchase 

coverage also decreased in both 

surveys.17

The diverging results from the 

two surveys may reflect real-world 

changes. For instance, the timing of 

changes in economic conditions may 

affect when individuals experience 

coverage transitions. Higher employment in the latter part of the year 

may not be reflected in coverage 

estimates at time of interview (ACS), 

but may be captured by measures of 

any coverage in the previous calendar 

year (CPS ASEC).18 At the same time, 

the operational changes to CPS ASEC 

data collection required due to the 

COVID-19 pandemic may also have 

contributed to higher estimates of 

employer-provided coverage.

Health Insurance Coverage in 2019 by 

Selected Characteristics 

The prevalence of health insurance 

coverage varies across social and 

economic characteristics. This section 

16 The increase in Medicare coverage was 

partly due to growth in the number of people 

aged 65 and older. Among those 65 years 

and older, the Medicare coverage rate did not 

statistically change between 2018 and 2019 in 

either survey. However, the percentage of the 

U.S. population 65 years and older increased 

between 2018 and 2019. 17 The 2018–2019 differences of the ACS 

estimates for Medicare, Medicaid, and Direct 

Purchase were not significantly different than 

the 2018–2019 differences of the CPS estimates 

for Medicare, Medicaid, and Direct Purchase, 

respectively. 18 Notably, since the ACS added health 

insurance questions, the comparisons in health 

insurance coverage between years have not 

resulted in statistically significant results that 

vary in direction of change between the two 

surveys. Until now, the two surveys have either 

both identified statistically significant year-toyear change in the same direction or the apparent change in the CPS ASEC was not statistically significant.

focuses on coverage at any time in 

2019 using the CPS ASEC. 

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 

other children may receive coverage 

through a parent or guardian’s plan up 

to the age of 25.19 In 2019, 1.1 percent of adults aged 65 and older were 

uninsured for the entire calendar year, 

followed by children under the age of 

19 (5.2 percent) and adults aged 19 to 

64 (11.1 percent) (Figure 2).

In 2019, coverage differed across race 

and Hispanic origin groups. The uninsured rates for non-Hispanic Whites 

and Asians were 5.2 percent and 6.2 

percent, respectively.20 The percentages of Blacks and Hispanics with 

no health insurance coverage for the 

entire calendar year were higher than 

for non-Hispanic Whites, at 9.6 percent and 16.7 percent, respectively. 

Hispanics had the highest uninsured 

19 The 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. 20 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. The ACS, based on a larger sample of the 

population, is a better source for estimating and 

identifying changes for small subgroups of the 

population.

rates among all race and ethnic 

groups (Figure 2).21

Family economic resources may 

also determine access to coverage. 

One way to consider the economic 

resources of a family is to look at 

coverage by the income-to-poverty 

ratio. The income-to-poverty ratio 

compares a family’s or an unrelated 

individual’s income with the applicable threshold. People in families are 

classified as being in poverty if their 

family income is less than their poverty threshold.22 People who live alone 

or with nonrelatives have a poverty 

status that is defined based on their 

own income. 

Health insurance coverage rates are 

generally higher for people in higher 

income-to-poverty ratio groups. In 

21 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.

Since Hispanics may be any race, data in this 

report for Hispanics overlap with data for race 

groups. Being Hispanic was reported by 15.6 percent of White householders who reported only 

one race, 5.0 percent of Black householders who 

reported only one race, and 2.5 percent of Asian 

householders who reported only one race.

Data users should exercise caution when 

interpreting aggregate results for the Hispanic 

population or for race groups because these 

populations consist of many distinct groups that 

differ in socioeconomic characteristics, culture, 

and nativity. For further information, see 

<www.census.gov/cps>. 22 The Office of Management and Budget 

determined the official definition of poverty in 

Statistical Policy Directive 14. Appendix B of the 

report, “Income and Poverty in the United States: 

2019,” provides a more detailed description of 

how the Census Bureau calculates poverty; see 

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

/publications/2020/demo/p60-270.pdf>.
U.S. Census Bureau Health Insurance Coverage in the United States: 2019 7

2019, the uninsured rate was highest among people in poverty (living 

below 100 percent of their poverty 

threshold) and decreased as the 

income-to-poverty ratio increased. 

People in poverty had the highest 

uninsured rate (15.9 percent), while 

people living at or above 400 percent 

of poverty had the lowest uninsured 

rate (3.0 percent). 

For many people aged 15 to 64, 

health insurance coverage is also 

related to work status such as working full-time, year-round; working 

less than full-time, year-round; or 

not working at all during the calendar year.23 In 2019, 10.2 percent of 

people who worked at some point 

during the previous calendar year did 

not have health insurance coverage. 

Full-time, year-round workers were 

less likely to be uninsured (8.9 percent) than people working less than 

23 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.

full-time, year-round (13.4 percent) 

or nonworkers (12.2 percent). 

Many adults obtain health insurance 

coverage through their spouse and, 

therefore, health insurance coverage 

is related to marital status. In 2019, 

adults aged 19 to 64 who were not 

married were about twice as likely 

to be uninsured than their married 

counterparts (15.0 percent compared 

with 7.6 percent).

Figure 2.

Percentage of People Without Health Insurance Coverage by Selected Characteristics: 2019 

8.0

11.3

3.0

5.2

 11.1

1.1

10.7

10.2

8.9

13.4

12.2

7.6

 15.0

 15.9

 16.7

(Population as of March 2020)

1

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

Note: In the Current Population Survey Annual Social and Economic Supplement (CPS ASEC), people are considered uninsured if they 

do not have health insurance coverage for the entire calendar year. For information on confidentiality protection, sampling error, 

nonsampling error, and definitions in the Current Population Survey, see <https://www2.census.gov/programs-surveys/cps/techdocs

/cpsmar20.pdf>.

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

6.2

9.6

8.0

5.2

11.1

Not married

Married

Total, aged 19 to 64

Marital Status

Did not work

Less than full-time, year-round workers 

Full-time, year-round workers 

All workers

Total, aged 15 to 64

Work Experience

At or above 400% of poverty

Between 100% and 399% of poverty

Below 100% of poverty

1Poverty universe

Income-to-Poverty Ratio

Hispanic (any race)

Asian

Black

White, not Hispanic

Race and Hispanic Origin

Aged 65 and older

Aged 19 to 64

Under age 19

Age

Total
8 Health Insurance Coverage in the United States: 2019 U.S. Census Bureau

Health Insurance Coverage Over 

Time

Although the CPS ASEC is the longest running survey producing estimates of health insurance coverage, 

the economic and political landscape 

has shifted over the past 25 years. 

These real-world changes have led to 

a robust agenda for survey improvement. Most recently, the Census 

Bureau has implemented improvements to the CPS ASEC in a two-step 

process, starting with a questionnaire 

redesign in 2014 and an updated 

processing system in 2019.

Due to changes in survey content 

and methodology, researchers should 

use caution when comparing health 

insurance coverage estimates from 

the CPS ASEC over time.24 CPS 

ASEC health insurance estimates for 

calendar year 2013 through 2017 are 

not directly comparable to previous 

years. Additionally, estimates for 

calendar year 2018 and later years 

should only be compared with 2017 

estimates from the 2018 ASEC Bridge 

file or 2016 estimates from the 2017 

Research file.

The ACS, which began collecting 

data on health insurance coverage in 

2008, provides comparable estimates 

of health insurance coverage and 

changes in health insurance coverage over a longer period than the 

24 For a discussion of measuring change 

over time with the CPS ASEC, see Berchick, 

Edward R., Jessica C. Barnett, and Rachel D. 

