Issued September 2022

P60-278

By Katherine Keisler-Starkey and Lisa N. Bunch

Health Insurance Coverage in the United States: 2021

Current Population Reports
Acknowledgments Katherine Keisler-Starkey and Lisa N. Bunch prepared this report under the 

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

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

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

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

the Demographic Systems Division, and Lisa Cheok of the Associate Director for 

Demographic Programs Directorate—Survey Operations, processed the Current 

Population Survey 2022 Annual Social and Economic Supplement (CPS ASEC) 

file.

Adam W. Reilly with the assistance of Kirk E. Davis, Raymond E. Dowdy, Lan N. 

Huynh, and Chandararith R. Phe programmed and produced the historical and 

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

Applications Branch, Demographic Surveys Division. 

Weimin Zhang, under the supervision of Emily Hood and David V. Hornick, all of 

the Demographic Statistical Methods Division, conducted the statistical review of 

all Current Population Survey data.

Lisa Cheok, assisted by Roberto Cases, of the Demographic Programs 

Directorate—Survey Operations, provided overall direction for the survey implementation. Charlie Carter, Agatha Jung, and Johanna Rupp, of the Application 

Development and Services Division, prepared and programmed the computerassisted interviewing instrument used to conduct the CPS ASEC. 

Additional people within the U.S. Census Bureau also made significant contributions to the preparation of this report. Adam Bee, Breauna Branch, Douglas 

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

Steinweg, Jonathan Vespa, and Natalie Young all of the Social, Economic, and 

Housing Statistics Division, reviewed the contents. 

Stacey Barber, Faye E. Brock, and Steven Brown provided publication management, editorial review, and 508 compliancy for print and electronic media. 

Linda Chen and Stephen Gibson provided graphic design and composition, all 

under the direction of Corey Beasley, Chief of the Graphic and Editorial Services 

Branch, Public Information Office.

The authors would like to also thank the Census Bureau field representatives and 

telephone interviewers who conducted the interviews that provide the data in 

this report. Without their dedication, the preparation of this report or any report 

from the Current Population Survey would be impossible.
U.S. Census Bureau

Robert L. Santos, 

Director

P60-278

Health Insurance Coverage

 in the United States: 2021 Issued September 2022
Suggested Citation

Katherine Keisler-Starkey

 and Lisa N. Bunch,

U.S. Census Bureau, 

Current Population Reports, 

P60-278, 

Health Insurance Coverage

 in the United States: 2021,

U.S. Government Publishing Office, 

Washington, DC,

September 2022.

U.S. CENSUS BUREAU

Robert L. Santos,

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: 2021 iii

Contents TEXT

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

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

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

Estimates of Health Insurance Coverage in the United States. . . . . . . . 2

Health Insurance Coverage by Type and Selected Characteristics. . . 3

Health Insurance Coverage by Age. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

Private Coverage. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

Public Coverage. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

Uninsured Rates for Children and Working-Age Adults by Selected 

Characteristics. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

Children Under Age 19. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

Working-Age Adults 19 to 64 Years Old. . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

Public and Private Health Insurance Coverage by Selected 

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

Public and Private Health Insurance Coverage by Age Categories. . . . . 10

Public and Private Health Insurance Coverage by Social and 

Demographic Characteristics. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

Summary. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

Additional Information About Health Insurance Coverage. . . . . . . . . . 14

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

Additional data. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

Data.census.gov . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

Public-Use Microdata. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

Census Data API. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

Source and Accuracy of the Estimates. . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

Comments. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

Endnotes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
iv Health Insurance Coverage in the United States: 2021 U.S. Census Bureau

TABLE

Table 1. Number and Percentage of People by Health Insurance Coverage Status and Type: 2020 to 2021 ... 4

FIGURES

Figure 1. Percentage of People by Type of Health Insurance Coverage and Change From 2020 to 2021 .... 3

Figure 2. Percentage of People Uninsured by Age Group: 2020 and 2021 ............................... 5

Figure 3. Percentage of People With Selected Coverage Types and Uninsured by Age Group: 

2020 and 2021 .......................................................................... 6

Figure 4. Percentage of Children Under the Age of 19 Without Health Insurance Coverage by

 Selected Characteristics: 2020 and 2021 .................................................. 8

Figure 5. Percentage of Working-Age Adults Without Health Insurance Coverage by Selected

 Characteristics: 2020 and 2021 ........................................................... 9

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

2020 and 2021 .......................................................................... 10

Figure 7. Health Insurance by Type and Income-to-Poverty Ratio for Children Under the Age of 19 

and Adults Aged 19 to 64: 2020 and 2021 ................................................. 11

Figure 8. Health Insurance Coverage by Characteristics: 2020 and 2021 ................................. 13

APPENDIXES

Appendix A. Effects of 2020 Census-Based Population Controls on 2020 Health Insurance Coverage 

        Estimates ............................................................................ 19

       Endnotes .............................................................................. 19

Appendix B. Estimates of Health Insurance Coverage: 2013 to 2021 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23

     Survey Redesign ........................................................................ 23

     Recent Changes in the Health Insurance Landscape ........................................ 23

     Estimates of Health Insurance Coverage: 2013 to 2021 ..................................... 24

       Uninsured Rate ..................................................................... 24

       Private Health Insurance Coverage .................................................... 25

       Public Health Insurance Coverage .................................................... 26

     Endnotes .............................................................................. 27

Appendix C. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29

APPENDIX TABLES

Table A-1. Health Insurance Coverage Status and Type: 2020 Estimates Using 2010 Census-Based 

       Population Controls and 2020 Census-Based Population Controls ........................... 20

Table A-2. Percentage of People Uninsured by Selected Characteristics: 2020 Estimates Using 

       2010 Census-Based Population Controls and 2020 Census-Based Population Controls ......... 21

Table C-1. Percentage of People by Health Insurance Coverage Status and Type by Selected 

       Characteristics: 2020 and 2021 ........................................................... 29

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

       2020 and 2021 ......................................................................... 31

Table C-3. Health Insurance Coverage Status and Type by Household Relationship and Family 

 Income-to-Poverty Ratio: 2020 and 2021 ................................................. 33

APPENDIX FIGURES

Figure B-1. Percentage of People Without Health Insurance Coverage: 2013 to 2021 ...................... 24 

Figure B-2. Percentage of People With Private Health Insurance Coverage: 2013 to 2021 ................... 25

Figure B-3. Percentage of People With Public Coverage and Medicaid Coverage: 2013 to 2021 ............. 26

Figure B-4. Percentage of People With Medicaid Coverage by Age Group: 2017 to 2021 ................... 27
U.S. Census Bureau Health Insurance Coverage in the United States: 2021 1

Health Insurance Coverage in the United States: 2021

INTRODUCTION

Health insurance offers a means 

for financing a person’s health 

care expenses. Health insurance 

coverage provides access to 

medical care, protection from 

high unexpected costs, and more 

economic stability for people 

and families. While the majority of people have private health 

insurance, primarily through an 

employer, others obtain coverage through programs offered 

by the government. Other 

individuals do not have health 

insurance coverage at all (refer 

to the “What Is Health Insurance 

Coverage?” text box).

Year-to-year, the rate of health 

insurance coverage and the distribution of coverage types may 

change due to economic trends, 

shifts in the demographic composition of the population such 

as population aging, and policy 

changes that affect access to 

care. Economic changes include 

job losses associated with the 

COVID-19 pandemic and related 

recession in 2020 and the subsequent employment gains occurring with economic recovery 

in 2021. Recent policy changes 

include increased federal funding for Medicaid in response 

to the COVID-19 pandemic. 

Specifically, Congress extended 

mandated continuous coverage 

for those with Medicaid for the 

duration of the pandemic and 

introduced additional measures to 

increase access to care by reducing the cost of coverage.1

What Is Health Insurance Coverage?

Health insurance coverage in the Current Population Survey Annual 

Social and Economic Supplement (CPS ASEC) refers to comprehensive coverage at any time during the calendar year for the civilian, 

noninstitutionalized population of the United States.* For reporting 

purposes, the U.S. Census Bureau broadly classifies health insurance 

coverage as private insurance or public insurance. 

Private Coverage

• Employment-based: Plan provided through an employer or 

union.

• Direct-purchase: Coverage purchased directly from an insurance company, or through a federal or state Marketplace 

(e.g., healthcare.gov).

• TRICARE: Coverage through TRICARE, formerly known as 

Civilian Health and Medical Program of the Uniformed Services.

Public Coverage

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

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

65 with long-term disabilities.

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

specific Medicaid government program and other programs 

for low-income individuals administered by the states such as 

Children’s Health Insurance Program (CHIP) and Basic Health 

Programs.

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

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

Department of Veterans Affairs and the military.

Additionally, people are considered uninsured if they only had coverage through the Indian Health Service (IHS), as IHS coverage is 

not considered comprehensive.

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

excludes single service plans such as accident, disability, dental, vision, or prescription medicine plans.
2 Health Insurance Coverage in the United States: 2021 U.S. Census Bureau

This report presents statistics on 

health insurance coverage in the 

United States in 2021 and changes 

in health insurance coverage rates 

between 2020 and 2021. The 

statistics in this report are based 

on information collected by the 

Current Population Survey Annual 

Social and Economic Supplement 

(CPS ASEC).* Estimates for 2020 

in this report will not match 

those published last year due to 

the implementation of the 2020 

Census-based population controls. 

Appendix A provides details.

The CPS is the longest-running 

household survey conducted 

by the U.S. Census Bureau. The 

key purpose of the CPS ASEC is 

to provide timely and detailed 

estimates of economic wellbeing, of which health insurance 

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. For information on 

changes to the CPS ASEC over 

time and 2021 health insurance 

coverage estimates in the context 

of a longer time frame, refer to 

Appendix B.

The 2021 estimates highlighted in 

this report are based on responses 

collected from February 2022 to 

April 2022. Respondents were 

asked to report any health insurance coverage they had during 

the previous calendar year. People 

are only considered uninsured if 

* The Census Bureau reviewed this data

product for unauthorized disclosure of confidential information and approved the disclosure avoidance practices applied to this 

release. CBDRB-FY22-355. All comparative 

statements have undergone statistical testing and are statistically significant at the 90 

percent confidence level unless otherwise 

noted.

they had no coverage at any time 

during the year.2

Highlights

• More people were insured in

2021 than 2020. In 2021, 8.3

percent of people, or 27.2

million, did not have health

insurance at any point during the year, representing a

decrease in the uninsured rate

and number of uninsured from

2020 (8.6 percent or 28.3 million) (Table 1).

• In 2021, private health insurance coverage continued to

be more prevalent than public

coverage, at 66.0 percent and

35.7 percent, respectively.3

• Of the subtypes of health

insurance coverage, employerbased insurance was the

most common, covering 54.3

percent of the population for

some or all of the calendar

year, followed by Medicaid

(18.9 percent), Medicare (18.4

percent), direct-purchase coverage (10.2 percent), TRICARE

(2.5 percent), and VA and

CHAMPVA coverage (1.0 percent) (Table 1 and Figure 1).4

• Overall, public coverage

increased between 2020 and

2021. In 2021, 35.7 percent of

people held public coverage

for some or all of the year,

marking a 1.2 percentagepoint increase from 2020.

• Between 2020 and 2021, the

rate of Medicaid coverage

increased by 0.9 percentage

points to cover 18.9 percent of

people (Table 1 and Figure 1).5

• The uninsured rate among

children under the age of 19

decreased 0.6 percentage

points to 5.0 percent between 

2020 and 2021, driven in part 

by an increase in public coverage (Figure 2).

• In 2021, 7.9 percent of fulltime, year-round workers had

public health insurance, up

1.8 percentage points from

2020. Among less than fulltime, year-round workers, the

percentage with public coverage increased 1.6 percentage

points to 22.6 percent during

this period (Figure 8).

ESTIMATES OF HEALTH 

INSURANCE COVERAGE IN 

THE UNITED STATES

This report classifies health insurance coverage into three different 

groups: overall coverage, private 

coverage, and public coverage 

(refer to the “What Is Health 

Insurance Coverage?” text box). In 

the CPS ASEC, people are considered to be insured if they were 

covered by any type of health 

insurance for part or all of the 

previous calendar year. People are 

considered uninsured if, for the 

entire year, they were not covered 

by any type of insurance.6

In 2021, most people (91.7 percent) had health insurance coverage at some point during the 

calendar year (Table 1 and Figure 

1). That is, 8.3 percent of people 

were uninsured for the entire 

calendar year. More people had 

private health insurance (66.0 percent) than public coverage (35.7 

percent).

Employer-based insurance was 

the most common subtype of 

health insurance in the civilian, 

noninstitutionalized population (54.3 percent), followed by 

Medicaid (18.9 percent), Medicare 
U.S. Census Bureau Health Insurance Coverage in the United States: 2021 3

(18.4 percent), direct-purchase 

insurance (10.2 percent), TRICARE 

(2.5 percent), and VA and 

CHAMPVA health care (1.0 percent) (Table 1).

The percentage of people covered 

by any type of health insurance in 

2021 was higher than in 2020. The 

percentage of people covered by 

public health insurance increased 

by 1.2 percentage points between 

2020 and 2021, offsetting the 0.6 

percentage-point decrease in 

private coverage over the same 

period.

Of the subtypes of private health 

insurance, employment-based 

coverage and direct-purchase 

insurance did not statistically 

change between 2020 and 2021. 

The percentage of people covered 

by TRICARE decreased to 2.5 percent between 2020 and 2021.7, 8

Of the three subtypes of public 

health insurance, both Medicare 

and Medicaid rates increased 

between 2020 and 2021, while 

the VA and CHAMPVA rate did 

not have any significant change. 

The rate of Medicaid coverage 

increased by 0.9 percentage 

points to 18.9 percent in 2021. The 

percentage of people covered by 

Medicare increased by 0.5 percentage points to 18.4 percent in 

2021. This increase was in part due 

to growth in the number of people 

aged 65 and over.9

HEALTH INSURANCE 

COVERAGE BY TYPE AND 

SELECTED CHARACTERISTICS 

Health Insurance Coverage by 

Age

Age is associated with the likelihood that a person has health 

insurance coverage, as well as 

with health coverage type. Older 

adults (aged 65 and over) and 

children (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 and 

young adults may receive coverage through a parent or guardian’s plan up to the age of 26, 

and children under the age of 19 

may qualify for coverage through 

Medicaid or the Children’s Health 

Insurance Program (CHIP).10

Between 2020 and 2021, there 

was a 0.6 percentage-point 

decrease in the uninsured rate for 

children under age 19. In 2020, 

5.6 percent of children were 

uninsured for the entire calendar 

year, while in 2021 the uninsured 

rate for children under age 19 fell 

Figure 1.

