American Community Survey Briefs

U.S. Department of Commerce

Economics and Statistics Administration

U.S. CENSUS BUREAU

census.gov

Health Insurance Coverage of Young Adults 

Aged 19 to 25: 2008, 2009, and 2011

INTRODUCTION

Historically, young adults have been a group with one 

of the highest uninsured rates.1 Although individual 

states had enacted laws that allowed adult children 

in various circumstances to be dependents on their 

parents’ private family health plans, only in 2010 was 

there a standardized national law that allowed all adult 

children under the age of 26 to be covered. 2 Because 

the change in law occurred mid-year, this report examines the coverage of young adults aged 19 to 25 in the 

2 years before the change (2008 and 2009) and in the 

year after the change (2011). To gain a perspective on 

what was happening to a similar group of people, the 

report uses adults aged 26 to 29, who did not have 

access to their parents’ policies, as a comparison group. 

Early estimates from the National Health Interview 

Survey have shown that the uninsured rate for adults 

aged 19 to 25 declined in the first 6 months of 2011 

compared with 2010.3 In addition, because the provision targets only private health insurance plans, one 

1 National Center for Health Statistics, Health, United States, 2008 

With Special Feature on the Health of Young Adults, Hyattsville, MD, 

2009. 2 Cantor, J. C., D. Belloff, A. C. Monheit, D. DeLia, and M. Koller 

(2012), “Expanding Dependent Coverage for Young Adults: Lessons 

From State Initiatives,” Journal of Health Politics, Policy and Law, 

Vol. 37(1), pages 99–128. 3 Cohen, Robin A. and Micheal E. Martinez, Health Insurance 

Coverage: Early Release of Estimates From the National Health 

Interview Survey, 2011, National Center for Health Statistics, June 

2012.

would expect a similarly patterned increase in private 

insurance during this period.4

COVERAGE OF YOUNG ADULTS AGED 19

TO 25 IN THE UNITED STATES

From 2008 to 2009, young adults aged 19 to 25 

followed a similar trend as those aged 26 to 29 in 

the percentage with health insurance (see Figure 1). 

Although the older group had a statistically higher rate 

of insurance coverage than the younger group in 2008 

(72.3 percent and 69.5 percent, respectively), both 

age groups experienced a similar decrease in coverage over that period. The insured rate for the 26-to-29 

year age group dropped 1.1 percentage points in 2009, 

while the rate for the 19-to-25 group decreased 1.2 

percentage points, a number not statistically different from the change of the older group (see Table 1). 

The same pattern holds for private insurance: the size 

4 The National Defense Authorization Act of January 2011 brought 

TRICARE into compliance with the other dependent provision laws.

Issued September 2012

ACSBR/11-11

By Jonathan Rodean 

Definition

Private health insurance: Health insurance provided through an employer or a 

union, a plan purchased by an individual 

from an insurance company, or TRICARE 

or other military health coverage. 
2 U.S. Census Bureau

of the decrease in the privately 

insured rate of the younger group 

(2.3 percentage points) is not statistically different from the rate of 

those aged 26 to 29 (2.2 percentage points).

After the dependent provision 

went into effect, the two groups 

experienced different changes 

in coverage from 2009 to 2011. 

As expected, the insured rate of 

adults 19 to 25 years old, those 

targeted by the dependent provision, increased from 68.3 to 

71.8 percent. The insured rate of 

those aged 26 to 29 continued to 

decrease, from 71.1 percent to 

70.3 percent.5

The divergence of the trends also 

occurred for private coverage, 

where the rate for young adults 

5 The 3.6 percentage point change in the 

insured rate of young adults aged 19 to 25 is 

statistically larger than the –0.8 percentage 

point change in the insured rate of those 

aged 26 to 29.

Figure 1. 

Percentage With Health Insurance Coverage by

Age Group and Type: 2008–2011

* Dependent provision went into effect mid-year.

Source: U.S. Census Bureau, 2008, 2009, 2010, and 2011 American Community Survey.

Aged 19–25

Any health insurance

Private health insurance

40

45

50

55

60

65

70

75

2008 2009 2010 2011

Aged 26–29

Percent insured by type

Year

(Civilian noninstitutionalized population 19 to 29 years. For information on

confidentiality protection, sampling error, nonsampling error, and definitions, 

see www.census.gov/acs/www/Downloads/data_documentation/Accuracy

/ACS_Accuracy_of_Data_2011.pdf)

Table 1

Health Insurance Coverage by Age Group and Type: 2008, 2009, and 2011

(Civilian noninstitutionalized population. For information on confidentiality protection, sampling error, nonsampling error, and definitions, see 

www.census.gov/acs/www/Downloads/data_documentation/Accuracy/ACS_Accuracy_of_Data_2011.pdf)

Type and age group

2008 2009 2011

Difference 

2009–2008

Difference 

2011–2009

Percent

Margin 

of error Percent

Margin 

of error Percent

Margin

of error Percent Percent

 Any health insurance

Age 19–25 . . . . . . . . . . . . . . . . . . . . . 69.5 0.2 68.3 0.2 71.8 0.2 *–1.2 *3.6