Upton, "Health Insurance Coverage in the 

United States: 2018," Appendix A, Current 

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

Washington DC, 2019, <www.census.gov/content

/dam/Census/library/publications/2019/demo

/p60-267.pdf>.

redesigned CPS ASEC.25 This report 

uses the ACS to present health insurance coverage over the longer time 

period. Further, this year the report 

uses ACS data to measure year-toyear changes in coverage by selected 

characteristics. These data for 2019 

were collected prior to the COVID19 pandemic and are not impacted 

by subsequent changes in survey 

operations. For more information, 

see the text box “The Impact of the 

Coronavirus (COVID-19) Pandemic 

on the CPS ASEC.” 

Health Insurance Coverage by Age: 

2008–2019

As shown in Figure 3, between 2008 

and 2013, the uninsured rate for 

children under the age of 19 steadily 

25 For a discussion of health insurance coverage in the ACS, see text box “Health Insurance 

Coverage in the ACS” in Berchick, Edward R., 

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, <www.census.gov

/content/dam/Census/library/publications/2019

/demo/p60-267.pdf>.

Figure 3.

Percentage of People Without Health Insurance Coverage by Age: 2008 to 2019

Note: Estimates reflect the population as of July of the calendar year. For information on confidentiality protection, sampling error, 

nonsampling error, and definitions in the American Community Survey, see <https://www2.census.gov/programs-surveys/acs

/tech_docs/accuracy/ACS_Accuracy_of_Data_2019.pdf>. 

Source: U.S. Census Bureau, 2008 to 2019 American Community Surveys (ACS), 1-Year Estimates.

Percent

0

5

10

15

20

25

2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019

Aged 19–64

Aged 0–18

Aged 65+

(Civilian noninstitutionalized population)
U.S. Census Bureau Health Insurance Coverage in the United States: 2019 9

declined and the uninsured rate for 

adults aged 65 and older increased 

slightly. Following an increase 

between 2008 and 2010 during and 

immediately following the recession, 

the uninsured rates for working-age 

adults declined between 2010 and 

2013. The uninsured rate further 

decreased by 4.1 percentage points 

for adults aged 19 to 64 and by 1.2 

percentage points for children under 

the age of 19 between 2013 and 2014, 

when many provisions of the Patient 

Protection and Affordable Care Act 

(ACA) were implemented.26

Between 2018 and 2019, the uninsured rate for the two under-65 age 

groups each increased by 0.4 percentage points, to 12.9 percent for adults 

aged 19 to 64 and to 5.7 percent for 

children under the age of 19. The 

uninsured rate for people aged 65 

and older did not statistically change 

between 2018 and 2019.

Health Insurance Coverage by 

Selected Characteristics: 2010, 2018, 

and 2019 

Between 2018 and 2019, Hispanics 

experienced the largest change in 

uninsured rates among race and 

Hispanic origin groups, increasing 

from 17.9 percent in 2018 to 18.7 percent in 2019, a 0.7 percentage-point 

increase. The percentage of nonHispanic Whites and Asians without 

health insurance coverage increased 

by 0.2 and 0.3 percentage points, 

respectively. However, there was no 

statistical change in the percentage 

of Blacks without health insurance 

coverage between 2018 and 2019 

(Appendix Table A-2).27

26 See text box “Health Insurance Coverage 

and the Affordable Care Act” in Berchick, 

Edward R., Emily Hood, and Jessica C. Barnett, 

"Health Insurance Coverage in the United States: 

2017," Current Population Reports, P60-264, 

U.S. Census Bureau, Washington DC, 

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

/publications/2018/demo/p60-264.pdf>. 27 The change in the uninsured rate between 

2018 and 2019 for Asians was not statistically different from the change for Blacks or the change 

for non-Hispanic Whites.

The increase in the uninsured rate 

for Hispanics was driven by a 1.4 

percentage-point decrease in the 

percentage of Hispanics with public 

coverage (to 36.3 percent) (Figure 

4). Despite the decrease in their 

overall coverage, the percentage 

of Hispanics with private coverage 

increased by 0.6 percentage points 

(to 50.1 percent) between 2018 and 

2019 (Figure 4 and Appendix Table 

A-2).28 Between 2018 and 2019, 

Blacks also experienced an increase 

in private coverage (0.4 percentage 

points)29 and a decrease in public coverage (0.4 percentage points).30 The 

percentage of non-Hispanic Whites 

with private coverage decreased 0.4 

percentage points to 74.7 percent, 

while the percentage with public 

coverage increased 0.2 percentage 

points to 34.3 percent. 

Health insurance coverage and type 

also vary by income-to-poverty ratio. 

People in higher income-to-poverty 

groups were more likely to be covered 

through private coverage than people 

in lower income-to-poverty groups 

in 2019. For example, in 2019, 87.6 

percent of people with income-topoverty ratio at or above 400 percent 

of poverty had private coverage, 

compared with 60.1 percent for those 

with incomes 100 to 399 percent of 

poverty, and 26.6 percent for those 

with incomes below poverty. 

In contrast, public coverage was the 

most prevalent for the population 

in poverty (65.2 percent) and least 

prevalent for the population with 

income-to-poverty ratios at or above 

400 percent of poverty (21.9 percent). 

Between 2018 and 2019, rates of private coverage decreased among the 

28 The change in the private coverage rate 

between 2018 and 2019 for Hispanics was not 

statistically different from the change for Blacks 

or Asians. 29 The change in the private coverage rate 

between 2018 and 2019 for Blacks was not statistically different from the change for Hispanics 

or Asians. 30 The change in the public coverage rate 

between 2018 and 2019 for Blacks was not statistically different from the change for Asians.

populations with income-to-poverty 

ratios between 100 and 399 percent of 

poverty and at or above 400 percent 

of poverty.31 Rates of public health 

insurance decreased among the populations with income-to-poverty ratios 

between 100 and 399, but increased 

for those at or above 400 percent of 

poverty. Both private and public coverage rates for people with incometo-poverty ratio below 100 percent 

of their poverty threshold did not 

statistically change (Figure 4).32

Workers are generally more likely 

to have private coverage than nonworkers, due to the availability of 

employment-based coverage. In 2019, 

84.6 percent of full-time, year-round 

workers were covered through private 

insurance, a decrease of 0.5 percentage points compared with 2018. 

Private insurance coverage rates for 

those who worked less than full-time, 

year-round decreased by 0.3 percentage points to 66.4 percent.33 Private 

coverage did not statistically change 

for nonworkers between 2018 and 

2019.

Looking at public coverage in 2019, 

nonworkers were about twice as likely 

as those who worked less than fulltime, year-round to have public coverage: 42.6 percent and 21.0 percent 

had public coverage, respectively. 

About 7.4 percent of full-time, yearround workers had public coverage. 

Between 2018 and 2019, public coverage decreased by 0.5 percentage 

points for nonworkers, 0.2 percentage 

points among those who worked fulltime, year-round, and 0.2 percentage 

31 The change in the private coverage rate 

between 2018 and 2019 for those with incometo-poverty ratios between 100 and 399 percent 

of poverty was not statistically different from 

the change for those at or above 400 percent of 

poverty. 32 The change in the public coverage rate 

between 2018 and 2019 for those with incometo-poverty ratios between 100 and 399 percent 

of poverty was not statistically different from the 

change for those in poverty. 33 The change in the private coverage rate 

between 2018 and 2019 for those who worked 

full-time, year-round was not statistically different from the change for those who worked less 

than full-time, full-year-round.
10 Health Insurance Coverage in the United States: 2019 U.S. Census Bureau

 Total

Race and Hispanic Origin

White, not Hispanic

Black

Asian

Hispanic (any race)

Income-to-Poverty Ratio

1Poverty universe

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

Figure 4.