Percentage of People by Type of Health Insurance Coverage and Change From 2020 to 2021

 VA and CHAMPVA1

 Medicaid

 Medicare

Any public plan

 TRICARE

 Marketplace

 Direct-purchase

 Employment-based

Any private plan

With health insurance 

Uninsured

Type of Coverage in 2021 Change: 2020 to 2021

(Population as of March of the following year)

No statistical change between years

8.3 *-0.4

*0.4

*-0.6

-0.2

-0.1

 0.1

*-0.3

*1.2

*0.5

*0.9

0.1

91.7

66.0

54.3

10.2

3.5

2.5

35.7

18.4

18.9

1.0

* Denotes a statistically significant change between 2020 and 2021 at the 90 percent confidence level.

1

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

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

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

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

at <https://www2.census.gov/programs-surveys/cps/techdocs/cpsmar22.pdf>.

Source: U.S. Census Bureau, Current Population Survey, 2021 and 2022 Annual Social and Economic Supplements (CPS ASEC).
4 Health Insurance Coverage in the United States: 2021 U.S. Census Bureau Table 1. Number and Percentage of People by Health Insurance Coverage Status and Type: 2020 to 2021 (Numbers in thousands. Margins of error in thousands or percentage points as appropriate. Population as of March of the following year. Information on confidentiality protection, sampling error, nonsampling error, and definitions is available at <https://www2.census.gov/programs-surveys/cps/techdocs/cpsmar22.pdf>) Coverage type 20201 2021 Change in percent (2021 less 2020) Number Margin of error2 (±) Percent Margin of error2 (±) Number Margin of error2 (±) Percent Margin of error2 (±)     Total. . . . . . . . . . . . . . . . . 327,521 152 X X 328,074 148 X X X Any health plan. . . . . . . . . . . . . . . 299,230 651 91.4 0.2 300,887 748 91.7 0.2 *0.4  Any private plan3, 4. . . . . . . . . . . . 217,896 1,168 66.5 0.4 216,366 1,077 66.0 0.3 *–0.6   Employment-based3. . . . . . . . 178,737 1,076 54.6 0.3 178,285 1,123 54.3 0.3 –0.2   Direct-purchase3. . . . . . . . . . . . 33,869 649 10.3 0.2 33,555 705 10.2 0.2 –0.1    Marketplace coverage3. . . . 10,924 443 3.3 0.1 11,389 447 3.5 0.1 0.1   TRICARE3. . . . . . . . . . . . . . . . . . 9,165 580 2.8 0.2 8,299 527 2.5 0.2 *–0.3  Any public plan3, 5. . . . . . . . . . . . . 112,925 924 34.5 0.3 117,095 911 35.7 0.3 *1.2   Medicare3. . . . . . . . . . . . . . . . . . 58,541 349 17.9 0.1 60,226 378 18.4 0.1 *0.5   Medicaid3. . . . . . . . . . . . . . . . . . 58,778 909 17.9 0.3 61,940 843 18.9 0.3 *0.9   VA and CHAMPVA3, 6. . . . . . . . 2,967 175 0.9 0.1 3,151 192 1.0 0.1 0.1 Uninsured7. . . . . . . . . . . . . . . . . . . 28,291 626 8.6 0.2 27,187 727 8.3 0.2 *–0.4 * An asterisk preceding an estimate indicates change is statistically different from zero at the 90 percent confidence level. X Not applicable. 1 Implementation of 2020 Census-based population controls. 2 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. 3 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. 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. 7 In the CPS ASEC, individuals are considered to be uninsured if they did not have health insurance coverage for the entire calendar year. Source: U.S. Census Bureau, Current Population Survey, 2021 and 2022 Annual Social and Economic Supplements(CPS ASEC).
U.S. Census Bureau Health Insurance Coverage in the United States: 2021 5

to 5.0 percent. For all other age 

groups, there were no significant 

changes in the uninsured rate 

between 2020 and 2021 (Figure 

2). There were differences in 

the uninsured rate between age 

groups in 2021. For working-age 

adults, 14.9 percent of those 

aged 19 to 25 were uninsured for 

the entire calendar year of 2021, 

followed by those aged 26 to 34 

(13.5 percent), adults aged 35 to 

44 (11.9 percent), and those aged 

45 to 64 (9.4 percent) (Figure 

2). In 2021, 1.2 percent of adults 

aged 65 and older were uninsured for the entire calendar year. 

For adults, the uninsured rate 

decreases as age increases.

Private Coverage

Private coverage rates varied 

by broad age groups (Figure 3). 

For example, the percentage of 

working-age adults aged 19 to 64 

covered by private coverage was 

72.5 percent, compared with 61.9 

percent of children under age 19 

and 48.7 percent of those aged 65 

and older in 2021. Among adults 

aged 19 to 64 with private coverage, most people had employment-based coverage (62.9 percent of all adults aged 19 to 64). 

About 24.4 percent of adults aged 

65 and older had employmentbased coverage, and 21.9 percent 

held coverage they purchased 

directly.11

Between 2020 and 2021, there 

was no statistical change in private coverage or private coverage 

subtypes such as employmentbased or direct-purchase for most 

broad age groups. Among those 

aged 65 and older, however, the 

percentage of people with directpurchase coverage decreased 

by 1.4 percentage points to 21.9 

percent.

Public Coverage

In 2021, more than one-third of 

children under age 19 had public 

health coverage, compared with 

18.7 percent of adults aged 19 to 

64. Most adults aged 65 and older 

(93.5 percent) held public coverage. Among children under age 19, 

most of those with public health 

insurance were covered through 

Medicaid or CHIP (35.9 percent); 

among adults aged 65 and older, 

93.4 percent were covered through 

the Medicare program. About 15.4 

percent of working-age adults 

were covered through Medicaid, 

and 3.8 percent held Medicare.

Between 2020 and 2021, public 

coverage rates increased among 

children under age 19 and adults 

aged 19 to 64 by 1.3 percentage 

points and 0.9 percentage points, 

respectively.12 For these groups, 

this increase was driven by an 

increase in Medicaid coverage. 

Medicaid increased 1.2 percentage points for children under age 

19 and 0.9 percentage points 

for working-age adults over this 

period. Medicaid also increased 1.1 

percentage points for those aged 

65 and older between 2020 and 

2021.13

Figure 2.

Percentage of People Uninsured by Age Group: 2020 and 2021

(Population as of March of the following year)

5.6

5.0

14.3

14.9

12.5

11.9

9.8 9.4

14.1

13.5

1.0 1.2

2020 2021

 Under age 19* Aged 19 to 25 Aged 26 to 34 Aged 35 to 44 Aged 45 to 64 Aged 65 or over

* Denotes a statistically significant change between 2020 and 2021 at the 90 percent confidence level.

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

<https://www2.census.gov/programs-surveys/cps/techdocs/cpsmar22.pdf>.

Source: U.S. Census Bureau, Current Population Survey, 2021 and 2022 Annual Social and Economic Supplements (CPS ASEC).
6 Health Insurance Coverage in the United States: 2021 U.S. Census Bureau

Under Age 19

Uninsured

Private

Employment-based

Direct-purchase

TRICARE

Public

Medicare

Medicaid

VA and CHAMPVA1

Aged 19 to 64

Uninsured

Private

Employment-based

Direct-purchase

TRICARE

Public

Medicare

Medicaid

VA and CHAMPVA1

Aged 65 and Older

Uninsured

Private

Employment-based

Direct-purchase

TRICARE

Public

Medicare

Medicaid

VA and CHAMPVA1

Figure 3.

Percentage of People With Selected Coverage Types and Uninsured by Age Group: 

2020 and 2021

(Population as of March of the following year)

* Denotes a statistically significant change between 2020 and 2021 at the 90 percent confidence level.

Z Rounds to zero.

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

Department of Veterans Affairs (VA) and the military.

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

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

at <https://www2.census.gov/programs-surveys/cps/techdocs/cpsmar22.pdf>.

Source: U.S. Census Bureau, Current Population Survey, 2021 and 2022 Annual Social and Economic Supplements (CPS ASEC).

 93.4

 1.2

 2.2

 7.4

 3.3

 21.9

 24.4

 48.7

 11.6

 0.9

 15.4

 3.8

 18.7

 2.4

 8.7

 5.0

 0.1

 0.5

 2.4

 5.5

 54.7

 36.4

 35.9

 62.9

 72.5

 61.9

 93.5

Type of Coverage by Age in 2021 Change: 2020 to 2021

*-0.6

-0.4

0.2

-0.1

*-0.6

*1.3

0.1

*1.2

Z

-0.3

-0.3

-0.1

0.1

*-0.2

*0.9

-0.1

*0.9

0.1

0.1

-1.0

-0.1

*-1.4

0.2

Z

Z

*1.1

Z

No statistical change between years
U.S. Census Bureau Health Insurance Coverage in the United States: 2021 7

UNINSURED RATES FOR 

CHILDREN AND WORKINGAGE ADULTS BY SELECTED 

CHARACTERISTICS

As described above, most adults 

aged 65 and older were covered 

by health insurance, primarily 

through Medicare. Among children under age 19 and workingage adults aged 19 to 64, however, 

health insurance status varies 

across groups, and some groups 

may experience changes in coverage while others do not.

Children Under Age 19

Although the uninsured rate 

decreased by 0.6 percentage 

points for all children between 

2020 and 2021, changes in health 

insurance coverage in 2021 

among children under age 19 did 

not occur equally across groups 

(Figure 4).

The percentage of non-Hispanic 

White children without health 

insurance coverage was not statistically different in 2021 compared 

with 2020. However, the uninsured 

rate decreased for Black children (by 1.6 percentage points) 

and increased for Asian children 

(by 1.8 percentage points) to 4.3 

percent and 4.6 percent, respectively.14 In 2021, 8.6 percent of 

Hispanic children were uninsured, 

which is not statistically different 

from 2020.15, 16, 17

In 2021, 4.5 percent of native-born 

children were uninsured, representing a 0.7 percentage-point 

decrease compared to 2020.18

However, among foreign-born 

children, 18.6 percent were uninsured, including 5.2 percent of 

children who were naturalized citizens and 22.6 percent of children 

who were not citizens.19

Health insurance rates for children 

also varied by region.20 For example, 6.8 percent of children living 

in the South were uninsured in 

2021, 0.9 percentage points lower 

than in 2020 (7.7 percent). The 

uninsured rates for children in the 

Northeast (3.0 percent), children 

in the Midwest (3.7 percent), and 

children in the West (4.7 percent) 

were not statistically different 

from 2020 and were lower than 

the uninsured rate for children in 

the South.21

The Patient Protection and 

Affordable Care Act (ACA) 

provides the option for states 

to expand Medicaid eligibility 

to people whose income-topoverty ratio falls under a particular threshold. As of January 1, 

2021, 36 states and the District of 

Columbia had expanded Medicaid 

eligibility requirements (“expansion states”). The remaining 14 

states had not expanded Medicaid 

eligibility (“nonexpansion states”). 

The uninsured rate for children 

living in nonexpansion states 

decreased by 1.6 percentage 

points to 7.1 percent. The uninsured rate for children living in 

expansion states in 2021 (4.0 percent) was not statistically different 

from 2020.

Working-Age Adults 19 to 64 

Years Old

Adults aged 19 to 64 may have different health insurance outcomes 

from other age groups because 

they do not qualify for programs 

such as CHIP, and only qualify for 

Medicare under limited circumstances. In 2021, 11.6 percent of 

adults aged 19 to 64 did not have 

health insurance coverage, which 

was not statistically different from 

2020 (Figure 5). However, there 

were some differences between 

groups in these years.

The uninsured rate decreased by 

1.6 percentage points for Black 

adults aged 19 to 64 between 

2020 and 2021 to 12.7 percent. 

There was no significant change 

for White (7.5 percent), Asian 

(7.7 percent), or Hispanic (25.1 

percent) adults in this age group 

(Figure 5).22

There was also a significant 

decrease in the uninsured rate for 

native-born adults aged 19 to 64. 

In 2021, 9.1 percent of native-born 

adults aged 19 to 64 were uninsured, compared to 9.6 percent 

in 2020. There was no significant 

change in the uninsured rate for 

foreign-born adults aged 19 to 64 

(22.8 percent) and no change in 

the uninsured rate for either naturalized citizens (10.3 percent) or 

noncitizens (33.1 percent).

For many adults aged 19 to 64, 

health insurance coverage is 

related to employment status, 

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

year-round; or not working at all. 

In 2021, 10.7 percent of workers 

were uninsured, representing a 

decline of 0.4 percentage points 

compared to 2020. Among fulltime, year-round workers aged 

19 to 64, the uninsured rate rose 

by 0.6 percentage points to 9.1 

percent. For adults aged 19 to 64 

who worked less than full-time, 

year-round, the uninsured rate fell 

from 16.4 percent in 2020 to 15.1 

percent in 2021.23 These differences may reflect changes in the 

composition of the labor force 

through the pandemic and economic recovery.
8 Health Insurance Coverage in the United States: 2021 U.S. Census Bureau

Figure 4.

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

Selected Characteristics: 2020 and 2021 

 

2021 

2020

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

 5.0

 5.6

 3.4

 3.8

 4.3

 5.9

 4.6

2.8

 8.6

 9.5

 4.5

 5.2

 3.0

 3.2

 3.7

 4.4

 6.8

 7.7

 4.7

 4.9

 4.0

 4.0

 7.1

 8.6

 18.6

 17.7

 22.6

20.8

 5.2

 7.5

* Denotes a statistically significant change between 2020 and 2021 at the 90 percent confidence level.

1

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

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

or as those who reported Asian regardless of whether they also reported another race (the race-alone-or-in-combination concept). This 

table shows estimates for the race-alone population.

2 Medicaid expansion status as of January 1, 2021. Expansion states on or before January 1, 2021, include AK, AR, AZ, CA, CO, CT, DC, DE, 

HI, IA, ID, IL, IN, KY, LA, MA, MD, ME, MI, MN, MT, ND, NE, NH, NJ, NM, NV, NY, OH, OR, PA, RI, UT, VA, VT, WA, and WV. For more 

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

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

<https://www2.census.gov/programs-surveys/cps/techdocs/cpsmar22.pdf>.