Age 26–29 . . . . . . . . . . . . . . . . . . . . . 72.3 0.2 71.1 0.2 70.3 0.3 *–1.1 *–0.8

 With private insurance

Age 19–25 . . . . . . . . . . . . . . . . . . . . . 60.4 0.2 58.1 0.2 60.8 0.2 *–2.3 *2.7

Age 26–29 . . . . . . . . . . . . . . . . . . . . . 62.8 0.3 60.6 0.3 58.7 0.3 *–2.2 *–1.9

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

Source: U.S. Census Bureau, 2008, 2009, and 2011 American Community Survey.
U.S. Census Bureau 3

aged 26 to 29 increased by 2.7 percentage points. For the older age 

group, the decrease in private coverage continued. The decrease in 

private coverage among the older 

age group was 1.9 percentage 

points, greater than the decrease 

in the rate with any type of health 

insurance (0.8 percentage points).6

COVERAGE OF YOUNG 

ADULTS AGED 19 TO 25 

AMONG STATES

For young adults aged 19 to 25, no 

state experienced a decrease in the 

insured rate from 2009 to 2011. 

While 37 states and the District 

of Columbia had an increase in 

6 The 2.7 percentage point change in the 

privately insured rate of young adults aged 

19 to 25 is statistically larger than the –1.9 

percentage point change in the insured rate 

of those aged 26 to 29.

coverage, 13 states did not have 

a statistically significant change 

(see Figure 2 and Table 2). Vermont 

had the highest increase in coverage in the young adult age group, 

increasing from an insured rate of 

75.2 in 2009 to 89.1 in 2011. In 

addition, Vermont was 1 of only 9 

states whose increase was greater 

than the national average.7 Six 

states had a change in the insured 

rate that was less than the national 

average.8

7 The nine states whose change in the 

insured rate was greater than the national 

average were Colorado, Maine, Maryland, 

Michigan, New York, Ohio, Pennsylvania, 

South Carolina, and Vermont. 8 The six states whose change in the 

insured rate was less than the national 

average were Florida, Massachusetts, New 

Mexico, Virginia, Washington, and Wisconsin.

Like the total insured rate, no state 

showed a decrease in the rate of 

private insurance from 2009 to 

2011 for young adults aged 19 

to 25. While the private insurance 

rate showed a statistically significant increase in 37 states and the 

District of Columbia, 13 states had 

no significant change (see Figure 

3 and Table 2). Six states and the 

District of Columbia had a change 

in rate above the national average.9

Vermont had the largest increase 

in private insurance at 10.5 percentage points.10 Only 4 states had 

changes in the privately insured 

9 The six states whose change in the rate 

of private insurance was greater than the 

national average were Illinois, Michigan, Ohio, 

Pennsylvania, South Carolina, and Vermont. 10 The change in rate of Vermont was not 

significantly different from that of Delaware, 

the District of Columbia, or Wyoming.

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

(TX

(

CA

MT

(

AZ

ID

(

NV

( (

KS

CO

NM

(

OR

UT

SD

(IL

WY

(

NE (IA

(FL

(

MN

(

OK

ND

(

WI

WA

(

GA

(

AL

(

MO

(PA

AR

(LA

(

NC

MS

(

NY

(IN

(

MI

(

VA

(TN

(

KY

(SC

(

OH

(

ME

(

WV

(

VT

NH

(

NJ

(

MD

(

MA

(

CT

(

DE

RI

(

DC

AK

( (PR HI

Source: U.S. Census Bureau, 2009 and 2011 American Community

Survey, 2009 and 2011 Puerto Rico Community Survey.

0 500 Miles

0 100 Miles

0 100 Miles 0 50 Miles

Change in Percentage of Young Adults Aged 19 to 25 

With Any Kind of Health Insurance

for the United States and Puerto Rico: 2009 to 2011

Figure 2.

U.S. percent is 3.6

United States percentage

does not include data for

Puerto Rico.

Percent by state

5.5 or more

4.2 to 5.4

2.5 to 4.1

Less than 2.5

Note: A state abbreviation surrounded by 

the " " symbol denotes the value for the

state’s change is statistically different from

zero.

(
4 U.S. Census Bureau

Table 2.

Health Insurance Coverage of Young Adults Aged 19 to 25 by State and Puerto Rico: 2009 

and 2011

(Civilian noninstitutionalized population. For information on confidentiality protection, sampling error, nonsampling error, and definitions, see 

www.census.gov/acs/www/Downloads/data_documentation/Accuracy/ACS_Accuracy_of_Data_2011.pdf)