Percentage of People by Health Coverage Type and Selected Characteristics: 2010, 

2018, and 2019

(Civilian noninstitutionalized population. If 2018 appears to be missing for a characteristic, then it is within 

1.0 percentage point of the 2019 estimate. The dierence in the 2018 and 2019 point estimates may still be 

statistically significant. To determine the significance of these dierences, please see Table A-2)

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

Note: Dierences are calculated with unrounded numbers, which may produce dierent results from using the rounded values in the

figure. 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. For information on confidentiality protection, sampling error, nonsampling error, and definitions in the American 

Community Survey, see <https://www2.census.gov/programs-surveys/acs/tech_docs/accuracy/ACS_Accuracy_of_Data_2019.pdf>.

Source: U.S. Census Bureau, 2010, 2018, and 2019 American Community Surveys (ACS), 1-Year Estimates.

Percent 

2010 2018 2019 2010 2018 2019

0 20 40 60 80 100 0 20 40 60 80 100

Public Private
U.S. Census Bureau Health Insurance Coverage in the United States: 2019 11

points among those who worked less 

than full-time, year-round.34

Because health insurance can be 

obtained through a spouse, marital 

status is an important factor for coverage. Neither married nor unmarried 

adults experienced a statistical change 

in private coverage rates between 

2018 and 2019.35 Among married 

adults in 2019, 12.0 percent had public 

coverage, a 0.6 percentage-point 

decrease compared with 2018. Among 

unmarried adults in 2019, 23.5 percent 

had public coverage, a 0.5 percentagepoint decrease from 2018.

For all social and demographic characteristics examined, public coverage 

increased between 2010 and 2019.36

Private coverage generally increased 

over this same time period, with a 

few exceptions. The percentage of 

non-Hispanic Whites covered by private health insurance decreased 0.4 

percentage points between 2010 and 

2019. During this period, private coverage rates also decreased for people 

who were not in poverty.

Children Without Health Insurance 

Coverage

In 2019, 5.7 percent of children 

under the age of 19 did not have 

coverage at the time of interview, a 

0.4 percentage-point increase from 

2018. In 2019, there were about 

320,000 more uninsured children 

than there were in 2018. For many 

34 The change in the public coverage rate 

between 2018 and 2019 for those who worked 

full-time, year-round was not statistically different from the change for those who worked less 

than full-time, year-round. 35 In Figure 4, unmarried adults include those 

who were never married, as well as those who 

are widowed, divorced, or separated. For estimates of health insurance coverage for each of 

these groups, see Appendix Table A-2. 36 Overall, public coverage increased from 

approximately 90 million recipients to 114 million between 2010 and 2019.

selected characteristics, the percentage of children without coverage 

was significantly higher in 2019 than 

in 2018 (Figure 5). 

The uninsured rate increased for 

children in each income-to-poverty 

group. The uninsured rate increased 

0.7 percentage points for children living in families in poverty.37 For those 

between 100 and 399 percent of poverty and those above 400 percent of 

poverty, the uninsured rate increased 

by 0.5 percentage points and 0.3 percentage points, respectively. In both 

years, the percentage of children 

without health insurance coverage 

decreased as the income-to-poverty 

ratio increased.

The uninsured rate increased for all 

children between 2018 and 2019, but 

the increase was largest for Hispanic 

children. The uninsured rate increased 

for non-Hispanic White children (by 

0.2 percentage points) and Black children (by 0.3 percentage points) to 4.3 

percent and 4.6 percent, respectively.38 In 2019, 9.2 percent of Hispanic 

children were uninsured, representing 

a 1.0 percentage-point increase from 

2018.

Other characteristics also reveal that 

changes in health insurance coverage between 2018 and 2019 among 

children under the age of 19 did not 

occur equally across regional groups. 

For example, children living in the 

South were more likely to be uninsured than children living in other 

37 The change in the uninsured rate between 

2018 and 2019 for those under the age of 19 

and in poverty was not statistically different 

from the change for those under the age of 19 

with income-to-poverty ratios between 100 and 

399 percent of poverty. 38 The change in the uninsured rate between 

2018 and 2019 for non-Hispanic White children 

under the age of 19 was not statistically different from the change for Black children under 

the age of 19.

regions in the United States, and 

between 2018 and 2019, their uninsured rate increased 0.6 percentage 

points to 7.7 percent.39 The uninsured 

rate also increased for children in the 

Northeast (0.2 percentage points), 

children in the Midwest (0.3 percentage points), and children in the West 

(0.5 percentage points).40

Health Insurance Coverage for 

Adults Aged 19 to 64 by Incometo-Poverty Ratio and Medicaid 

Expansion Status 

The ACA provided the option for 

states to expand Medicaid eligibility 

to people whose income-to-poverty 

ratio fell under a particular threshold.41 As of January 1, 2019, 32 

states and the District of Columbia 

had expanded Medicaid eligibility 

(“expansion states”)42; 18 states had 

not expanded Medicaid eligibility 

(“nonexpansion states”). The uninsured rate in 2019 varied by state 

Medicaid expansion status. In 2019, 

among adults aged 19 to 64, those 

in expansion states had lower uninsured rates (9.8 percent) than those 

39 For information about how the 

Census Bureau classifies regions, see 

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

/maps-data/maps/reference/us_regdiv.pdf>. 40 The change in the uninsured rate in the 

Northeast was statistically different from the 

change in the uninsured rate for people in the 

South or West. The other decreases were not 

statistically different from one another. 41 For a list of the state and their Medicaid 

expansion status as of January 1, 2019, see 

Appendix Table A-3: Percentage of People 

Without Health Insurance Coverage by State: 

2010, 2018, and 2019. 42 Only states that officially expanded 

Medicaid eligibility as of January 1, 2019, are 

included as expansion states for 2019. States 

that had not expanded as of January 1, 2019, 

are not included as expansion states even if they 

later implemented Medicaid expansion with 

retroactive access, as people are asked their 

coverage at the time of interview. For example, 

Maine expanded Medicaid eligibility on January 

10, 2019, retroactive to July 2, 2018. Maine is 

not considered an expansion state in this report. 
12 Health Insurance Coverage in the United States: 2019 U.S. Census Bureau

Figure 5.

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

Characteristics: 2018 to 2019

2019 

2018 

 5.7

5.2

 5.6

 5.2

 7.4

 6.6

 6.9

 6.4

 2.6

 2.3

 4.3

 4.1

 5.1

 4.7

 3.3

 3.1

 7.7

 7.1

 4.9

 4.4

 4.2

 3.8

 8.1

 7.3

 4.7

 4.3

 4.6

 4.4

 4.1

 3.9

 9.2

 8.2

 7.7

 6.2

 25.5

 24.0

(Civilian noninstitutionalized population, Children aged 19 and under)

1

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

2 Medicaid expansion status as of January 1, 2019. For a list of expansion and nonexpansion states, see Appendix Table A-3, Percentage of 

People Without Health Insurance Coverage by State: 2010, 2018, and 2019.

Note: All presented statistics have a statistically dierent change between 2018 and 2019 at the 90 percent confidence level, except 

for Asian. Dierences are calculated with unrounded numbers, which may produce dierent results from using the rounded values in the figure. 