Source: U.S. Census Bureau, Current Population Survey, 2021 and 2022 Annual Social and Economic Supplements (CPS ASEC).

Nonexpansion state*

Expansion state

Medicaid Expansion Status2

West

South*

Midwest

Northeast

Region

Noncitizen

Naturalized citizen

Foreign-born

Native-born*

Nativity

Hispanic (any race)

Asian*

Black*

White, not Hispanic

Race and Hispanic Origin1

Total*
U.S. Census Bureau Health Insurance Coverage in the United States: 2021 9

Figure 5.

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

Characteristics: 2020 and 2021 

 

2021 

 11.6 2020

 11.9

 7.5

 7.7

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

West

South

Midwest*

Northeast

Region

Never married

Separated

Divorced

Widowed

Married2

Marital Status

Did not work

Worked less than full-time, year-round*

Worked full-time, year-round*

All workers*

Work Experience

Noncitizen

Naturalized citizen

Foreign-born

Native-born*

Nativity

Hispanic (any race)

Asian

Black*

White, not Hispanic

Race and Hispanic Origin1

Total

 12.7

 14.2

 7.7

 7.7

 9.1

 9.6

 22.8

22.9

 33.1

 33.8

 10.3

 10.7

 10.7

 11.2

 9.1

 8.4

 15.1

 16.4

 14.8

14.7

 25.1

24.9

8.1

 8.5

 12.3

 12.3

 12.5

 13.3

 19.0

 20.4

 15.8

 16.0

 7.4

 6.7

 7.7

 8.6

16.0

 16.5

11.0

 11.4

* Denotes a statistically significant change between 2020 and 2021 at the 90 percent confidence level. 

1 Federal surveys give respondents the option of reporting more than one race. Therefore, two basic ways of defining 

a race group are possible. A group, such as Asian, may be defined as those who reported Asian and no other race 

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

(the race-alone-or-in-combination concept). This figure shows estimates for the race-alone population.

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

spouse present,” and “married, spouse absent."

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

<https://www2.census.gov/programs-surveys/cps/techdocs/cpsmar22.pdf>.

Source: U.S. Census Bureau, Current Population Survey, 2021 and 2022 Annual Social and Economic Supplements (CPS ASEC).
10 Health Insurance Coverage in the United States: 2021 U.S. Census Bureau

Marital status is related to health 

insurance coverage, as many 

married adults share their health 

plan. Among adults aged 19 to 64 

in 2021, those who were married 

were less likely to be uninsured 

(8.1 percent) than separated 

adults (19.0 percent), never 

married adults (15.8 percent), 

divorced adults (12.5 percent), or 

widowed adults (12.3 percent).24

Health insurance rates for adults 

aged 19 to 64 also varied by 

region. For example, 7.7 percent of 

adults living in the Midwest in 2021 

were uninsured, a 0.9 percentagepoint decrease from 2020.25 There 

were no significant changes in the 

uninsured rates for adults aged 19 

to 64 in other regions.26

For adults aged 19 to 64, health 

insurance coverage may be 

related to both poverty status 

and whether or not they live in an 

expansion state.27

For example, uninsured rates were 

lower for all income-to-poverty 

groups in expansion states 

compared to uninsured rates in 

nonexpansion states. In 2021, the 

uninsured rate for those in poverty 

in nonexpansion states was 

35.7 percent, compared to 17.2 

percent in expansion states. For 

those in poverty in nonexpansion 

states, the uninsured rate fell by 

2.7 percentage points between 

2020 and 2021. In contrast, there 

was no significant change in the 

uninsured rate for other incometo-poverty groups (Figure 6).28

PUBLIC AND PRIVATE HEALTH 

INSURANCE COVERAGE BY 

SELECTED CHARACTERISTICS

Public and Private Health 

Insurance Coverage by Age 

Categories

The CPS ASEC can also be used 

to look more closely at health 

Figure 6.

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

2020 and 2021

Percentage-Point Change in Uninsured Rate Between 2020 and 2021

16.8 17.2

-2.7*

-0.9

Z

-1.0*

0.5

-0.4

0.1

-0.3

13.9 13.5

38.3

35.7

23.1 22.2

17.7 16.7

6.4 6.1

3.7 3.8

9.0 9.0

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

2020 2021 Expansion States1

2020 2021 Nonexpansion States1

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

* Denotes a statistically significant change between 2020 and 2021 at the 90 percent confidence level.

Z Rounds to zero.

1

 Medicaid expansion status as of January 1, 2021. Expansion states on or before January 1, 2021, include AK, AR, AZ, CA, CO, CT, DC, DE, 

HI, IA, ID, IL, IN, KY, LA, MA, MD, ME, MI, MN, MT, ND, NE, NH, NJ, NM, NV, NY, OH, OR, PA, RI, UT, VA, VT, WA, and WV. For more 

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

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

at <https://www2.census.gov/programs-surveys/cps/techdocs/cpsmar22.pdf>. 

Source: U.S. Census Bureau, Current Population Survey, 2021 and 2022 Annual Social and Economic Supplements (CPS ASEC).
U.S. Census Bureau Health Insurance Coverage in the United States: 2021 11

insurance coverage by type for 

selected social and economic 

characteristics. Examining 

changes in health coverage by 

type also highlights how these 

changes affect the uninsured rate 

for different groups.

Health insurance coverage and 

type is associated with family 

income-to-poverty ratio, which 

provides a measure of a family’s economic resources. Family 

resources may determine the 

ability to afford private health 

insurance, and families below 

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

insurance options. Further, policies implemented in response to 

the COVID-19 pandemic may have 

increased access to and affordability of public and private health 

coverage.

As the income-to-poverty ratio 

increases, the percent uninsured 

declines for children under age 19 

and working-age adults aged 19 

to 64 (Figure 7). Among workingage adults, those living in poverty 

had the highest uninsured rate 

for the full calendar year (24.0 

percent), while those living at or 

above 400 percent of the poverty 

line had the lowest uninsured rate 

for all of 2021 (4.5 percent).

Uninsured1

Below

100% of poverty

Between 

100% and 399% 

of poverty

At or above

400% of poverty

Private Coverage1

Below

100% of poverty

Between 

100% and 399% 

of poverty

At or above

400% of poverty

Public Coverage1

Below

100% of poverty

Between 

100% and 399% 

of poverty

At or above

400% of poverty

Figure 7.

Health Insurance by Type and Income-to-Poverty Ratio for Children Under the Age of 19 and Adults 

Aged 19 to 64: 2020 and 2021

(Population as of March of the following year)

* Denotes a statistically significant change between 2020 and 2021 at the 90 percent confidence level.

Z Rounds to zero.

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

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

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

<https://www2.census.gov/programs-surveys/cps/techdocs/cpsmar22.pdf>.

Source: U.S. Census Bureau, Current Population Survey, 2021 and 2022 Annual Social and Economic Supplements (CPS ASEC).

8.3 24.0

Under Age 19 Aged 19 to 64

6.4 16.7

25.4 44.2

51.8 79.7

5.7

7.2

15.5 27.1

53.4 61.8

91.8

93.2

1.7

4.5

Insurance Type by Income-to-Poverty Ratio in 2021 Change: 2020 to 2021

-1.0

-1.1

-0.5

-0.6

*-0.4

Z

-0.8

-0.9

*-1.5

-0.1

-0.1 -0.3

2.3

*2.4

*2.0

*0.8

*1.2

*0.5

No statistical change between years
12 Health Insurance Coverage in the United States: 2021 U.S. Census Bureau

Among children living in families 

below 100 percent of poverty and 

children living in families between 

100 and 399 percent of poverty, 

there was no statistically significant change in the uninsured rate 

between 2020 and 2021 (Figure 

7). In 2021, 8.3 percent of children living in families below 100 

percent of poverty did not have 

health insurance at any time, and 

6.4 percent of children living in 

families between 100 and 399 

percent of poverty did not have 

health insurance. However, for 

children living in families at 400 

percent of poverty or above, the 

uninsured rate decreased 0.4 

percentage points to 1.7 percent 

in 2021.29 There was no significant 

change in the uninsured rate for 

adults aged 19 to 64 by incometo-poverty ratio or for children in 

other income-to-poverty groups 

(Figure 7).

For private insurance, 15.5 percent of children under age 19 

and 27.1 percent of working-age 

adults living in poverty held 

private health coverage. Each 

group with a higher income-topoverty ratio had a higher rate 

of private insurance. Those living 

at or above 400 percent of the 

poverty line were the most likely 

to have private health insurance 

(93.2 percent for children under 

age 19 and 91.8 percent for adults 

aged 19 to 64) (Figure 7). The 

rate of private coverage fell by 1.5 

percentage points between 2020 

and 2021 among children living 

in families between 100 and 399 

of poverty.30 However, there was 

no statistical change in private 

coverage rates for other age and 

income-to-poverty groups.

In contrast, those living in poverty were the most likely to have 

public insurance (79.7 percent 

for children under age 19 and 51.8 

percent for working-age adults 

aged 19 to 64), while those living 

at or above 400 percent of the 

poverty line were the least likely to 

have public health insurance (7.2 

percent for children under age 19 

and 5.7 percent for working-age 

adults). The percentage of people 

with public insurance decreases 

as the income-to-poverty ratio 

increases. Between 2020 and 

2021, public coverage increased 

for people in most age and 

income-to-poverty categories. The 

public coverage rate was not statistically different between 2020 

and 2021 for children in poverty.31

PUBLIC AND PRIVATE HEALTH 

INSURANCE COVERAGE BY 

SOCIAL AND DEMOGRAPHIC 

CHARACTERISTICS

Differences in coverage type and 

changes in coverage can be seen 

across groups. For example, in 

2021, Hispanic individuals had 

the highest uninsured rate (18.3 

percent), followed by Black (9.0 

percent), Asian (6.2 percent), and 

non-Hispanic White (5.2 percent) 

people (Appendix Table C-1).

Lower uninsured rates for nonHispanic White and Asian individuals reflect higher private coverage rates.32 In 2021, non-Hispanic 

White individuals had the highest 

rate of private coverage (73.2 

percent), followed by Asian (72.4 

percent), Black (55.1 percent), 

and Hispanic individuals (48.8 

percent) (Figure 8). Although 

there was no significant change in 

private coverage between 2020 

and 2021 for Hispanic, Asian, and 

Black individuals, private coverage 

rates declined by 0.7 percentage 

points among non-Hispanic White 

individuals (Figure 8).

Between 2020 and 2021, most 

race and Hispanic origin groups 

saw an increase in public coverage rates. The increase in public 

coverage rates was similar for 

three groups. Non-Hispanic White 

individuals had public coverage 

increase 1.3 percentage points (to 

34.6 percent), Black individuals 

had an increase of 1.4 percentage points (to 42.7 percent), 

and Hispanic individuals had an 

increase of 1.1 percentage points 

(to 37.0 percent). However, there 

was no significant change in 

public coverage rates for Asian 

individuals.

People in both expansion and 

nonexpansion states also experienced an increase in public 

coverage rates between 2020 

and 2021. Those in expansion 

states had a 1.4 percentage-point 

increase in public health insurance 

coverage (37.0 percent), while 

those in nonexpansion states had 

a 1.0 percentage-point increase 

in public coverage (33.1 percent). 

Between 2020 and 2021, private 

coverage rates in expansion states 

fell 0.9 percentage points to 67.1 

percent.

When looking at health insurance 

by work experience or disability 

status, we restrict our analyses to 

adults aged 15 to 64. For many 

adults aged 15 to 64, health insurance coverage is related to work 

status as many workers may be 

covered by their employers’ health 

plans. Indeed, workers were more 

likely than nonworkers to be covered by private health insurance. 

In 2021, 85.0 percent of full-time, 

year-round workers were covered 

through a private insurance plan, 

compared with 66.5 percent of 

those working less than full-time, 

year-round. Those who did not 

work were the least likely to have 
U.S. Census Bureau Health Insurance Coverage in the United States: 2021 13

Total

Race and Hispanic Origin1

White, not Hispanic

Black

Asian

Hispanic (any race)

Expansion Status2

Expansion state

Nonexpansion state

Total, aged 15 to 64

Work Experience

All workers

Worked full-time, year-round

Worked less than full-time, 

year-round

Did not work

Disability Status3

With a disability

With no disability

Total, aged 19 to 64

Marital Status

Married4

Not married

Figure 8.

Health Insurance Coverage by Characteristics: 2020 and 2021

(Population as of March of the following year)

 81.7

12.1 79.7

7.9 85.0

35.7 66.0

Private Public

34.6 73.2

37.0 67.1

33.1 63.7

19.9 71.9

22.6 66.5

17.2 73.9

18.7 72.5

41.2 50.3

46.3 52.3

42.7 55.1

27.4 72.4

37.0 48.8

13.4

24.2 63.1

Health Insurance Coverage in 2021 Change: 2020 to 2021

* Denotes a statistically significant change between 2020 and 2021 at the 90 percent confidence level.

Z Rounds to zero.

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

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

those who reported Asian regardless of whether they also reported another race (the race-alone-or-in-combination concept). This table shows 

estimates for the race-alone population.

2 Medicaid expansion status as of January 1, 2021. Expansion states on or before January 1, 2021, include AK, AR, AZ, CA, CO, CT, DC, DE, HI, IA, 

ID, IL, IN, KY, LA, MA, MD, ME, MI, MN, MT, ND, NE, NH, NJ, NM, NV, NY, OH, OR, PA, RI, UT, VA, VT, WA, and WV. For more information, refer 

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

3 The sum of those with and without a disability does not equal the total because disability status is not defined for individuals in the 

U.S. armed forces. 

4 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. Information on confidentiality protection, sampling error, nonsampling error, and definitions is available at 

<https://www2.census.gov/programs-surveys/cps/techdocs/cpsmar22.pdf>.

Source: U.S. Census Bureau, Current Population Survey, 2021 and 2022 Annual Social and Economic Supplements (CPS ASEC).

*-0.6

*1.2

*-0.7

*1.3

0.6

*1.4

-0.1

0.6

-1.1

*1.1

*-0.9

*1.4

Z

*1.0

-0.4

*1.0

Z

*0.7

*-2.0

*1.8

-0.1

*1.6

*-1.6

*1.8

1.2

-1.1

-0.3

*0.9

-0.3

*0.9

-0.4

*1.1

-0.3

*0.7

No statistical change between years
14 Health Insurance Coverage in the United States: 2021 U.S. Census Bureau

private health insurance coverage 

at 50.3 percent. Both full-time, 

year-round workers and those 

who did not work experienced a 

decrease in private coverage rates 

between 2020 and 2021 (by 2.0 

percentage points and 1.6 percentage points, respectively).

Rates of public coverage followed 

a different pattern. Nonworkers 

were more likely than workers 

to have public coverage (41.2 

percent of nonworkers and 12.1 

percent of workers). Full-time, 

year-round workers were the least 

likely to have public coverage at 

7.9 percent, while 22.6 percent of 

workers who worked less than fulltime, year-round were covered by 

public coverage in 2021.

Between 2020 and 2021, there 

was an increase in public coverage across work statuses. The 

percentage of full-time, yearround workers with public coverage increased by 1.8 percentage 

points, while public insurance 

coverage rates for those who 

worked less than full-time, yearround increased by 1.6 percentage 

points. For nonworkers, public 

coverage increased by 1.8 percentage points.

People with a disability were less 

likely than people with no disability to have private health insurance coverage and more likely 

to have public coverage. In 2021, 

46.3 percent of adults with a disability had private coverage, compared with 73.9 percent of adults 

with no disability. At the same 

time, 52.3 percent of adults with 

a disability and 17.2 percent with 

no disability had public coverage. 

Between 2020 and 2021, public 

coverage increased 0.9 percentage points among people with no 

disability but did not statistically 

change for people with a disability 

during this period.33

There are also differences in the 

distribution of coverage type 

by marital status. For example, 

in 2021, 81.7 percent of married 

adults aged 19 to 64 held private coverage, compared to 63.1 

percent of those who were not 

married. Married adults were also 

less likely to hold public coverage (13.4 percent) than their 

nonmarried counterparts (24.2 

percent). Although there was no 

significant change in private coverage for either group between 

2020 and 2021, the percentage of 

married adults with public coverage increased by 1.1 percentage 

points. Public coverage rates also 

increased among those who were 

not married by 0.7 percentage 

points during the same period.

SUMMARY

This past year the uninsured rate 

decreased by 0.4 percentage 

points. Overall, private coverage 

continued to be more prevalent 

than public insurance. Private 

coverage rates decreased, while 

the rate of public health coverage increased between 2020 and 

2021. People in many social and 

demographic groups saw their 

uninsured rate decline since 2020, 

driven in part by an increase in 

public health coverage rates. 

Changes in coverage between 

2020 and 2021 may be related to 

changes in labor force composition through the pandemic and 

recent economic recovery, as 

well as to policies addressing the 

COVID-19 pandemic.

ADDITIONAL INFORMATION 

ABOUT HEALTH INSURANCE 

COVERAGE

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 American 

Community Survey (ACS). Singleyear estimates are available for 

geographic units with a population 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 all states and counties. These estimates are based 

on statistical models using data 

from a variety of sources including current surveys, administrative 

records, and annual population 

estimates. In general, SAHIE estimates have lower variances than 

ACS estimates but are released 

later because they incorporate 

these additional data into their 

models.

SAHIE estimates are available 

at <www.census.gov/programssurveys/sahie.html>. The most 

recent estimates are for 2020.

Additional data

The CPS ASEC is used to produce 

additional health insurance 

coverage tables. These tables are 

available on the Census Bureau’s 

Health Insurance website. The 

website may be accessed through 

the Census Bureau’s home 

page at <www.census.gov> or 

directly at <www.census.gov/

data/tables/2022/demo/healthinsurance/p60-278.html>.
U.S. Census Bureau Health Insurance Coverage in the United States: 2021 15

For assistance with health insurance data, contact the Census 

Bureau Customer Services Center 

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

search your topic of interest using 

the Census Bureau’s “Question 

and Answer Center” found at 

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

Data.census.gov

Data.census.gov is a platform to 

access data and digital content 

from the Census Bureau. It allows 

access to the Census Bureau’s 

most popular surveys and programs such as the CPS, ACS, 

decennial census, economic census, and more.

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 at 

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

api-documentation/data-censusgov-release-notes.pdf>.

In addition to the 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 <data.census.gov/

mdat>. The MDAT provides data 

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

from the CPS ASEC.

Public-Use Microdata

Microdata for the CPS ASEC 

are available online at <www.

census.gov/data/datasets/timeseries/demo/cps/cps-asec.html>. 

Technical methods have been 

applied to CPS microdata to 

avoid disclosing the identities of 

individuals from whom data were 

collected.

Census Data API

The Census Data Application 

Programming Interface (API) 

gives the public access to 

pretabulated data from various 

Census Bureau data programs. It 

is an efficient way to query data 

directly from Census Bureau servers with many advantages, including the ability to easily download 

target variables and geographies 

and immediately access the most 

current data. Users can find which 

datasets are currently available 

via API at <www.census.gov/data/

developers/data-sets.html>.

SOURCE AND ACCURACY OF 

THE ESTIMATES 

The estimates in this report are 

from the CPS ASEC. The CPS is 

the longest-running survey conducted by the Census Bureau. The 

CPS is a household survey primarily used to collect employment 

data. The sample universe for the 

basic CPS consists of the resident civilian, noninstitutionalized 

population of the United States. 

People in institutions, such as 

prisons, long-term care hospitals, and nursing homes, are not 

eligible to be interviewed in the 

CPS. Students living in dormitories are included in the estimates 

only if information about them is 

reported in an interview at their 

parents’ home. Since the CPS is a 

household survey, people who are 

homeless and not living in shelters 

are not included in the sample.

The CPS ASEC collects data in 

February, March, and April each 

year, asking detailed questions 

categorizing income into over 50 

sources. The key purpose of the 

CPS ASEC is to provide timely 

and comprehensive estimates 

of income, poverty, and health 

insurance and to measure change 

in these national-level estimates. 

The CPS ASEC is the official 

source of national poverty estimates calculated in accordance 

with the Office of Management 

and Budget’s Statistical Policy 

Directive 14.

The CPS ASEC collects data in 

the 50 states and the District of 

Columbia; these data do not represent residents of Puerto Rico or 

U.S. Island Areas.34 The 2021 CPS 

ASEC sample consists of about 

90,800 addresses. The CPS ASEC 

includes military personnel who 

live in a household with at least 

one other civilian adult, regardless of whether they live off post 

or on post. All other armed forces 

personnel are excluded. The estimates in this report are controlled 

to March 2022 independent 

estimates of national population 

by age, sex, race, and Hispanic 

origin. Beginning with the “Health 

insurance Coverage in the United 

States: 2021” report, population 

estimates are based on 2020 

Census population counts and 

are updated annually taking into 

account births, deaths, emigration, and immigration. For more 

information, refer to Appendix A.

The estimates in this report (which 

may be shown in text, figures, and 

tables) are based on responses 

from a sample of the population 

and may differ from actual values 

because of sampling variability or 

other factors. As a result, apparent 

differences between the estimates 

for two or more groups may not be 

statistically significant. All comparative statements have undergone 

statistical testing and are statistically significant at the 90 percent 

confidence level unless otherwise 

noted. In this report, the variances of estimates were calculated 

using the Successive Difference 

Replication (SDR) method.
16 Health Insurance Coverage in the United States: 2021 U.S. Census Bureau

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 Generalized Variance 

Functions approach. Under this 

approach, generalized variance 

parameters were used in formulas provided in the source and 

accuracy statement to estimate 

standard errors. Further information on replicate weights, standard 

errors, income top-coding and 

data swapping on the public-use 

file, and changes to the CPS ASEC 

data file is available at <https://

www2.census.gov/programssurveys/cps/techdocs/cpsmar22.

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, 

contact:

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>.

ENDNOTES

1

 For more information, refer to 

“Families First Coronavirus Response 

Act, P.L. 116-127,” March 18, 2020, <www.

congress.gov/116/plaws/publ127/PLAW116publ127.pdf>; Congressional Research 

Service, “Health Care Provisions in the 

Families First Coronavirus Response 

Act, P.L. 116-127,” R46316, April 17, 2020, 

<https://crsreports.congress.gov/product/pdf/R/R46316>; “American Rescue 

Plan Act of 2021,” P.L. 117-2, March 11, 

2021, <www.congress.gov/117/plaws/

publ2/PLAW-117publ2.pdf>; Katie 

Keith, “Final Coverage Provisions In the 

American Rescue Plan and What Comes 

Next,” Health Affairs Blog, DOI: 10.1377/

hblog20210311.725837, March 11, 2021. 2 The CPS ASEC also includes a measure 

of health insurance coverage held at the 

time of the interview. Although this measure of coverage cannot predict coverage 

in a given calendar year, it offers a snapshot 

of health insurance coverage early in the 

year when CPS ASEC data are collected. 3 Some people may have more than one 

coverage type during the calendar year. 4 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. 5 Throughout this report, details may not 

sum to totals because of rounding. 6 Infants born after the calendar-year 

reference period are excluded from estimates in this report. 7 Although TRICARE imposed a monthly 

enrollment fee on certain retired beneficiaries and their dependents in 2021, enrollment remained relatively stable at about 

9.5 million people in 2018 and 9.6 million 

people in 2019, 2020, and 2021 according to TRICARE beneficiary data. Given 

the small sample size and relative stability in enrollment reported by the Military 

Health System, it is difficult to determine 

whether the apparent decline in the CPS 

ASEC between 2020 and 2021 reflects real 

change in TRICARE coverage. For more 

information, refer to the Annual Evaluation 

of the TRICARE Program, <www.health.

mil/Military-Health-Topics/Access-CostQuality-and-Safety/Health-Care-ProgramEvaluation/Annual-Evaluation-of-theTRICARE-Program>. 8 The percentage-point change in 

the overall rate of employment-based 

coverage was not statistically different 

from the percentage-point change in the 

rate of direct-purchase coverage or the 

percentage-point change in the rate of 

TRICARE coverage. 9 The proportion of the population 

65 years and older with Medicare coverage did not statistically change between 

2020 and 2021. However, the percentage 

of the U.S. population 65 years and older 

increased between 2020 and 2021. 10 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. 11 Although most people aged 65 and 

older held coverage through Medicare, 

51.4 percent of people aged 65 and older 

reported holding more than one type of 

coverage concurrently for some or all of 

calendar year 2021. 12 The percentage-point change in the 

rate of public coverage for children under 

age 19 was not statistically different from 

the percentage-point change in the rate 

of public coverage for working-age adults 

aged 19 to 64. 13 The percentage-point change in the 

rate of Medicaid coverage for children 

under age 19 was not statistically different 

from the percentage-point change in the 

rate of Medicaid coverage for working-age 

adults aged 19 to 64 or adults aged 65 and 

older. The percentage-point change in the 

rate of Medicaid coverage for working-age 

adults aged 19 to 64 was not statistically 

different from the percentage-point change 

in the rate of Medicaid coverage for adults 

aged 65 and older. 14 In 2021, the percentage of Asian 

children without health insurance coverage was not statistically different from the 

percentage of non-Hispanic White children 

without coverage or Black children without 

coverage. 15 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-aloneor-in-combination concept). The body of 

this report (text, figures, and tables) shows 

data using the first approach (race alone). 

Use of the single-race population does not 

imply that it is the preferred method of 

presenting or analyzing data. The Census 

Bureau uses a variety of approaches. 

Data for American Indians and Alaska 

Natives, Native Hawaiians and Other Pacific 

Islanders, and those reporting two or 

more races are not shown separately. In 

this report, the term “non-Hispanic White” 

refers to people who are not Hispanic and 

who reported White and no other race. The 

Census Bureau uses non-Hispanic Whites 

as the comparison group for other race 

groups and Hispanics. Because Hispanic 

people may be any race, data in this report 

for Hispanic people overlap with data for 

racial groups. Of those who reported only 

one race, 16.6 percent of White householders, 5.6 percent of Black householders, 

and 2.9 percent of Asian householders also 

reported being Hispanic. Data users should 

exercise caution when interpreting aggregate results for the Hispanic population and 

for race groups because these populations 

consist of many distinct groups that differ 

in socioeconomic characteristics, culture, 

and recency of immigration. Data were first 

collected for Hispanic people in 1972. 16 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. 17 The percentage-point change in the 

uninsured rate was not statistically different between non-Hispanic White children, 

Black children, and Hispanic children. 18 In 2021, the percentage of native-born 

children with health insurance coverage was 

not statistically different from the percentage of naturalized children with coverage. The percentage-point change in the 

uninsured rate was not statistically different 

between native-born children, foreign-born 

children, naturalized citizen children, and 

noncitizen children. 19 Between 2020 and 2021, there was no 

statistical change in the uninsured rate for 

children who were foreign-born, naturalized 

citizens, or noncitizens.
U.S. Census Bureau Health Insurance Coverage in the United States: 2021 17

20 For information about how the Census 

Bureau classifies regions, refer to <https://

www2.census.gov/geo/pdfs/maps-data/

maps/reference/us_regdiv.pdf>. 21 In 2021, the percentage of children in 

the Northeast without health insurance coverage was not statistically different from 

the percentage of children in the Midwest 

without coverage. The percentage-point 

change in the uninsured rate was not statistically different between children in the 

Northeast, Midwest, South, or West. 22 The percentage-point change in the 

uninsured rate was not statistically different 

for Black individuals and Asian individuals. 23 In 2021, the percentage of adults who 

worked less than full-time with no health 

insurance coverage was not statistically 

different from the percentage of adults 

who did not work with no health insurance 

coverage. The percentage-point change 

in the uninsured rate was not statistically 

different between those who did not work 

and workers or those who worked full-time, 

year-round. 24 In 2021, the percentage of widowed 

adults with no health insurance coverage 

was not statistically different from the percentage of divorced adults with no health 

insurance coverage.

25 The percentage-point change in the 

uninsured rate for those in the Midwest was 

not statistically different from the change 

for the people in the South or the West. 26 In 2021, the percentage of workingage adults in the Northeast with no health 

insurance coverage was not statistically 

different from the percentage of workingage adults in the Midwest with no health 

insurance coverage. 27 The Office of Management and Budget 

determined the official definition of poverty 

in Statistical Policy Directive 14. Appendix B 

of the “Poverty in the United States: 2021” 

report provides a more detailed description 

of how the Census Bureau calculates poverty. More information is available at <www.

census.gov/library/publications/2022/

demo/p60-277.html>. 28 The percentage-point change in 

the uninsured rate was not statistically 

different between individuals in poverty 

in nonexpansion states and individuals 

in other poverty groups in nonexpansion 

states. The percentage-point change in 

the uninsured rate was not statistically 

different between individuals in poverty in 

nonexpansion states and those between 

100 and 399 percent of poverty in expansion states.