For information on confidentiality protection, sampling error, nonsampling error, and definitions in the American Community Survey, see 

<https://www2.census.gov/programs-surveys/acs/tech_docs/accuracy/ACS_Accuracy_of_Data_2019.pdf>.

Source: U.S. Census Bureau, 2018 and 2019 American Community Surveys (ACS), 1-Year Estimates.

Expansion state

Nonexpansion state

Medicaid Expansion Status2

West

South

Midwest

Northeast

Region

Noncitizen

Naturalized citizen

Native-born citizen

Nativity

Hispanic (any race)

Asian

Black

White, not Hispanic

Race and Hispanic Origin

At or above 400% of poverty

Between 100% and 399% of poverty

Below 100% of poverty

1Poverty universe

Income-to-Poverty Ratio

Total
U.S. Census Bureau Health Insurance Coverage in the United States: 2019 13

in nonexpansion states (18.4 percent) 

(Figure 6).

Under the ACA, states can expand 

Medicaid eligibility to people whose 

income-to-poverty ratio falls under a 

particular threshold. For adults aged 

19 to 64, the relationship between 

poverty status and health insurance 

coverage in 2019 may be related to 

the state of residence and whether 

that state expanded Medicaid eligibility (Figure 6).43

43 Thirty-two states and the District of 

Columbia expanded Medicaid eligibility on or 

before January 1, 2019. For a list of the states and

their Medicaid expansion status as of January 1,

2019, see Appendix Table A-3: Percentage of 

People Without Health Insurance Coverage by 

State: 2010, 2018, and 2019.

Uninsured rates were lower for all 

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

states. At the same time, the uninsured rate increased for individuals in 

all income-to-poverty groups in both 

expansion and nonexpansion states 

between 2018 and 2019. The magnitude of change between the years 

varied by poverty status and state 

expansion status. For people living 

below the poverty line, the uninsured 

rate increased by 0.7 percentage 

points in expansion states to 16.4 

percent, and 1.7 percentage points in 

nonexpansion states to 36.4 percent. 

For those living between 100 and 399 

percent of poverty, the percentage 

of people without health insurance 

increased 1.1 percentage points to 

14.6 percent in expansion states, and 

1.0 percentage points to 23.3 percent 

in nonexpansion states.44 The uninsured rate for those living at or above 

400 percent of poverty increased 

by 0.3 percentage points in expansion states to 4.2 percent, and by 0.6 

percentage points in nonexpansion 

states to 7.1 percent over the same 

period.

44 The change in the uninsured rate for those 

living between 100 and 399 percent of poverty 

in expansion states is not statistically different 

from the change in the uninsured rate for those 

living between 100 and 399 percent of poverty 

in nonexpansion states.

1

 Medicaid expansion status as of January 1, 2019. For a list of expansion and nonexpansion states, see Appendix Table A-3, Percentage of 

People Without Health Insurance Coverage by State: 2010, 2018, and 2019.

Note: All presented statistics have a statistically different change between 2018 and 2019 at the 90 percent confidence level. Differences

are calculated with unrounded numbers, which may produce different results from using the rounded values in the figure. For information 

on confidentiality protection, sampling error, nonsampling error, and definitions in the American Community Survey, see 

<https://www2.census.gov/programs-surveys/acs/tech_docs/accuracy/ACS_Accuracy_of_Data_2019.pdf>. 

Source: U.S. Census Bureau, 2018 and 2019 American Community Surveys (ACS), 1-Year Estimates.

Figure 6.

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

2018 to 2019

Percentage-point change in uninsured rate between 2018 and 2019

15.6 16.4

1.7

1.0 0.7 0.6 0.7

1.1

0.3 0.5

13.4 14.6

34.7 36.4

22.2 23.3

17.6 18.4

6.5 7.1

3.9 4.2

9.3 9.8

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 2019 Expansion states1

2018 2019 Nonexpansion states1

(Civilian noninstitutionalized population, adults aged 19 to 64)
14 Health Insurance Coverage in the United States: 2019 U.S. Census Bureau

State Estimates of Health Insurance 

Coverage

In 2019, the percentage of people 

without health insurance at the time 

of interview in each state ranged 

from 3.0 percent (Massachusetts) to 

18.4 percent (Texas) (Figures 7 and 

8).45 Five states and the District of 

Columbia had an uninsured rate of 

less than 5.0 percent, and seven states 

had an uninsured rate of 12.0 percent 

45 The percentage of people without health 

insurance coverage in Massachusetts (3.0 

percent) was not statistically different from the 

percentage without coverage in the District of 

Columbia (3.5 percent).

or more.46 The remainder of states 

had uninsured rates between 5.0 and 

11.9 percent in 2019 (Figure 8).

Between 2018 and 2019, the percentage of people without health insurance coverage decreased in one state 

and increased in 19 states (Figure 8). 

The magnitude of decrease in Virginia 

was 0.9 percentage points. The largest increase was in Wyoming, which 

increased by 1.8 percentage points. 

However, Wyoming’s increase was not 

significantly different from the majority of other states. All other increases 

46 Consistent with Figure 7, classification into 

these categories is based on rounded uninsured 

rates.

were less than 1.0 percentage points. 

Thirty states and the District of 

Columbia did not have a statistically 

significant change in their uninsured 

rate.

Many Medicaid expansion states 

had uninsured rates lower than 

the national average, while many 

nonexpansion states had uninsured 

rates above the national average 

(Figure 8). In 2019, the uninsured 

rates by state ranged from 3.0 percent 

to 12.2 percent in expansion states, 

and from 5.7 percent to 18.4 percent 

in nonexpansion states. 

! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! !

DC

TX

CA

MT

AZ

ID

NV

NM

CO

IL

OR

UT

KS

WY

IA

NE

SD

MN

FL

ND

OK

WI

MO

WA

AL GA

LA

AR

MI

IN

PA

NY

NC

MS

TN

VA

KY

OH

SC

ME

WV

VT

NH

NJ

MA

CT

MD

DE

RI

AK

HI

0 500 Miles

0 100 Miles

0 100 Miles

A state with a circle around its abbreviation expanded Medicaid eligibility on or before January 1, 2019.

Note: For information on confidentiality protection, sampling error, nonsampling error, and definitions in the American Community Survey,

see <https://www2.census.gov/programs-surveys/acs/tech_docs/accuracy/ACS_Accuracy_of_Data_2019.pdf>.

Source: U.S. Census Bureau, 2019 American Community Survey (ACS), 1-Year Estimates.

Percent without

health insurance

coverage

12.0 or more

9.0 to 11.9

7.0 to 8.9

5.0 to 6.9

Less than 5.0

Figure 7.

Uninsured Rate by State: 2019

(Civilian noninstitutionalized population)

U.S. : 9.2
U.S. Census Bureau Health Insurance Coverage in the United States: 2019 15

1Massachusetts 1District of Columbia 1Rhode Island 1Hawaii 1Vermont

1Minnesota 1Iowa 1New York

Wisconsin 2Pennsylvania

2Michigan 1Connecticut 1Maryland 2New Hampshire 1Kentucky

1Delaware

1Ohio 1Washington 1West Virginia

1North Dakota

1Oregon

1Illinois 1California 1New Jersey 5Virginia

1Colorado

Maine 3Montana

Nebraska

3Indiana

4Louisiana

1Arkansas

United States

Kansas

Utah

Alabama 1New Mexico

Missouri

Tennessee

South Dakota

Idaho

South Carolina

North Carolina

1Arizona

1Nevada

3Alaska

Wyoming

Mississippi

Florida

Georgia

Oklahoma

Texas

1 Expanded Medicaid eligibility as of January 1, 2014. 

2 Expanded Medicaid eligibility after January 1, 2014, and on or before January 1, 2015. 

3 Expanded Medicaid eligibility after January 1, 2015, and on or before January 1, 2016. 

4 Expanded Medicaid eligibility after January 1, 2016, and on or before January 1, 2017.

5 Expanded Medicaid eligibility after January 1, 2018, and on or before January 1, 2019.

Note: For information on confidentiality protection, sampling error, nonsampling error, and definitions in the American Community 

Survey, see <https://www2.census.gov/programs-surveys/acs/tech_docs/accuracy/ACS_Accuracy_of_Data_2019.pdf>. 