29 The percentage-point change in the 

uninsured rate was not statistically different 

for children in poverty, between 100 and 

399 percent of poverty, or children in families above 400 percent of poverty. 30 The percentage-point change in the 

private coverage rate was not statistically different between children in families 

between 100 and 399 percent of poverty, 

children in families above 400 percent of 

poverty, children in families in poverty, and 

adults in poverty or adults between 100 

and 399 percent of poverty. 31 The percentage-point change in the 

public coverage rate was not statistically 

different between children in poverty and 

those in other age and income groups. 32 In 2021, there was no statistical difference in health insurance coverage between 

non-Hispanic White individuals and Asian 

individuals. 33 There was no statistical change in 

private coverage among people with a disability or people with no disability between 

2020 and 2021. 34 U.S. Island Areas include American 

Samoa, Guam, the Commonwealth of the 

Northern Mariana Islands, and the Virgin 

Islands of the United States.

U.S. Census Bureau Health Insurance Coverage in the United States: 2021 19

APPENDIX A. EFFECTS OF 2020 CENSUS-BASED POPULATION CONTROLS ON 2020 HEALTH 

INSURANCE COVERAGE ESTIMATES

To create estimates for the 

U.S. population from a sample, the 

Current Population Survey Annual 

Social and Economic Supplement 

(CPS ASEC) applies weights to 

the sample based on independent estimates of the civilian, 

noninstitutionalized population 

by sex, age, race, and Hispanic/

non-Hispanic categories.1

 These 

independent estimates are based 

off the date of the most recent 

decennial census and measure 

population change from one year 

to the next using administrative data and other sources on 

births, deaths, and net migration. 

Population change is added to 

a base to produce estimates for 

the following year. The estimates 

are updated annually to include 

an additional year of data and to 

revise earlier years of the time 

series. Each decade, the base of 

the estimates is updated to reflect 

new census results.2 Weighting 

adjustments mitigate nonresponse 

bias based on age, sex, race, and 

Hispanic origin and ensure that 

the weighted sample is representative of the U.S. population.

Updated population controls 

that use the 2020 Census were 

employed to weight the 2022 CPS 

ASEC as well as the estimates 

in this report. To show year-toyear changes across consistently 

weighted data, the 2020 estimates in this report have been 

updated to use the 2020 Censusbased population controls. As a 

result, the 2020 estimates may 

not match the estimates published 

in the September 2021 reports, 

which used 2010 Census-based 

population controls.

This appendix demonstrates the 

effect of using the 2020 Censusbased population controls on 

the 2020 data by presenting key 

health insurance estimates using 

both the 2010 and 2020 Censusbased population controls. 

Overall, using 2020 Census-based 

population controls resulted in 

statistically significant but substantively minor differences in the 

2020 estimates.

Table A-1 shows the effect of 

the new population controls on 

the 2020 estimates for the number and percentage of people 

with each health insurance type. 

Using updated population controls, the percentage of people 

who were uninsured was higher 

by 0.05 percentage points. This 

result was driven by lower rates of 

public coverage (–0.33 percentage points) using the 2020-based 

controls. Although the updated 

population controls yielded a 

lower percentage of people with 

Medicare coverage (–0.50 percentage points), the percentage of 

people covered by Medicaid was 

higher (0.16 percentage points).3

Higher rates of employmentbased coverage (0.16 percentage 

points) largely offset lower rates 

of direct-purchase coverage (–0.11 

percentage points), resulting in a 

0.03 percentage-point change in 

private coverage when the 2020 

Census-based population controls 

are used.

Table A-2 shows effects of the 

new population controls on the 

number and percentage of people 

who were uninsured by demographic characteristics. Although 

the uninsured rate among White 

individuals was higher using the 

updated controls, there were no 

statistically significant differences 

in the uninsured rate for other 

race or Hispanic origin groups.4

Uninsured rates were lower using 

the new controls among young 

adults aged 19 to 25 (–0.06 percentage points) and aged 26 to 

34 (–0.08 percentage points). 

Using the new population controls resulted in higher uninsured 

rates among working-age adults 

aged 35 to 64 (0.09 percentage points). Notably, the difference in the uninsured rate using 

both sets of controls was 0.20 

percentage points or less for all 

characteristics.

ENDNOTES

1

 More information on CPS Survey 

design is available in Current Population 

Survey Design and Methodology Technical 

Paper 77 at <https://www2.census.gov/

programs-surveys/cps/methodology/CPSTech-Paper-77.pdf>. 2 In recent decades, the decennial 

census has usually provided all the data 

necessary to produce the population base 

used in the population controls. However, 

changes in disclosure avoidance practices 

and delays in the 2020 Census necessitated 

changes to the data sources that produce 

the base population for the Vintage 2021 

population estimates. The updated population controls use a Blended Base that draws 

on the 2020 Census, 2020 Demographic 

Analysis Estimates, and Vintage 2020 

Postcensal Population Estimates. More 

information on this methodology can 

be found at <https://www2.census.gov/

programs-surveys/popest/technicaldocumentation/methodology/2020-2021/

methods-statement-v2021.pdf>. 3 The change in the percentage of 

people covered by Medicaid was not statistically different from the change in the 

percentage of people with employmentbased coverage. 4 The change in the percentage of White 

individuals without insurance was not 

statistically different from the change in the 

percentage of non-Hispanic White individuals without insurance.
20 Health Insurance Coverage in the United States: 2021 U.S. Census Bureau

Table A-1.

Health Insurance Coverage Status and Type: 2020 Estimates Using 2010 Census-Based Population 

Controls and 2020 Census-Based Population Controls

(Numbers in thousands. Margins of error in thousands or percentage points as appropriate. Population as of March of the 

following year. Information on confidentiality protection, sampling error, nonsampling error, and definitions is available at 

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

Coverage type

2020 Change (2020 

Census-based 

controls less 2010 

Census-based 

controls)

2010 Census-based controls 2020 Census-based controls

Number

Margin 

of error1

(±) Percent

Margin 

of error1

(±) Number

Margin 

of error1

(±) Percent

Margin 

of error1

(±) Number Percent

    Total. . . . . . . . . . . . . . . 325,638 153 X X 327,521 152 X X *1,883 X

Any health plan. . . . . . . . . . . . 297,680 638 91.4 0.2 299,230 651 91.4 0.2 *1,550 *–0.05

Any private plan2, 3. . . . . . . . . 216,532 1,166 66.5 0.4 217,896 1,168 66.5 0.4 *1,365 *0.03

  Employment-based2. . . . . . 177,175 1,070 54.4 0.3 178,737 1,076 54.6 0.3 *1,561 *0.16

  Direct-purchase2. . . . . . . . . 34,041 653 10.5 0.2 33,869 649 10.3 0.2 *–172 *–0.11

   Marketplace coverage2. . 10,804 439 3.3 0.1 10,924 443 3.3 0.1 *120 *0.02

  TRICARE2. . . . . . . . . . . . . . . 9,183 579 2.8 0.2 9,165 580 2.8 0.2 *–18 *–0.02

 Any public plan2, 4. . . . . . . . . . 113,337 923 34.8 0.3 112,925 924 34.5 0.3 *–412 *–0.33

  Medicare2. . . . . . . . . . . . . . . 59,844 393 18.4 0.1 58,541 349 17.9 0.1 *–1,304 *–0.50

  Medicaid2. . . . . . . . . . . . . . . 57,921 893 17.8 0.3 58,778 909 17.9 0.3 *857 *0.16

  VA and CHAMPVA2, 5. . . . . . 2,979 175 0.9 0.1 2,967 175 0.9 0.1 –12 *–0.01

Uninsured6. . . . . . . . . . . . . . . . 27,957 612 8.6 0.2 28,291 626 8.6 0.2 *333 *0.05

* An asterisk preceding an estimate indicates change is statistically different from zero at the 90 percent confidence level.

X Not applicable.

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

year.3 Private health insurance includes coverage provided through an employer or union, coverage purchased directly, or TRICARE.

4 Public health insurance coverage includes Medicaid, Medicare, CHAMPVA (Civilian Health and Medical Program of the Department of 

Veterans Affairs), and care provided by the Department of Veterans Affairs and the military. 5 Includes CHAMPVA, as well as care provided by the Department of Veterans Affairs and the military.

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

 Source: U.S. Census Bureau, Current Population Survey, 2021 Annual Social and Economic Supplement (CPS ASEC).
U.S. Census Bureau Health Insurance Coverage in the United States: 2021 21

Table A-2.

Percentage of People Uninsured by Selected Characteristics: 2020 Estimates Using 

2010 Census-Based Population Controls and 2020 Census-Based Population Controls—Con.

(Numbers in thousands. Margins of error in thousands or percentage points as appropriate. Population as of March of the 

following year. Information on confidentiality protection, sampling error, nonsampling error, and definitions is available at 

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

Characteristic

2020 Change (2020 

Census-based 

controls less 

2010 Censusbased 

controls)

2010 Census-based controls 2020 Census-based controls

Total

Uninsured1

Total

Uninsured1

Number

Margin 

of 

error2

(±) Percent

Margin 

of 

error2

(±) Number

Margin 

of 

error2

(±) Percent

Margin 

of 

error2

(±) Number Percent

   2020 Total. . . . . . . . . 325,638 27,957 612 8.6 0.2 327,521 28,291 626 8.6 0.2 *333 *0.05

Race3 and Hispanic Origin

White. . . . . . . . . . . . . . . . . . . . 247,763 20,631 512 8.3 0.2 249,000 20,902 523 8.4 0.2 *272 *0.07

White, not Hispanic. . . . . . 194,230 10,419 386 5.4 0.2 195,002 10,601 393 5.4 0.2 *182 *0.07

Black. . . . . . . . . . . . . . . . . . . . . 43,427 4,523 244 10.4 0.6 43,770 4,557 247 10.4 0.6 *34 Z 

Asian. . . . . . . . . . . . . . . . . . . . 20,125 1,180 115 5.9 0.6 20,322 1,197 117 5.9 0.6 *16 0.02

Hispanic (any race). . . . . . . . 61,160 11,192 411 18.3 0.7 61,739 11,292 416 18.3 0.7 *100 –0.01

Age

Under 65 years. . . . . . . . . . . . 269,802 27,395 616 10.2 0.2 273,245 27,735 631 10.2 0.2 *340 Z 

Under 19 years4. . . . . . . . . . 76,156 4,291 224 5.6 0.3 77,553 4,361 228 5.6 0.3 *70 *–0.01

19 to 64 years. . . . . . . . . . . 193,646 23,103 520 11.9 0.3 195,692 23,373 532 11.9 0.3 *270 0.01

  19 to 25 years5. . . . . . . . . 29,269 4,210 188 14.4 0.6 29,302 4,197 188 14.3 0.6 *–13 *–0.06

  26 to 34 years. . . . . . . . . 40,916 5,809 236 14.2 0.6 40,614 5,734 234 14.1 0.6 *–75 *–0.08

  35 to 64 years. . . . . . . . . 123,461 13,084 368 10.6 0.3 125,776 13,442 381 10.7 0.3 *359 *0.09

65 years and older. . . . . . . . . 55,836 563 69 1.0 0.1 54,276 556 69 1.0 0.1 *–7 *0.02

Income-to-Poverty Ratio

Total, poverty universe6. . . . 325,156 27,926 612 8.6 0.2 327,032 28,259 626 8.6 0.2 *333 *0.05

Below 100 percent of 

poverty. . . . . . . . . . . . . . . . . 37,156 6,396 353 17.2 0.8 37,461 6,460 359 17.2 0.8 *64 0.03

Below 138 percent of 

poverty. . . . . . . . . . . . . . . . . 56,337 9,076 383 16.1 0.6 56,740 9,176 390 16.2 0.6 *100 *0.06

Between 100 and 399 

percent of poverty. . . . . . . 144,380 16,673 492 11.5 0.3 145,094 16,879 503 11.6 0.3 *206 *0.09

At or above 400 percent 

of poverty. . . . . . . . . . . . . . . 143,620 4,858 243 3.4 0.2 144,478 4,920 247 3.4 0.2 *63 *0.02

State Medicaid Expansion 

Status7

 Lived in Medicaid 

expansion state. . . . . . . . . . 211,948 13,632 427 6.4 0.2 214,030 13,869 432 6.5 0.2 *237 *0.05

 Did not live in Medicaid 

expansion state. . . . . . . . . . 113,690 14,325 425 12.6 0.4 113,491 14,422 431 12.7 0.4 *97 *0.11

   Total, 15 to 64 

   years old. . . . . . . . . 210,421 24,236 544 11.5 0.3 213,017 24,539 557 11.5 0.3 *303 Z 

Disability Status8

With disability. . . . . . . . . . . 15,134 1,356 118 9.0 0.7 15,450 1,380 118 8.9 0.7 *24 –0.03

With no disability. . . . . . . . 194,199 22,880 520 11.8 0.3 196,478 23,159 531 11.8 0.3 *279 0.01

Footnotes provided at end of table.
22 Health Insurance Coverage in the United States: 2021 U.S. Census Bureau

Table A-2.

Percentage of People Uninsured by Selected Characteristics: 2020 Estimates Using 

2010 Census-Based Population Controls and 2020 Census-Based Population Controls—Con.

(Numbers in thousands. Margins of error in thousands or percentage points as appropriate. Population as of March of the 

following year. Information on confidentiality protection, sampling error, nonsampling error, and definitions is available at 

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

Characteristic

2020 Change (2020 

Census-based 

controls less 

2010 Censusbased 

controls)

2010 Census-based controls 2020 Census-based controls

Total

Uninsured1

Total

Uninsured1

Number

Margin 

of 

error2

(±) Percent

Margin 

of 

error2

(±) Number

Margin 

of 

error2

(±) Percent

Margin 

of 

error2

(±) Number Percent

Work Experience

All workers. . . . . . . . . . . . . . . 154,502 17,041 433 11.0 0.3 155,989 17,219 440 11.0 0.3 *178 0.01

Worked full-time, 

year-round. . . . . . . . . . . . 99,588 8,410 277 8.4 0.3 100,466 8,504 280 8.5 0.3 *94 *0.02

Worked less than 

 full-time, year-round. . . . 54,913 8,631 302 15.7 0.5 55,523 8,715 305 15.7 0.5 *84 –0.02

Did not work at least 1 

week. . . . . . . . . . . . . . . . . . . . 55,920 7,195 270 12.9 0.4 57,028 7,320 277 12.8 0.4 *125 –0.03

* An asterisk preceding an estimate indicates change is statistically different from zero at the 90 percent confidence level.

Z Rounds to zero.

1

 Individuals are considered to be uninsured if they did not have health insurance coverage for the entire calendar year.

2 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. 3 Federal surveys give respondents the option of reporting more than one race. Therefore, two basic ways of defining a race group are possible. A group, such as Asian, may be defined as those who reported Asian and no other race (the race-alone or single-race concept) or as those 

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

using the first approach (race alone). The use of the single-race population does not imply that it is the preferred method of presenting or analyzing data. The Census Bureau uses a variety of approaches. Data for American Indians and Alaska Natives, Native Hawaiians and Other Pacific 

Islanders, and those reporting two or more races are not shown separately. 4 Children under the age of 19 are eligible for Medicaid/CHIP.

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

eligible to be a dependent on a parent’s health insurance plan. 6 The poverty universe excludes unrelated individuals under the age of 15 such as foster children.

7 Expansion states on or before January 1, 2020, include AK, AR, AZ, CA, CO, CT, DC, DE, HI, IA, ID, IL, IN, KY, LA, MA, MD, ME, MI, MN, MT, ND, 

NH, NJ, NM, NV, NY, OH, OR, PA, RI, UT, VA, VT, WA, and WV. For more information, refer to <www.medicaid.gov/state-overviews/index.html>. 8 The sum of those with and without a disability does not equal the total because disability status is not defined for individuals in the 

U.S. armed forces.

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, 2021 Annual Social and Economic Supplement (CPS ASEC).
U.S. Census Bureau Health Insurance Coverage in the United States: 2021 23

APPENDIX B. ESTIMATES OF HEALTH INSURANCE COVERAGE: 2013 TO 2021

The Current Population Survey 

Annual Social and Economic 

Supplement (CPS ASEC) is used 

to produce official estimates of 

income and poverty, and it serves 

as the most widely cited source 

of estimates on health insurance 

coverage and the uninsured.

SURVEY REDESIGN

As part of the U.S. Census 

Bureau’s commitment to improvement, the CPS ASEC underwent 

a two-stage redesign in recent 

years, including changes to 

the questionnaire incorporated 

between 2014 and 2016, followed 

by changes to post-survey collection processing methods in 

2019.1

 Evidence suggests that the 

redesign effectively addressed 

known limitations to CPS ASEC 

health coverage and improved 

health insurance coverage 

measurement.2

In consideration of these and previous changes in survey design, 

researchers should use caution 

when comparing health coverage estimates over time. Due 

to the differences in measurement, health insurance estimates 

for calendar years 2013 through 

2017 are not directly comparable 

to previous years. Estimates for 

calendar years 2018 and beyond 

may be compared with each other 

and with 2017 estimates from the 

2018 CPS ASEC Bridge File or 

2016 estimates from the 2017 CPS 

ASEC Research File. Although it is 

not appropriate to directly compare 2018 estimates with earlier 

years processed with the legacy 

system, it is helpful to examine 

the estimates in this report in the 

context of a longer time to better understand the changes that 

occurred in health coverage in 

2021.

RECENT CHANGES IN 

THE HEALTH INSURANCE 

LANDSCAPE

Changes in health coverage over 

time reflect economic trends, 

demographic shifts, and changes 

in federal and state policy. Several 

such policy changes are related 

to the Patient Protection and 

Affordable Care Act (ACA). 

Many of the provisions of the ACA 

went into effect in 2014, including the establishment of health 

insurance Marketplaces (such as 

healthcare.gov) and the optional 

expansion of Medicaid eligibility by states. The first year, 24 

states and the District of Columbia 

expanded eligibility thresholds for 

Medicaid. By 2021, all but 14 states 

had expanded Medicaid eligibility.

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

be eligible for coverage options 

under the ACA. Based on family 

income, some people may qualify 

for subsidies or tax credits to help 

pay for premiums associated with 

health insurance plans. In addition, 

people with lower incomes may 

be eligible for Medicaid coverage 

if they resided in one of the states 

(or the District of Columbia) that 

expanded Medicaid eligibility.

Notably, some provisions of the 

ACA no longer apply. For example, as of 2019, the individual mandate penalty requiring individuals 

to be covered by health insurance 

or pay a tax penalty was cancelled 

at the federal level, although 

several states and the District 

of Columbia have continued or 

implemented state health insurance coverage mandates.3

The economic shock related to 

the COVID-19 pandemic in 2020 

and recovery in the wake of the 

continued COVID-19 pandemic 

also may have affected health 

insurance coverage in 2021. 

The Families First Coronavirus 

Response Act required states, as 

a condition of receiving increased 

Medicaid funding, to provide 

continuous coverage for Medicaid 

beneficiaries for the duration of 

the COVID-19 pandemic.4 An executive order signed in January 2021 

extended the Special Enrollment 

Period for Marketplace coverage through July 15, 2021. The 

American Rescue Plan Act further increased Medicaid funding 

to states, expanded the income 

thresholds for eligibility for 

Marketplace tax credits, increased 

premium subsidies for those eligible, waived Marketplace coverage 

premiums for the unemployed, 

and introduced additional measures to increase access to care 

and reduce the cost of coverage.5

Data from the Centers for 

Medicare and Medicaid Services 

showed that Medicaid enrollment 

continued to increase in 2021, 

following a dramatic increase in 

2020 after declines in enrollment 

from 2017 to 2019. Specifically, 

after increasing by about 6.3 

million adults and 3.3 million 

children between February 2020 

and January 2021, Medicaid 

enrollment among adults aged 

19 and older increased from 40.6 

million to 44.7 million during the 

period between February 2021 

and January 2022. Medicaid/
24 Health Insurance Coverage in the United States: 2021 U.S. Census Bureau

CHIP enrollment among children 

under age 19 increased from 38.5 

million to 40.1 million during the 

same period.6 Further, data on 

Marketplace enrollment also suggest an increase from 11.4 million people who enrolled or were 

re-enrolled in Marketplace plans 

during the 2020 Open Enrollment 

Period to 12.0 million people 

who enrolled or re-enrolled in 

Marketplace plans during the 2021 

Open Enrollment Period.7 An additional 2.8 million people enrolled 

in Marketplace coverage in 2021 

during the Special Enrollment 

Period.

The coronavirus pandemic and 

related stay-at-home orders 

during the spring of 2020 also 

affected how the Census Bureau 

collected data for the CPS ASEC. 

The edition of this report released 

in September 2020 (P60-271) provides an overview of the issues.8

In addition, the Census Bureau 

produced several working papers 

exploring how changes in CPS 

data collection in 2020 may have 

affected 2019 estimates. These 

analyses revealed that the 2020 

CPS ASEC sample differed from 

the previous year with respect to a 

number of characteristics that are 

correlated with health insurance 

coverage. For example, the 2020 

CPS ASEC sample was older, more 

educated, and more likely to have 

a disability than the 2019 sample.9 Researchers should consider 

the effect of the pandemic on 

CPS ASEC data collection when 

interpreting changes in health 

insurance coverage between 2019 

and other years using the CPS 

ASEC. As a result, no comparisons 

between calendar year coverage 

in 2019 (collected in 2020) and 

other survey years are reported in 

this appendix.

ESTIMATES OF HEALTH 

INSURANCE COVERAGE: 2013 

TO 2021

Uninsured Rate

Figure B-1 shows the percentage 

of people without health insurance 

coverage from 2013 to 2017, under 

the legacy processing system, and 

2017 to 2021, using the updated 

processing system.10 All comparisons between 2013 and 2020 use 

2010 Census-based population 

controls; all comparisons between 

2020 and 2021 use 2020 Censusbased population controls, consistent with the other comparisons in 

the report.11

Figure B-1.

Percentage of People Without Health Insurance Coverage: 2013 to 2021 

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

Note: ACA marks when provisions of the Aordable Care Act went into eect. Information on 

confidentiality protection, sampling error, nonsampling error, and definitions is available at 

<https://www2.census.gov/programs-surveys/cps/techdocs/cpsmar22.pdf>. 

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

Supplement Bridge File and 2014 to 2022 Annual Social and Economic Supplements (CPS ASEC).

13.3

10.4

9.1

8.8 8.8

8.5 8.0

8.6

8.6 8.3

7.9

ACA Recession

0

5

10

15

2013 2014 2015 2016 2017 2018 2019 2020 2021

Legacy processing system 

Updated processing system

(2010 population controls) 

Updated processing system

(2020 population controls) 

No comparison
U.S. Census Bureau Health Insurance Coverage in the United States: 2021 25

The uninsured rate declined from 

2013 to 2014, when many provisions of the Patient Protection 

and Affordable Care Act (ACA) 

went into effect, and continued 

to decline through 2016.12 The 

uninsured rate for 2017 was lower 

under the updated processing 

system than under the legacy 

system. However, the percentage 

of uninsured increased between 

2017 and 2018 by 0.5 percentage 

points to 8.5 percent.

At 8.6 percent, the uninsured 

rate in 2020 was not significantly 

different than the uninsured rate 

in 2018.13 The CPS ASEC only 

includes people who had no coverage at all during calendar year 

2020 as uninsured. Therefore, 

people losing health insurance 

coverage in 2020 were not considered uninsured in 2020 in the 

CPS ASEC.

In 2021, 8.3 percent of people 

were uninsured for the entire year, 

representing a 0.4 percentagepoint decline in the uninsured 

rate from 2020 (8.6 percent). The 

decrease in the uninsured rate was 

driven in part by an increase in 

public coverage.

Private Health Insurance 

Coverage

The percentage of people with 

private health insurance coverage 

from 2013 to 2021 is presented in 

Figure B-2.14

As shown, there was an increase 

in private coverage rates between 

2013 and 2015, coinciding with 

the implementation of the ACA, 

followed by a leveling of private 

coverage between 2015 and 2017. 

Using the updated processing 

system, there was no statistically 

significant change in the private 

coverage rate between 2017 and 

2018. However, between 2018 and 

2020, the percentage of people 

with private coverage at any point 

during the year declined from 67.3 

percent to 66.5 percent, decreasing another 0.5 percentage points 

to 66.0 percent from 2020 to 2021.

0

60

65

70

2013 2014 2015 2016 2017 2018 2019 2020 2021

Figure B-2.

Percentage of People With Private Health Insurance Coverage: 2013 to 2021 

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

Note: ACA marks when provisions of the Aordable Care Act went into eect. Information on 

confidentiality protection, sampling error, nonsampling error, and definitions is available at 

<https://www2.census.gov/programs-surveys/cps/techdocs/cpsmar22.pdf>. 

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

Supplement Bridge File and 2014 to 2022 Annual Social and Economic Supplements (CPS ASEC).

64.1

66.0

67.2 67.5 67.2

67.3

68.0

66.5

66.5 66.0

67.7

Legacy processing system 

Updated processing system

(2010 population controls) 

Updated processing system

(2020 population controls) 

ACA

Recession

No comparison
26 Health Insurance Coverage in the United States: 2021 U.S. Census Bureau

Public Health Insurance 

Coverage

Figure B-3 shows the percentage 

of people with public coverage 

and Medicaid coverage in the CPS 

ASEC from 2013 to 2021. Using the 

legacy processing system, public 

coverage increased from 2013 to 

2017.15 Public coverage rates were 

lower in 2017 using the updated 

processing system compared to 

the legacy processing system. 

However, TRICARE is defined as 

private coverage in the updated 

processing system and as public 

coverage in the legacy system. 

Although public coverage rates 

declined between 2017 and 2018 

using the updated processing 

system, the percentage of people 

holding public coverage increased 

to 34.8 percent between 2018 and 

2020. Using 2020 Census-based 

population controls, the public 

coverage rate was 34.5 percent 

in 2020. Between 2020 and 2021, 

the public coverage rate increased 

1.2 percentage points to 35.7 percent, driven by an increase in rates 

of Medicare and Medicaid coverage. Using 2020 Census-based 

population controls, Medicaid 

coverage rates increased by 0.9 

percentage points to 18.9 percent 

in 2021.

Although there was no significant 

difference in Medicaid coverage 

rates reported in the CPS ASEC 

between 2018 and 2020, the lack 

of apparent change masked a 

0.4 percentage-point increase in 

the percentage of working-age 

adults aged 19 to 64 covered 

by Medicaid during this period 

(Figure B-4). Working-age adults 

may have been more vulnerable 

to losing coverage during the 

COVID-19 pandemic than another 

age group. A closer look reveals 

that Medicaid coverage rates 

increased for all broad age groups 

between 2020 and 2021, which 

may reflect the changes in policies 

to improve access to care.

Recession

0

15

20

25

30

35

40

45

2013 2014 2015 2016 2017 2018 2019 2020 2021

Figure B-3.

Percentage of People With Public Coverage and Medicaid Coverage: 2013 to 2021 

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

Note: ACA marks when provisions of the Aordable Care Act went into eect. Information on 

confidentiality protection, sampling error, nonsampling error, and definitions is available at 

<https://www2.census.gov/programs-surveys/cps/techdocs/cpsmar22.pdf>. 

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

Supplement Bridge File and 2014 to 2022 Annual Social and Economic Supplements (CPS ASEC).

17.5

19.5

34.6

19.6

37.7 36.5 37.1

19.4 19.3

18.5 17.9 17.2 17.8

17.9 18.9

34.4 34.1

34.8

34.5

35.7

34.8

37.3

Public coverage

Medicaid coverage

Legacy processing system Updated processing system

(2010 population controls) 

Updated processing system

(2020 population controls) 

ACA

No comparison
U.S. Census Bureau Health Insurance Coverage in the United States: 2021 27

ENDNOTES

1

 For more information on the survey 

redesign, refer to Appendix A in Edward R. 

Berchick, Jessica C. Barnett, and Rachel D. 

Upton, “Health Insurance Coverage in the 

United States: 2018,” Current Population 

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

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

library/publications/2019/demo/p60-267.

html>. 2 Heide Jackson and Edward R. 

Berchick, “Improvements in Uninsurance 

Estimates for Fully Imputed Cases in the 

Current Population Survey Annual Social 

and Economic Supplement,” Inquiry: 

The Journal of Health Care Organization, 

Provision, and Financing, 2020; and Edward 

R. Berchick and Heide Jackson, “Data 

Processing Improvements for Estimates of 

Health Insurance Coverage in the Current 

Population Survey Annual Social and 

Economic Supplement,” Medical Care and 

Research Review, 2022.