Source: U.S. Census Bureau, 2010, 2018, and 2019 American Community Surveys (ACS), 1-Year Estimates.

0 5 10 15 20 25

Figure 8.

Percentage of People Without Health Insurance Coverage by State: 2010, 2018, and 2019

(Civilian noninstitutionalized population. States with names in bold experienced a statistically significant change between 

2018 and 2019)

Percent 

2019 2018 2010
16 Health Insurance Coverage in the United States: 2019 U.S. Census Bureau

For all states and the District of 

Columbia, the uninsured rate 

decreased significantly between 2010 

and 2019.

More Information About Health 

Insurance Coverage

Additional Data and Contacts

Detailed tables, historical tables, 

press releases, and briefings are 

available on the Census Bureau’s 

Health Insurance Web site at 

<www.census.gov/topics/health

/health-insurance.html>.

Additional information on the twostage redesign of the CPS ASEC 

can be found in Appendix A of last 

year’s report, “Health Insurance in the 

United States: 2018” at <www.census

.gov/content/dam/Census/library

/publications/2019/demo/p60-267

.pdf>.

State and Local Estimates of Health 

Insurance Coverage

The Census Bureau publishes annual 

estimates of health insurance coverage by state and other smaller geographic units based on data collected 

in the 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. 

The Census Bureau’s Small Area 

Health Insurance Estimates (SAHIE) 

program also produces single-year 

estimates of health insurance for 

states and all counties. These estimates are based on 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 2018.

SOURCE AND ACCURACY OF THE 

ESTIMATES 

The estimates in this report are from 

two surveys: the CPS ASEC and the 

ACS. 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, longterm 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 14.47

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 

47 The Office of Management and Budget 

determined the official definition of poverty in 

Statistical Policy Directive 14. Appendix B of the 

report “Income and Poverty in the United States: 

2019” provides a more detailed description of 

how the Census Bureau calculates poverty; see 

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

/library/publications/2020/demo/p60-270

.pdf>.

Areas. The 2020 CPS ASEC sample 

consists of about 91,500 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 this report are controlled 

to March 2020 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 both the Successive 

Difference Replication (SDR) method 

and the Generalized Variance 

Function (GVF) approach. 

Beginning with the 2011 CPS ASEC 

report, the standard errors and 

confidence intervals displayed in the 

text tables were calculated using the 

SDR method. In previous years, the 

standard errors of CPS ASEC estimates were calculated using the GVF 

approach. Under this approach, generalized variance parameters were used 

in formulas provided in the source and 

accuracy (S&A) statement to estimate 

standard errors. Further information 

about the CPS ASEC and the source 

and accuracy of the estimates is 

available at <https://www2.census

.gov/programs-surveys/cps/techdocs

/cpsmar20.pdf>.
U.S. Census Bureau Health Insurance Coverage in the United States: 2019 17

Additional estimates in this report 

are from the American Community 

Survey (ACS). The ACS is an ongoing, nationwide survey designed to 

provide demographic, social, economic, and housing data at different 

levels of geography. While the ACS 

includes Puerto Rico and the group 

quarters population, the ACS data 

in this report focus on the civilian 

noninstitutionalized population of 

the United States (excluding Puerto 

Rico and some people living in group 

quarters). It has an annual sample 

size of about 3.5 million addresses. 

ACS variances were calculated using 

the SDR method as well. For information on the ACS sample design and 

other topics, visit <www.census.gov

/programs-surveys/acs/>.

ADDITIONAL DATA AND CONTACTS

The CPS ASEC and the ACS are 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

/2020/demo/health-insurance

/p60-271.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>.

Customized Tables

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 CPS, ACS, 

Decennial Census, Economic Census, 

and more. Through the centralized 

experience on data.census.gov, data 

users of all skill levels can search 

premade tables or create custom 

statistics from Public Use Microdata 

files. 

The Census Bureau created easy 

ways to visualize, customize, and 

download data through a single 

platform on data.census.gov in 

response to user feedback. To learn 

more about data.census.gov, check 

out the release notes and FAQs 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 replaces CPS Table 

Creator and DataFerrett in providing 

data users the ability to create customized tables using public-use data 

from the CPS ASEC.

Public-Use Microdata

CPS ASEC 

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.

ACS 

The ACS Public Use Microdata 

Sample files (PUMS) are samples of 

the actual responses to the ACS and 

include most population and housing 

characteristics. These files provide 

users with the flexibility to prepare 

customized tabulations and can be 

used for detailed research and analysis. Files have been edited to protect 

the confidentiality of all individuals 

and of all individual households. The 

smallest geographic unit that is identified within the PUMS is the Public 

Use Microdata Area. These data are 

available online at <www.census.gov

/programs-surveys/acs/technical

-documentation/pums.html>. 

Because the PUMS file is a sample of 

the ACS, estimates of health insurance coverage may differ slightly from 

those in this report.

Census Data API

The Census Data Application 

Programming Interface (API) gives the 

public access to raw statistical 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 data sets 

are currently available via API online 

at <www.census.gov/data

/developers/data-sets.html>.

Technical Documentation

For more information on replicate 

weights, standard errors, income 

topcoding and data swapping on the 

public-use file, and changes to the 

CPS ASEC data file from the prior 

year, see <https://www2.census.gov

/programs-surveys/cps/techdocs

/cpsmar20.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>.
18 Health Insurance Coverage in the United States: 2019 U.S. Census Bureau Table A-1. Percentage of People by Type of Health Insurance Coverage for Selected Ages and Characteristics Using CPS ASEC Data: 2018 and 2019 (Numbers in thousands, margins of error in percentage points. Population as of March of the following year. For information on confidentiality protection, sampling error, nonsampling error, and definitions, see (https://www2.census.gov/programs-surveys/cps/techdocs/cpsmar20.pdf>) Characteristic Total 2018 number 2019 number Any health insurance Uninsured5 2018 2019 Change (2019 less 2018)2 Private health insurance3 Public health insurance4 2018 2019 Change (2019 less 2018)2 2018 2019 Change (2019 less 2018)2 2018 2019 Change (2019 less 2018)2 Percent Margin of error1 (±) Percent Margin of error1 (±) Percent Margin of error1 (±) Percent Margin of error1 (±) Percent Margin of error1 (±) Percent Margin of error1 (±) Percent Margin of error1 (±) Percent Margin of error1 (±)     Total . . . . . . . . . . . . . . . . . Race6 and Hispanic Origin White ..........................  White, not Hispanic ........... Black .......................... Asian .......................... Hispanic (any race) .............. Income-to-Poverty Ratio Total, poverty universe . . . . . . . . . Below 100 percent of poverty .... Below 138 percent of poverty .... Between 100 and 199 percent of poverty ....................... Between 200 and 299 percent of poverty ....................... Between 300 and 399 percent of poverty ....................... At or above 400 percent of poverty ....................... Total, 19 to 64 years old . . . . . . . . Marital Status Married7 ........................ Widowed ....................... Divorced ....................... Separated ...................... Never married .................. Total, 15 to 64 years old . . . . . . . . Work Experience All workers .....................  Worked full-time, year-round ..  Worked less than full-time,  year-round ................. Did not work at least 1 week ..... 323,668 247,472 194,679 42,758 19,770 59,925 323,172 38,056 58,204 55,302 50,632 43,624 135,559 193,548 101,805 3,385 18,683 4,200 65,475 210,794 155,221 111,950 43,271 55,573 324,550 247,869 194,518 42,991 19,905 60,517 324,048 33,879 52,816 51,349 48,924 43,078 146,818 193,272 100,795 3,319 18,290 3,802 67,065 210,228 157,181 112,803 44,379 53,047 91.5 91.8 94.6 90.3 93.2 82.2 91.5 83.7 84.4 86.4 89.2 91.9 96.6 88.3 91.7 86.3 87.0 80.1 84.0 88.7 89.3 90.5 86.2 86.9 0.2 0.2 0.2 0.5 0.6 0.6 0.2 0.6 0.6 0.6 0.5 0.4 0.2 0.3 0.3 1.6 0.7 2.0 0.5 0.3 0.3 0.3 0.5 0.4 92.0 92.2 94.8 90.4 93.8 83.3 92.0 84.1 84.6 85.9 89.0 91.7 97.0 88.9 92.4 86.5 88.0 81.0 84.3 89.3 89.8 91.1 86.6 87.8 0.2 0.2 0.2 0.5 0.7 0.7 0.2 0.8 0.6 0.6 0.5 0.5 0.2 0.3 0.3 1.7 0.7 1.8 0.5 0.3 0.3 0.3 0.5 0.5 *0.4 *0.4 0.2 0.1 0.6 *1.1 *0.4 0.4 0.2 –0.5 –0.2 –0.2 *0.4 *0.6 *0.7 0.3 *1.0 0.8 0.3 *0.6 *0.5 *0.5 0.4 *0.9 67.3 69.3 74.8 55.4 73.1 49.6 67.3 22.0 24.7 41.6 64.4 75.1 89.2 73.5 82.3 55.6 64.7 52.4 64.7 72.8 80.5 85.1 68.5 51.3 0.4 0.4 0.4 1.1 1.3 1.0 0.4 0.8 0.7 0.9 0.8 0.8 0.3 0.4 0.4 2.2 1.0 2.3 0.6 0.4 0.4 0.4 0.7 0.8 68.0 70.1 75.2 55.2 74.4 51.6 68.1 22.9 25.2 39.9 63.0 72.6 88.8 74.4 83.4 56.5 67.4 51.8 65.1 73.9 80.8 85.8 68.2 53.2 0.3 0.4 0.4 0.9 1.1 0.9 0.3 0.9 0.8 1.0 0.9 0.8 0.3 0.4 0.4 2.5 1.0 2.2 0.6 0.4 0.3 0.3 0.7 0.7 *0.8 *0.8 0.5 –0.3 1.3 *2.0 *0.8 1.0 0.5 *–1.7 *–1.4 *–2.5 –0.4 *0.9 *1.1 0.9 *2.7 –0.6 0.4 *1.1 0.3 *0.7 –0.3 *1.8 34.4 33.8 33.2 41.2 26.1 36.5 34.3 66.8 65.8 54.4 36.2 27.7 18.5 17.6 12.6 34.9 25.3 29.7 21.6 18.8 11.1 7.2 21.3 40.2 0.3 0.3 0.3 0.9 1.1 0.8 0.3 0.9 0.7 0.8 0.8 0.7 0.3 0.3 0.3 2.2 1.0 1.8 0.5 0.3 0.2 0.2 0.6 0.7 34.1 33.5 33.0 41.8 25.2 35.8 34.0 66.6 65.9 55.5 37.3 29.5 19.2 17.2 12.2 33.5 23.6 31.4 21.3 18.2 11.2 7.0 21.6 39.1 0.3 0.3 0.4 0.9 0.9 0.8 0.3 1.0 0.8 1.0 0.9 0.8 0.3 0.3 0.4 2.3 0.9 1.9 0.5 0.3 0.3 0.2 0.6 0.7 –0.3 –0.3 –0.2 0.6 –0.9 –0.7 –0.3 –0.3 0.2 1.2 1.2 *1.9 *0.7 *–0.5 –0.4 –1.4 *–1.7 1.7 –0.3 *–0.6 0.1 –0.1 0.4 *–1.1 8.5 8.2 5.4 9.7 6.8 17.8 8.5 16.3 15.6 13.6 10.8 8.1 3.4 11.7 8.3 13.7 13.0 19.9 16.0 11.3 10.7 9.5 13.8 13.1 0.2 0.2 0.2 0.5 0.6 0.6 0.2 0.6 0.6 0.6 0.5 0.4 0.2 0.3 0.3 1.6 0.7 2.0 0.5 0.3 0.3 0.3 0.5 0.4 8.0 7.8 5.2 9.6 6.2 16.7 8.0 15.9 15.4 14.1 11.0 8.3 3.0 11.1 7.6 13.5 12.0 19.0 15.7 10.7 10.2 8.9 13.4 12.2 0.2 0.2 0.2 0.5 0.7 0.7 0.2 0.8 0.6 0.6 0.5 0.5 0.2 0.3 0.3 1.7 0.7 1.8 0.5 0.3 0.3 0.3 0.5 0.5 *–0.4 *–0.4 –0.2 –0.1 –0.6 *–1.1 *–0.4 –0.4 –0.2 0.5 0.2 0.2 *–0.4 *–0.6 *–0.7 –0.3 *–1.0 –0.8 –0.3 *–0.6 *–0.5 *–0.5 –0.4 *–0.9 * Changes between the estimates are statistically different from zero at the 90 percent confidence level.

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 Details may not sum to totals because of rounding.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 Department of Veterans Affairs and the military.5 Individuals are considered to be uninsured if they do not have health insurance coverage for the entire calendar year.6 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 singlerace 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. 

7 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 and 2020 Annual Social and Economic Supplements (CPS ASEC).
U.S. Census Bureau Health Insurance Coverage in the United States: 2019 19 Table A-2. Percentage of People by Type of Health Insurance Coverage for Selected Ages and Characteristics Using ACS Data: 2018 and 2019 (Numbers in thousands, margins of error in percentage points. Civilian noninstitutionalized population. For information on confidentiality protection, sampling error, nonsampling error, and definitions, see (https://www2.census.gov/programs-surveys/acs/tech_docs/accuracy/ACS_Accuracy_of_Data_2019.pdf>) Characteristic Total 2018 number 2019 number Any health insurance Uninsured 2018 2019 Change (2019 less 2018)2 Private health insurance3 Public health insurance4 2018 2019 Change (2019 less 2018)2 2018 2019 Change (2019 less 2018)2 2018 2019 Change (2019 less 2018)2 Percent Margin of error1 (±) Percent Margin of error1 (±) Percent Margin of error1 (±) Percent Margin of error1 (±) Percent Margin of error1 (±) Percent Margin of error1 (±) Percent Margin of error1 (±) Percent Margin of error1 (±)     Total . . . . . . . . . . . . . . . . . Race5 and Hispanic Origin White ..........................  White, not Hispanic ........... Black .......................... Asian .......................... Hispanic (any race) .............. Income-to-Poverty Ratio Total, poverty universe . . . . . . . . . Below 100 percent of poverty .... Below 138 percent of poverty .... Between 100 and 199 percent of poverty ....................... Between 200 and 299 percent of poverty ....................... Between 300 and 399 percent of poverty ....................... At or above 400 percent of poverty ....................... Total, 19 to 64 years old . . . . . . . . Marital Status Married6 ........................ Widowed ....................... Divorced ....................... Separated ...................... Never married .................. Total, 15 to 64 years old . . . . . . . . Work Experience All workers .....................  Worked full-time, year-round ..  Worked less than full-time,  year-round ................. Did not work at least 1 week ..... 322,249 233,038 194,357 40,385 18,317 59,022 318,500 41,838 62,225 55,314 50,877 43,720 126,752 193,295 96,942 3,193 21,005 4,245 67,911 210,307 160,032 107,050 52,982 46,160 323,121 233,212 194,023 40,702 18,534 59,687 319,225 39,464 58,864 53,043 50,359 44,035 132,325 192,988 96,394 3,116 20,865 4,031 68,582 209,861 160,568 109,506 51,063 45,128 91.1 92.0 94.0 89.9 93.7 82.1 91.1 84.5 84.8 85.4 88.7 92.1 96.4 87.5 91.0 86.7 85.9 80.2 83.6 88.0 88.4 90.3 84.7 85.8 0.1 0.1