3 California, Massachusetts, New Jersey, 

Rhode Island, Vermont, and the District of 

Columbia have continued or implemented 

state coverage mandates after the cancellation of the federal individual mandate. 4 For more information, refer to the 

“Health Care Provisions in the Families 

First Coronavirus Response Act, P.L. 116-

127,” March 18, 2020, <www.congress.

gov/116/plaws/publ127/PLAW-116publ127.

pdf>; Congressional Research Service, 

“Health Care Provisions in the Families First 

Coronavirus Response Act,” P.L. 116-127, 

R46316, April 17, 2020, <https://crsreports.

congress.gov/product/pdf/R/R46316>. 5 For more information, refer to the 

“American Rescue Plan Act of 2021,” P.L. 117-

2, March 11, 2021, <www.congress.gov/117/

plaws/publ2/PLAW-117publ2.pdf>; Katie 

Keith, “Final Coverage Provisions in the 

American Rescue Plan and What Comes 

Next,” Health Affairs Blog, DOI: 10.1377/

hblog20210311.725837, March 11, 2021.

6 Appendix B of the December 2021 

and January 2022 Medicaid and CHIP 

Enrollment Trends Snapshot are available 

at <www.medicaid.gov/medicaid/nationalmedicaid-chip-program-information/

downloads/dec-2021-jan-2022-medicaidchip-enrollment-trend-snapshot.pdf>. 

Appendix B of the December 2020 

and January 2021 Medicaid and CHIP 

Enrollment Trends Snapshot are available 

at <www.medicaid.gov/medicaid/nationalmedicaid-chip-program-information/

downloads/december-2020-january2021-medicaid-chip-enrollment-trendsnapshot.pdf>. For information on 

changes in Medicaid enrollment between 

2017 and 2019, refer to <www.kff.org/

coronavirus-covid-19/issue-brief/analysisof-recent-national-trends-in-medicaidand-chip-enrollment/#:~:text=Total%20

enrollment%20fell%20from%20

73.4,but%20continued%20

until%20February%202020>.

Figure B-4.

Percentage of People With Medicaid Coverage by Age Group: 2017 to 2021 

36.5

35.3* 34.8

35.9*

6.6 7.4* 6.4 6.3 6.3

34.7

14.6 14.5 15.4*

14.0* 14.4*

Under age 19 Aged 19 to 64 Aged 65 and older

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

2017 2018 2020** 2020 2021 2017 2018 2020** 2020 2021 2017 2018 2020** 2020 2021

* Denotes a statistically significant change between 2017 and 2018, 2018 and 2020**, or 2020 and 2021. Users should consider the effect 

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

using the CPS ASEC. As a result, no comparisons between calendar year coverage in 2019 (collected in 2020) and other survey years are 

reported here.

** Denotes 2020 estimates using 2010 Census-based population controls.

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

<https://www2.census.gov/programs-surveys/cps/techdocs/cpsmar22.pdf>. 

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

2022 Annual Social and Economic Supplements (CPS ASEC).
28 Health Insurance Coverage in the United States: 2021 U.S. Census Bureau

7 For more information, refer to the 

Center for Medicare and Medicaid Services 

2021 Open Enrollment Report, <www.cms.

gov/files/document/health-insuranceexchanges-2021-open-enrollment-reportfinal.pdf>, and 2021 Final Marketplace 

Special Enrollment Period Report at <www.

hhs.gov/sites/default/files/2021-sep-finalenrollment-report.pdf>. 8 For more information, refer to “The 

Impact of the Coronavirus (COVID-19) 

Pandemic on the CPS ASEC” text box 

in “Health Insurance Coverage in the 

United States: 2019,” available at <www.

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

publications/2020/demo/p60-271.pdf>. 9 Additional information related to the 

impact of COVID-19 on the 2020 CPS 

ASEC is available from Edward R. Berchick, 

Laryssa Mykyta, and Sharon M. Stern, 

“The Influence of COVID-19- Related Data 

Collection Changes on Measuring Health 

Insurance Coverage in the 2020 CPS 

ASEC,” <www.census.gov/library/workingpapers/2020/demo/SEHSD-WP2020-13.

html>; and Jonathan Rothbaum and 

C. Adam Bee, “Coronavirus Infects 

Surveys, Too: Nonresponse Bias During 

the Pandemic in the CPS ASEC,” <www.

census.gov/library/working-papers/2020/

demo/SEHSD-WP2020-10.html>. 10 Throughout this appendix, details may 

not sum to totals because of rounding. 11 For more information on the difference between 2020 estimates using 2020 

Census-based population controls and the 

previous version using 2010 Census-based 

population controls, refer to Appendix A.

12 There was no significant change in 

the uninsured rate between 2016 and 2017 

using the legacy processing system. 13 Comparisons between 2018 and 2020 

estimates use 2010 Census-based population controls. 14 Private coverage includes employersponsored insurance, insurance purchased 

directly by an individual, through a broker, 

or through the Marketplace (such as 

healthcare.gov). The updated processing 

system further includes TRICARE as private 

coverage. 15 Under the legacy processing system, 

public coverage increased annually, except 

for 2015 to 2016, which was not a significant 

change.
U.S. Census Bureau Health Insurance Coverage in the United States: 2021 29

APPENDIX C.

Table C-1. 

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

2020 and 2021—Con.

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

nonsampling error, and definitions is available at <https://www2.census.gov/programs-surveys/cps/techdocs/cpsmar22.pdf>)

Characteristic

Total

Number

Any health insurance

Uninsured4

Percent

Margin of 

error1 (±)

Private health 

insurance2

Public health 

insurance3

Percent

Margin of 

error1 (±) Percent

Margin of 

error1 (±) Percent

Margin of 

error1 (±)

    2021 Total. . . . . . . . . . . 328,074 91.7 0.2 66.0 0.3 35.7 0.3 8.3 0.2

Race5 and Hispanic Origin

White. . . . . . . . . . . . . . . . . . . . . . . 248,776 91.8 0.2 67.8 0.4 35.0 0.3 8.2 0.2

 White, not Hispanic. . . . . . . . . 194,186 94.8 0.2 73.2 0.4 34.6 0.3 5.2 0.2

Black. . . . . . . . . . . . . . . . . . . . . . . . 43,963 91.0 0.6 55.1 1.2 42.7 1.0 9.0 0.6

Asian. . . . . . . . . . . . . . . . . . . . . . . 20,681 93.8 0.7 72.4 1.4 27.4 1.3 6.2 0.7

Hispanic (any race). . . . . . . . . . . 62,515 81.7 0.6 48.8 0.9 37.0 0.8 18.3 0.6

Age

Under age 65. . . . . . . . . . . . . . . . 271,881 90.2 0.3 69.5 0.4 23.7 0.3 9.8 0.3

 Under age 196. . . . . . . . . . . . . . 77,026 95.0 0.3 61.9 0.6 36.4 0.6 5.0 0.3

 Aged 19 to 64. . . . . . . . . . . . . . 194,855 88.4 0.3 72.5 0.4 18.7 0.3 11.6 0.3

  Aged 19 to 257. . . . . . . . . . . 29,045 85.1 0.6 68.2 0.8 19.2 0.7 14.9 0.6

  Aged 26 to 34. . . . . . . . . . . . 40,312 86.5 0.6 70.6 0.8 18.8 0.6 13.5 0.6

  Aged 35 to 44. . . . . . . . . . . . 43,190 88.1 0.6 73.6 0.7 17.5 0.6 11.9 0.6

  Aged 45 to 64. . . . . . . . . . . . 82,308 90.6 0.4 74.5 0.5 19.1 0.5 9.4 0.4

Aged 65 and older. . . . . . . . . . . . 56,193 98.8 0.1 48.7 0.8 93.5 0.3 1.2 0.1

Nativity

Native-born. . . . . . . . . . . . . . . . . . 281,229 93.6 0.2 67.8 0.4 36.4 0.3 6.4 0.2

Foreign-born. . . . . . . . . . . . . . . . 46,845 80.5 0.8 54.6 0.9 31.7 0.8 19.5 0.8

 Naturalized citizen. . . . . . . . . . 22,877 92.1 0.6 62.5 1.2 38.7 1.1 7.9 0.6

 Not a citizen. . . . . . . . . . . . . . . 23,968 69.4 1.3 47.1 1.2 25.0 1.1 30.6 1.3

Region

Northeast. . . . . . . . . . . . . . . . . . . 56,065 94.7 0.4 68.1 1.0 38.8 1.0 5.3 0.4

Midwest. . . . . . . . . . . . . . . . . . . . . 67,933 94.5 0.4 71.0 0.8 35.3 0.9 5.5 0.4

South. . . . . . . . . . . . . . . . . . . . . . . 126,144 88.6 0.4 63.3 0.6 34.0 0.5 11.4 0.4

West. . . . . . . . . . . . . . . . . . . . . . . . 77,933 92.1 0.4 64.4 0.7 36.6 0.6 7.9 0.4

State Medicaid Expansion 

Status8

Lived in Medicaid expansion 

state. . . . . . . . . . . . . . . . . . . . . . . 215,594 93.6 0.2 67.1 0.4 37.0 0.4 6.4 0.2

Did not live in Medicaid 

expansion state. . . . . . . . . . . . . 112,480 88.1 0.4 63.7 0.6 33.1 0.6 11.9 0.4

Footnotes provided at end of table.
30 Health Insurance Coverage in the United States: 2021 U.S. Census Bureau

Table C-1. 

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

2020 and 2021—Con.

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

nonsampling error, and definitions is available at <https://www2.census.gov/programs-surveys/cps/techdocs/cpsmar22.pdf>)

Characteristic

Total

Number

Any health insurance

Uninsured4

Percent

Margin of 

error1 (±)

Private health 

insurance2

Public health 

insurance3

Percent

Margin of 

error1 (±) Percent

Margin of 

error1 (±) Percent

Margin of 

error1 (±)

    2020 Total9. . . . . . . . . . 327,521 91.4 0.2 66.5 0.4 34.5 0.3 8.6 0.2

Race5 and Hispanic Origin

White. . . . . . . . . . . . . . . . . . . . . . . 249,000 91.6 0.2 68.6 0.4 33.9 0.3 8.4 0.2

 White, not Hispanic. . . . . . . . . 195,002 94.6 0.2 74.0 0.4 33.3 0.4 5.4 0.2

Black. . . . . . . . . . . . . . . . . . . . . . . . 43,770 89.6 0.6 54.6 1.0 41.3 0.8 10.4 0.6

Asian. . . . . . . . . . . . . . . . . . . . . . . 20,322 94.1 0.6 72.5 1.2 26.8 1.1 5.9 0.6

Hispanic (any race). . . . . . . . . . . 61,739 81.7 0.7 49.9 0.9 35.9 0.7 18.3 0.7

Age

Under age 65. . . . . . . . . . . . . . . . 273,245 89.8 0.2 69.9 0.4 22.8 0.3 10.2 0.2

 Under age 196. . . . . . . . . . . . . . 77,553 94.4 0.3 62.3 0.6 35.1 0.6 5.6 0.3

 Aged 19 to 64. . . . . . . . . . . . . . 195,692 88.1 0.3 72.9 0.4 17.9 0.3 11.9 0.3

  Aged 19 to 257. . . . . . . . . . . 29,302 85.7 0.6 69.4 0.9 18.3 0.8 14.3 0.6

  Aged 26 to 34. . . . . . . . . . . . 40,614 85.9 0.6 70.4 0.8 18.2 0.6 14.1 0.6

  Aged 35 to 44. . . . . . . . . . . . 42,786 87.5 0.5 73.5 0.7 16.4 0.6 12.5 0.5

  Aged 45 to 64. . . . . . . . . . . . 82,990 90.2 0.3 75.0 0.5 18.3 0.4 9.8 0.3

Aged 65 and older. . . . . . . . . . . . 54,276 99.0 0.1 49.7 0.8 93.5 0.3 1.0 0.1

Nativity

Native-born. . . . . . . . . . . . . . . . . . 282,347 93.1 0.2 68.2 0.4 35.1 0.3 6.9 0.2

Foreign-born. . . . . . . . . . . . . . . . 45,174 80.6 0.8 55.8 0.9 30.7 0.7 19.4 0.8

 Naturalized citizen. . . . . . . . . . 22,803 91.6 0.6 64.0 1.0 36.5 0.9 8.4 0.6

 Not a citizen. . . . . . . . . . . . . . . 22,371 69.4 1.2 47.5 1.3 24.9 1.0 30.6 1.2

Region

Northeast. . . . . . . . . . . . . . . . . . . 56,344 95.1 0.4 69.1 0.9 37.4 1.0 4.9 0.4

Midwest. . . . . . . . . . . . . . . . . . . . . 68,026 93.7 0.4 71.7 0.8 33.1 0.7 6.3 0.4

South. . . . . . . . . . . . . . . . . . . . . . . 125,273 88.2 0.4 63.5 0.6 33.3 0.5 11.8 0.4

West. . . . . . . . . . . . . . . . . . . . . . . . 77,878 91.7 0.3 65.1 0.7 35.4 0.6 8.3 0.3

State Medicaid Expansion 

Status8

Lived in Medicaid expansion 

state. . . . . . . . . . . . . . . . . . . . . . . 215,978 93.5 0.2 68.0 0.5 35.7 0.4 6.5 0.2

Did not live in Medicaid 

expansion state. . . . . . . . . . . . . 111,542 87.2 0.4 63.6 0.7 32.2 0.5 12.8 0.4

1

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

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

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

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

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

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

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

those who reported Asian regardless of whether they also reported another race (the race-alone-or-in-combination concept). This table shows 

data using the first approach (race alone). The use of the single-race population does not imply that it is the preferred method of presenting 

or analyzing data. The Census Bureau uses a variety of approaches. Data for American Indians and Alaska Natives, Native Hawaiians and Other 

Pacific Islanders, and those reporting two or more races are not shown separately. 6 Children under the age of 19 are eligible for Medicaid/CHIP.

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

eligible to be a dependent on a parent’s health insurance plan. 8 Medicaid expansion status as of January 1, 2021. Expansion states on or before January 1, 2021, include AK, AR, AZ, CA, CO, CT, DC, DE, HI, 

IA, ID, IL, IN, KY, LA, MA, MD, ME, MI, MN, MT, ND, NE, NH, NJ, NM, NV, NY, OH, OR, PA, RI, UT, VA, VT, WA, and WV. For more information, refer to 

<www.medicaid.gov/state-overviews/index.html>. 9 Implementation of 2020 Census-based population controls.