Z

0.1

0.2

0.2

0.1

0.1

0.1

0.1

0.1

0.1

Z

0.1

0.1

0.4

0.2

0.4

0.1

0.1

0.1

0.1

0.1

0.1

90.891.7

93.7

89.9

93.4

81.3

90.8

84.0

84.1

84.8

87.8

91.4

96.1

87.1

90.5

86.3

85.7

79.3

83.3

87.6

88.0

89.8

84.2

85.3

0.10.1

0.1

0.1

0.2

0.2

0.1

0.1

0.1

0.1

0.1

0.1

0.1

0.1

0.1

0.4

0.2

0.4

0.1

0.1

0.1

0.1

0.1

0.1

*–0.3

*–0.3

*–0.2

Z

*–0.3

*–0.7

*–0.3

*–0.5

*–0.7

*–0.7

*–0.8

*–0.7

*–0.2

*–0.4

*–0.4

–0.4

–0.2

*–0.9

*–0.4

*–0.4

*–0.4

*–0.5

*–0.5

*–0.5

67.571.2

75.2

55.3

74.3

49.5

67.5

26.6

28.9

43.5

65.8

77.9

88.5

72.8

82.1

58.1

63.6

52.3

64.4

72.2

79.0

85.1

66.7

49.6

0.10.1

0.1

0.2

0.3

0.3

0.1

0.2

0.2

0.2

0.2

0.2

0.1

0.1

0.1

0.4

0.2

0.4

0.1

0.1

0.1

0.1

0.1

0.2

67.470.9

74.7

55.7

74.7

50.1

67.4

26.6

28.6

42.6

64.2

76.5

87.6

72.8

82.1

58.5

63.7

52.4

64.4

72.2

78.8

84.6

66.4

49.6

0.10.1

0.1

0.3

0.3

0.3

0.1

0.2

0.2

0.2

0.2

0.2

0.1

0.1

0.1

0.6

0.2

0.5

0.1

0.1

0.1

0.1

0.2

0.2

–0.1

*–0.3

*–0.4

*0.4

0.3

*0.6

–0.1

Z

*–0.3

*–1.0

*–1.6

*–1.4

*–0.9

Z

–0.1

0.4

Z

0.1

0.1

Z

*–0.2

*–0.5

*–0.3

Z

35.634.5

34.2

43.9

26.1

37.7

35.8

65.4

64.6

53.8

36.1

27.2

20.9

18.3

12.6

35.2

26.9

32.5

22.1

19.4

12.2

7.7

21.3

43.1

0.10.1

0.1

0.2

0.2

0.2

0.1

0.2

0.2

0.2

0.1

0.1

0.1

0.1

0.1

0.5

0.2

0.4

0.1

0.1

0.1

Z

0.1

0.1

35.434.5

34.3

43.5

25.6

36.3

35.5

65.2

64.1

53.4

36.1

27.6

21.9

17.7

12.0

34.4

26.6

31.3

21.6

18.8

11.8

7.4

21.0

42.6

0.10.1

0.1

0.2

0.2

0.2

0.1

0.2

0.1

0.2

0.2

0.2

0.1

0.1

0.1

0.6

0.2

0.4

0.1

0.1

0.1

0.1

0.1

0.2

*–0.2

Z

*0.2

*–0.4

*–0.5

*–1.4

*–0.2

–0.2

*–0.5

*–0.4

Z

*0.4

*1.0

*–0.6

*–0.6

*–0.8

*–0.3

*–1.1

*–0.5

*–0.6

*–0.4

*–0.2

*–0.2

*–0.5

8.98.0

6.0

10.1

6.3

17.9

8.9

15.5

15.2

14.6

11.3

7.9

3.6

12.5

9.0

13.3

14.1

19.8

16.4

12.0

11.6

9.7

15.3

14.2

0.10.1

Z

0.1

0.2

0.2

0.1

0.1

0.1

0.1

0.1

0.1

Z

0.1

0.1

0.4

0.2

0.4

0.1

0.1

0.1

0.1

0.1

0.1

9.28.3

6.3

10.1

6.6

18.7

9.2

16.0

15.9

15.2

12.2

8.6

3.9

12.9

9.5

13.7

14.3

20.7

16.7

12.4

12.0

10.2

15.8

14.7

0.10.1

0.1

0.1

0.2

0.2

0.1

0.1

0.1

0.1

0.1

0.1

0.1

0.1

0.1

0.4

0.2

0.4

0.1

0.1

0.1

0.1

0.1

0.1

*0.3

*0.3

*0.2

Z

*0.3

*0.7

*0.3

*0.5

*0.7

*0.7

*0.8

*0.7

*0.2

*0.4

*0.4

0.4

0.2

*0.9

*0.4

*0.4

*0.4

*0.5

*0.5

*0.5

* Changes between the estimates are statistically different from zero at the 90 percent confidence level.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 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 Details may not sum to totals because of rounding.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 Department of Veterans Affairs and the military.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 singlerace 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 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 at the time of interview.Source: U.S. Census Bureau, 2018 and 2019 American Community Surveys (ACS), 1-Year Estimates.
20 Health Insurance Coverage in the United States: 2019 U.S. Census Bureau

Table A-3. 

Percentage of People Without Health Insurance Coverage by State: 2010, 2018, and 2019

(Numbers in thousands. Civilian noninstitutionalized population. For information on confidentiality protection, sampling error, nonsampling error, 

and definitions, see <https://www2.census.gov/programs-surveys/acs/tech_docs/accuracy/ACS_Accuracy_of_Data_2019.pdf>) 

State

Medicaid 

expansion 

state? 