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, 2021 and 2022 Annual Social and Economic Supplements (CPS ASEC).
U.S. Census Bureau Health Insurance Coverage in the United States: 2021 31

Table C-2. 

Health Insurance Coverage Status and Type by Age and Selected Characteristics: 

2020 and 2021—Con.

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

nonsampling error, and definitions is available at <https://www2.census.gov/programs-surveys/cps/techdocs/cpsmar22.pdf>)

Characteristic

Total

Number

Any health insurance

Uninsured4

Percent

Margin of 

error1 (±)

Private health 

insurance2

Public health 

insurance3

Percent

Margin of 

error1 (±) Percent

Margin of 

error1 (±) Percent

Margin of 

error1 (±)

2021

    Total, 15 to 64 years 

    old. . . . . . . . . . . . . . . . 212,530 88.9 0.3 71.9 0.4 19.9 0.3 11.1 0.3

Disability Status5

 With disability. . . . . . . . . . . . . . 16,780 91.5 0.7 46.3 1.1 52.3 1.3 8.5 0.7

 With no disability. . . . . . . . . . . 194,836 88.6 0.3 73.9 0.4 17.2 0.3 11.4 0.3

Work Experience

All workers. . . . . . . . . . . . . . . . . . 155,775 89.5 0.3 79.7 0.4 12.1 0.3 10.5 0.3

 Worked full-time, 

 year-round. . . . . . . . . . . . . . . 111,015 90.9 0.3 85.0 0.3 7.9 0.2 9.1 0.3

 Worked less than full-time, 

 year-round. . . . . . . . . . . . . . . 44,760 85.8 0.5 66.5 0.7 22.6 0.6 14.2 0.5

Did not work at least 1 week. . . 56,756 87.2 0.5 50.3 0.7 41.2 0.7 12.8 0.5

    Total, 19 to 64 years 

    old. . . . . . . . . . . . . . . . 194,855 88.4 0.3 72.5 0.4 18.7 0.3 11.6 0.3

Marital Status

Married6. . . . . . . . . . . . . . . . . . . . . 99,078 91.9 0.3 81.7 0.5 13.4 0.4 8.1 0.3

Widowed. . . . . . . . . . . . . . . . . . . . 3,267 87.7 1.6 55.6 2.5 36.1 2.4 12.3 1.6

Divorced. . . . . . . . . . . . . . . . . . . . 18,138 87.5 0.7 64.5 1.1 25.8 1.1 12.5 0.7

Separated. . . . . . . . . . . . . . . . . . . 3,898 81.0 2.1 55.1 2.6 29.1 2.3 19.0 2.1

Never married. . . . . . . . . . . . . . . . 70,474 84.2 0.5 63.5 0.6 23.0 0.5 15.8 0.5

    Total, 26 to 64 years 

    old. . . . . . . . . . . . . . . . 165,810 88.9 0.3 73.3 0.4 18.6 0.3 11.1 0.3

Educational Attainment

No high school diploma. . . . . . . 13,604 69.8 1.3 34.3 1.1 38.4 1.3 30.2 1.3

High school graduate 

(includes equivalency). . . . . . . 45,600 84.3 0.7 61.4 0.9 26.4 0.7 15.7 0.7

Some college, no degree. . . . . . 23,509 89.3 0.6 71.3 0.9 22.1 0.8 10.7 0.6

Associate degree. . . . . . . . . . . . . 17,729 91.6 0.6 77.2 0.9 18.0 0.8 8.4 0.6

Bachelor’s degree. . . . . . . . . . . . 41,218 94.6 0.4 87.7 0.5 9.0 0.4 5.4 0.4

Graduate or professional 

degree. . . . . . . . . . . . . . . . . . . . . 24,150 96.7 0.3 92.2 0.6 6.5 0.5 3.3 0.3

Footnotes provided at end of table.
32 Health Insurance Coverage in the United States: 2021 U.S. Census Bureau

Table C-2. 

Health Insurance Coverage Status and Type by Age and Selected Characteristics: 

2020 and 2021—Con.

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

nonsampling error, and definitions is available at <https://www2.census.gov/programs-surveys/cps/techdocs/cpsmar22.pdf>)

Characteristic

Total

Number

Any health insurance

Uninsured4

Percent

Margin of 

error1 (±)

Private health 

insurance2

Public health 

insurance3

Percent

Margin of 

error1 (±) Percent

Margin of 

error1 (±) Percent

Margin of 

error1 (±)

20207

    Total, 15 to 64 years 

    old. . . . . . . . . . . . . . . . 213,017 88.5 0.3 72.3 0.4 18.9 0.3 11.5 0.3

Disability Status5

 With disability. . . . . . . . . . . . . . 15,450 91.1 0.7 45.1 1.2 53.3 1.2 8.9 0.7

 With no disability. . . . . . . . . . . 196,478 88.2 0.3 74.3 0.4 16.3 0.3 11.8 0.3

Work Experience

All workers. . . . . . . . . . . . . . . . . . 155,989 89.0 0.3 79.7 0.4 11.4 0.3 11.0 0.3

 Worked full-time, 

 year-round. . . . . . . . . . . . . . . 100,466 91.5 0.3 87.0 0.3 6.1 0.2 8.5 0.3

 Worked less than full-time, 

 year-round. . . . . . . . . . . . . . . 55,523 84.3 0.5 66.6 0.7 21.0 0.5 15.7 0.5

Did not work at least 1 week. . . 57,028 87.2 0.4 51.9 0.7 39.4 0.7 12.8 0.4

    Total, 19 to 64 years 

    old. . . . . . . . . . . . . . . . 195,692 88.1 0.3 72.9 0.4 17.9 0.3 11.9 0.3

Marital Status

Married6. . . . . . . . . . . . . . . . . . . . . 99,355 91.5 0.3 82.1 0.4 12.4 0.4 8.5 0.3

Widowed. . . . . . . . . . . . . . . . . . . . 3,364 87.7 1.5 59.8 2.4 32.6 2.5 12.3 1.5

Divorced. . . . . . . . . . . . . . . . . . . . 18,972 86.7 0.7 64.7 1.0 25.1 1.0 13.3 0.7

Separated. . . . . . . . . . . . . . . . . . . 3,835 79.6 2.0 53.0 2.3 29.6 2.0 20.4 2.0

Never married. . . . . . . . . . . . . . . . 70,165 84.0 0.5 63.8 0.6 22.3 0.5 16.0 0.5

    Total, 26 to 64 years 

    old. . . . . . . . . . . . . . . . 166,390 88.5 0.3 73.5 0.4 17.8 0.3 11.5 0.3

Educational Attainment

No high school diploma. . . . . . . 14,038 68.3 1.4 35.3 1.2 35.6 1.3 31.7 1.4

High school graduate 

(includes equivalency). . . . . . . 44,656 83.9 0.6 61.3 0.7 26.0 0.7 16.1 0.6

Some college, no degree. . . . . . 24,085 89.3 0.6 72.5 0.8 20.4 0.8 10.7 0.6

Associate degree. . . . . . . . . . . . . 17,971 90.9 0.6 77.6 0.9 16.5 0.8 9.1 0.6

Bachelor’s degree. . . . . . . . . . . . 41,384 94.0 0.4 87.4 0.5 8.8 0.4 6.0 0.4

Graduate or professional 

degree. . . . . . . . . . . . . . . . . . . . . 24,256 96.5 0.4 92.3 0.5 5.9 0.5 3.5 0.4

1

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

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

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

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

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

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

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

present,” and “married, spouse absent.” 7 Implementation of 2020 Census-based population controls.

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, 2021 and 2022 Annual Social and Economic Supplements (CPS ASEC).
U.S. Census Bureau Health Insurance Coverage in the United States: 2021 33

Table C-3. 

Health Insurance Coverage Status and Type by Household Relationship and Family 

Income-to-Poverty Ratio: 2020 and 2021—Con.

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

nonsampling error, and definitions is available at <https://www2.census.gov/programs-surveys/cps/techdocs/cpsmar22.pdf>)

Characteristic

Total

Number

Any health insurance

Uninsured4

Percent

Margin of 

error1 (±)

Private health 

insurance2

Public health 

insurance3

Percent

Margin of 

error1 (±) Percent

Margin of 

error1 (±) Percent

Margin of 

error1 (±)

    2021 Total. . . . . . . . . . . 328,074 91.7 0.2 66.0 0.3 35.7 0.3 8.3 0.2

Household Relationship

Married couple family. . . . . . . . . 193,919 93.9 0.3 74.2 0.4 30.4 0.4 6.1 0.3

 With children under 18 

 years. . . . . . . . . . . . . . . . . . . . . 106,849 93.1 0.4 74.8 0.6 21.7 0.6 6.9 0.4

Unmarried male reference 

person. . . . . . . . . . . . . . . . . . . . . 43,647 87.1 0.6 57.8 0.8 37.2 0.8 12.9 0.6

 With children under 18 

 years. . . . . . . . . . . . . . . . . . . . . 10,734 87.5 1.4 55.0 2.0 36.5 1.8 12.5 1.4

Unmarried female reference 

person. . . . . . . . . . . . . . . . . . . . . 72,592 91.2 0.4 50.6 0.7 51.3 0.7 8.8 0.4

 With children under 18 

 years. . . . . . . . . . . . . . . . . . . . . 31,730 90.8 0.7 42.3 1.3 53.8 1.2 9.2 0.7

Unrelated subfamilies. . . . . . . . . 1,024 84.3 4.5 46.3 6.6 40.6 5.7 15.7 4.5

Secondary individuals. . . . . . . . . 16,892 81.5 1.1 59.7 1.2 25.1 1.2 18.5 1.1

Income-to-Poverty Ratio

Total, poverty universe5. . . . . . . 327,548 91.7 0.2 66.0 0.3 35.6 0.3 8.3 0.2

Below 100 percent of 

poverty. . . . . . . . . . . . . . . . . . . . 37,808 83.8 0.8 22.6 0.9 66.7 1.0 16.2 0.8

Below 138 percent of 

poverty. . . . . . . . . . . . . . . . . . . . 56,839 84.3 0.7 23.9 0.8 66.4 0.8 15.7 0.7

Between 100 and 199 percent 

of poverty. . . . . . . . . . . . . . . . . . 52,533 86.8 0.5 38.6 0.8 57.4 0.8 13.2 0.5

Between 200 and 299 percent 

of poverty. . . . . . . . . . . . . . . . . . 49,916 89.0 0.6 60.1 0.8 39.3 0.8 11.0 0.6

Between 300 and 399 percent 

of poverty. . . . . . . . . . . . . . . . . . 42,688 91.1 0.5 71.1 0.9 30.8 0.8 8.9 0.5

At or above 400 percent of 

poverty. . . . . . . . . . . . . . . . . . . . 144,603 96.7 0.2 87.9 0.3 19.7 0.4 3.3 0.2

Footnotes provided at end of table.
34 Health Insurance Coverage in the United States: 2021 U.S. Census Bureau

Table C-3. 

Health Insurance Coverage Status and Type by Household Relationship and Family 

Income-to-Poverty Ratio: 2020 and 2021—Con.

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

nonsampling error, and definitions is available at <https://www2.census.gov/programs-surveys/cps/techdocs/cpsmar22.pdf>)

Characteristic

Total

Number

Any health insurance

Uninsured4

Percent

Margin of 

error1 (±)

Private health 

insurance2

Public health 

insurance3

Percent

Margin of 

error1 (±) Percent

Margin of 

error1 (±) Percent

Margin of 

error1 (±)

    2020 Total6. . . . . . . . . . 327,521 91.4 0.2 66.5 0.4 34.5 0.3 8.6 0.2

Household Relationship

Married couple family. . . . . . . . . 194,490 93.6 0.2 74.8 0.4 29.0 0.4 6.4 0.2

 With children under 18 

 years. . . . . . . . . . . . . . . . . . . . . 107,237 92.7 0.3 75.5 0.6 20.3 0.6 7.3 0.3

Unmarried male reference 

person. . . . . . . . . . . . . . . . . . . . . 42,228 86.9 0.6 58.9 0.9 36.3 0.8 13.1 0.6

 With children under 18 

 years. . . . . . . . . . . . . . . . . . . . . 11,019 86.2 1.4 54.7 1.9 35.5 1.8 13.8 1.4

Unmarried female reference

person. . . . . . . . . . . . . . . . . . . . . 72,797 90.2 0.4 50.2 0.7 49.9 0.6 9.8 0.4

 With children under 18 

 years. . . . . . . . . . . . . . . . . . . . . 32,368 89.4 0.7 41.8 1.1 52.1 1.1 10.6 0.7

Unrelated subfamilies. . . . . . . . . 1,030 86.7 3.8 51.3 6.0 38.4 5.2 13.3 3.8

Secondary individuals. . . . . . . . . 16,976 82.7 0.9 60.9 1.3 25.9 1.1 17.3 0.9

Income-to-Poverty Ratio

Total, poverty universe5. . . . . . 327,032 91.4 0.2 66.6 0.4 34.4 0.3 8.6 0.2

Below 100 percent of 

poverty. . . . . . . . . . . . . . . . . . . . 37,461 82.8 0.8 23.2 0.9 64.2 0.9 17.2 0.8

Below 138 percent of 

poverty. . . . . . . . . . . . . . . . . . . . 56,740 83.8 0.6 25.3 0.7 64.5 0.8 16.2 0.6

Between 100 and 199 percent 

of poverty. . . . . . . . . . . . . . . . . . 52,548 86.5 0.6 39.5 0.9 56.6 0.8 13.5 0.6

Between 200 and 299 percent 

of poverty. . . . . . . . . . . . . . . . . . 50,660 88.0 0.5 60.3 0.9 38.5 0.8 12.0 0.5

Between 300 and 399 percent 

of poverty. . . . . . . . . . . . . . . . . . 41,886 91.1 0.6 72.1 0.9 29.0 0.8 8.9 0.6

At or above 400 percent of 

poverty. . . . . . . . . . . . . . . . . . . . 144,478 96.6 0.2 88.3 0.3 18.7 0.3 3.4 0.2

1

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

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

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

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

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

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

6 Implementation of 2020 Census-based population controls.

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, 2021 and 2022 Annual Social and Economic Supplements (CPS ASEC).

Health Insurance Coverage in the United States: 2021 P60-278 Current Population Reports U.S. Census Bureau

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