Yes (Y) or 

No (N)1

2010 uninsured 2018 uninsured 2019 uninsured

Difference in uninsured

2019 less 2018 2019 less 2010

Percent

Margin of 

error2 (±) Percent

Margin of 

error2 (±) Percent

Margin of 

error2 (±) Percent

Margin of 

error2 (±) Percent

Margin of 

error2 (±) 

   United States ..... X 15.5 0.1 8.9 0.1 9.2 0.1 *0.3 0.1 *–6.3 0.1

Alabama .............. N 14.6 0.4 10.0 0.3 9.7 0.3 –0.3 0.4 *–4.9 0.5

Alaska. . . . . . . . . . . . . . . . . +Y 19.9 1.1 12.6 0.9 12.2 0.8 –0.4 1.2 *–7.6 1.3

Arizona ............... Y 16.9 0.3 10.6 0.3 11.3 0.3 *0.7 0.5 *–5.6 0.5

Arkansas .............. Y 17.5 0.5 8.2 0.3 9.1 0.4 *0.9 0.5 *–8.3 0.7

California .............. Y 18.5 0.2 7.2 0.1 7.7 0.1 *0.5 0.2 *–10.8 0.2

Colorado .............. Y 15.9 0.5 7.5 0.3 8.0 0.3 *0.5 0.4 *–7.9 0.5

Connecticut ........... Y 9.1 0.3 5.3 0.3 5.9 0.3 *0.6 0.4 *–3.2 0.5

Delaware .............. Y 9.7 0.8 5.7 0.7 6.6 0.6 0.9 0.9 *–3.1 1.0

District of Columbia .... Y 7.6 0.7 3.2 0.5 3.5 0.6 0.4 0.8 *–4.1 0.9

Florida ................ N 21.3 0.3 13.0 0.2 13.2 0.2 0.2 0.3 *–8.1 0.3

Georgia ............... N 19.7 0.4 13.7 0.3 13.4 0.3 –0.2 0.4 *–6.3 0.5

Hawaii. . . . . . . . . . . . . . . . . Y 7.9 0.5 4.1 0.4 4.2 0.4 0.1 0.5 *–3.7 0.6

Idaho ................. N 17.7 0.7 11.1 0.6 10.8 0.5 –0.3 0.8 *–6.9 0.9

Illinois ................. Y 13.8 0.2 7.0 0.2 7.4 0.2 *0.4 0.3 *–6.4 0.3

Indiana ................ +Y 14.8 0.3 8.3 0.3 8.7 0.3 *0.5 0.4 *–6.1 0.4

Iowa .................. Y 9.3 0.3 4.7 0.3 5.0 0.3 0.3 0.4 *–4.3 0.5

Kansas ................ N 13.9 0.4 8.8 0.4 9.2 0.4 0.4 0.5 *–4.7 0.6

Kentucky .............. Y 15.3 0.4 5.6 0.3 6.4 0.3 *0.8 0.4 *–8.8 0.5

Louisiana .............. #Y 17.8 0.4 8.0 0.3 8.9 0.3 *0.9 0.4 *–8.9 0.5

Maine ................. N 10.1 0.5 8.0 0.5 8.0 0.5 Z 0.7 *–2.1 0.7

Maryland .............. Y 11.3 0.3 6.0 0.2 6.0 0.3 Z 0.4 *–5.3 0.4

Massachusetts ......... Y 4.4 0.2 2.8 0.2 3.0 0.2 *0.2 0.2 *–1.4 0.3

Michigan .............. ^Y 12.4 0.2 5.4 0.1 5.8 0.2 *0.4 0.2 *–6.6 0.3

Minnesota ............. Y 9.1 0.3 4.4 0.2 4.9 0.2 *0.5 0.3 *–4.2 0.3

Mississippi ............. N 18.2 0.5 12.1 0.4 13.0 0.5 *0.8 0.7 *–5.2 0.7

Missouri ............... N 13.2 0.3 9.4 0.3 10.0 0.3 *0.6 0.4 *–3.1 0.4

Montana ............... +Y 17.3 0.7 8.2 0.5 8.3 0.5 0.1 0.7 *–9.1 0.9

Nebraska .............. N 11.5 0.4 8.3 0.4 8.3 0.4 Z 0.6 *–3.2 0.6

Nevada ................ Y 22.6 0.6 11.2 0.4 11.4 0.5 0.2 0.6 *–11.2 0.7

New Hampshire ........ ^Y 11.1 0.7 5.7 0.4 6.3 0.6 0.5 0.7 *–4.9 0.9

New Jersey ............ Y 13.2 0.2 7.4 0.2 7.9 0.2 *0.4 0.3 *–5.4 0.3

New Mexico. . . . . . . . . . . . Y 19.6 0.7 9.5 0.6 10.0 0.6 0.4 0.8 *–9.6 0.9

New York .............. Y 11.9 0.2 5.4 0.1 5.2 0.1 –0.2 0.2 *–6.7 0.2

North Carolina ......... N 16.8 0.3 10.7 0.2 11.3 0.3 *0.5 0.3 *–5.5 0.4

North Dakota .......... Y 9.8 0.7 7.3 0.6 6.9 0.7 –0.4 0.9 *–2.9 1.0

Ohio .................. Y 12.3 0.2 6.5 0.2 6.6 0.2 0.1 0.3 *–5.7 0.3

Oklahoma ............. N 18.9 0.3 14.2 0.3 14.3 0.3 0.1 0.5 *–4.6 0.5

Oregon ................ Y 17.1 0.4 7.1 0.3 7.2 0.3 0.1 0.4 *–10.0 0.5

Pennsylvania ........... ^Y 10.2 0.2 5.5 0.1 5.8 0.2 *0.2 0.2 *–4.4 0.3

Rhode Island ........... Y 12.2 0.7 4.1 0.5 4.1 0.6 Z 0.8 *–8.1 0.9

South Carolina ......... N 17.5 0.4 10.5 0.4 10.8 0.3 0.4 0.5 *–6.7 0.5

South Dakota .......... N 12.4 0.9 9.8 0.6 10.2 0.7 0.4 0.9 *–2.2 1.1

Tennessee ............. N 14.4 0.4 10.1 0.3 10.1 0.3 Z 0.4 *–4.2 0.5

Texas .................. N 23.7 0.2 17.7 0.2 18.4 0.2 *0.6 0.3 *–5.4 0.3

Utah .................. N 15.3 0.6 9.4 0.5 9.7 0.5 0.2 0.7 *–5.7 0.8

Vermont ............... Y 8.0 0.7 4.0 0.5 4.5 0.5 0.5 0.7 *–3.6 0.8

Virginia ................ ~Y 13.1 0.3 8.8 0.3 7.9 0.3 *–0.9 0.4 *–5.1 0.4

Washington ............ Y 14.2 0.4 6.4 0.2 6.6 0.3 0.2 0.3 *–7.6 0.4

West Virginia .......... Y 14.6 0.6 6.4 0.4 6.7 0.4 0.3 0.6 *–7.9 0.7

Wisconsin ............. N 9.4 0.2 5.5 0.2 5.7 0.2 0.3 0.3 *–3.7 0.3

Wyoming .............. N 14.9 1.1 10.5 0.9 12.3 1.3 *1.8 1.5 *–2.6 1.7

* Statistically different from zero at the 90 percent confidence level. 

^ Expanded Medicaid eligibility after January 1, 2014, and on or before January 1, 2015. 

+ Expanded Medicaid eligibility after January 1, 2015, and on or before January 1, 2016. 

# Expanded Medicaid eligibility after January 1, 2016, and on or before January 1, 2017. 

~ Expanded Medicaid eligibility after January 1, 2018, and on or before January 1, 2019.

Z Rounds to zero.

1 Medicaid expansion status as of January 1, 2019. For more information, see 

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

2 A margin of error is a measure of an estimate’s variability. The larger the margin of error 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. Margins of error shown in 

this table are based on standard errors calculated using replicate weights.

Note: Differences are calculated with unrounded numbers, which may produce different 

results from using the rounded values in the table.

Source: U.S. Census Bureau, 2010, 2018, and 2019 American Community Surveys (ACS), 

1–Year Estimates.