Area

Any health insurance coverage Private health insurance

2009 2011

Difference

2009 2011

Percent Difference

Margin 

of error 

(±)1 Percent

Margin

of error 

(±)1 Percent

Margin 

of error 

(±)1 Percent

Margin

of error 

(±)1

 United States . . 68.3 0.2 71.8 0.2 *3.6 58.1 0.2 60.8 0.2 *2.7

Alabama . . . . . . . . . . . 68.0 1.3 71.8 1.4 *3.8 58.6 1.3 63.2 1.4 *4.6

Alaska . . . . . . . . . . . . . 61.4 4.2 64.7 3.4 3.3 55.5 4.1 53.2 3.6 –2.3

Arizona . . . . . . . . . . . . 66.1 1.2 70.1 1.5 *4.0 50.6 1.4 51.6 1.5 1.0

Arkansas . . . . . . . . . . . 60.6 2.1 63.1 1.8 2.5 50.2 2.0 54.4 1.8 *4.1

California . . . . . . . . . . . 63.7 0.5 67.0 0.5 *3.3 53.3 0.5 55.1 0.5 *1.8

Colorado . . . . . . . . . . . 68.2 1.3 73.9 1.5 *5.7 61.6 1.4 65.4 1.6 *3.8

Connecticut . . . . . . . . . 79.3 1.4 83.2 1.3 *3.8 68.6 1.6 69.4 1.6 0.8

Delaware . . . . . . . . . . . 75.8 3.1 82.4 2.5 *6.6 58.9 4.1 66.4 2.6 *7.5

District of Columbia . . . 87.5 2.3 91.6 2.0 *4.1 66.8 3.4 74.6 2.7 *7.8

Florida . . . . . . . . . . . . . 59.3 0.8 61.2 0.9 *1.8 51.2 0.8 52.0 0.9 0.8

Georgia . . . . . . . . . . . . 60.6 1.2 63.9 1.4 *3.3 53.5 1.2 55.8 1.4 *2.3

Hawaii . . . . . . . . . . . . . 82.7 2.0 86.1 1.7 *3.4 70.5 2.5 71.8 2.4 1.3

Idaho . . . . . . . . . . . . . . 67.6 2.1 70.3 2.6 2.7 61.3 1.9 62.7 2.8 1.4

Illinois . . . . . . . . . . . . . . 69.9 0.8 74.6 0.8 *4.7 59.6 0.8 64.1 0.8 *4.5

Indiana . . . . . . . . . . . . . 69.7 1.2 73.1 1.0 *3.4 60.6 1.2 64.3 1.1 *3.7

Iowa . . . . . . . . . . . . . . . 80.1 1.3 83.2 1.1 *3.1 71.2 1.5 74.6 1.3 *3.4

Kansas . . . . . . . . . . . . . 73.2 1.6 77.1 1.5 *3.9 67.5 1.7 71.5 1.5 *4.0

Kentucky . . . . . . . . . . . 65.8 1.4 69.3 1.1 *3.5 55.9 1.3 60.0 1.3 *4.1

Louisiana . . . . . . . . . . . 64.6 1.7 68.0 1.4 *3.3 54.0 1.9 55.5 1.4 1.6

Maine . . . . . . . . . . . . . . 74.1 2.2 81.4 1.8 *7.3 56.3 2.5 61.1 2.5 *4.8

Maryland . . . . . . . . . . . 75.0 1.3 81.7 1.0 *6.7 66.8 1.3 70.7 1.2 *3.8

Massachusetts . . . . . . . 90.3 0.7 92.1 0.6 *1.7 73.0 1.1 75.0 1.0 *2.0

Michigan . . . . . . . . . . . 71.2 0.8 76.3 0.9 *5.1 56.6 1.0 61.5 0.9 *4.9

Minnesota . . . . . . . . . . 78.8 0.9 82.6 0.9 *3.8 66.5 1.1 69.3 1.0 *2.9

Mississippi . . . . . . . . . . 62.8 1.9 64.3 1.6 1.5 50.0 1.7 52.7 1.7 *2.7

Missouri . . . . . . . . . . . . 71.4 1.3 74.2 1.1 *2.8 62.7 1.5 65.5 1.2 *2.7

Montana . . . . . . . . . . . . 66.1 3.1 66.4 3.1 0.3 59.7 3.3 59.1 3.3 –0.7

Nebraska . . . . . . . . . . . 72.4 1.8 76.9 1.7 *4.5 66.9 1.7 71.1 2.0 *4.2

Nevada . . . . . . . . . . . . 55.2 2.1 61.7 2.1 *6.5 51.6 2.1 55.2 2.4 *3.6

New Hampshire . . . . . . 77.2 2.5 80.3 2.2 3.1 71.1 2.8 75.8 2.3 *4.7

New Jersey . . . . . . . . . 69.9 1.0 74.6 1.0 *4.7 63.0 1.0 65.9 1.0 *2.9

New Mexico . . . . . . . . . 61.4 2.2 60.6 2.0 –0.8 47.1 2.6 45.7 2.4 –1.4

New York . . . . . . . . . . . 74.5 0.7 79.7 0.5 *5.2 58.4 0.6 61.1 0.7 *2.7

North Carolina . . . . . . . 66.9 0.9 69.6 1.1 *2.7 55.8 1.1 58.7 1.0 *2.9

North Dakota . . . . . . . . 81.6 2.8 82.5 2.0 0.9 74.9 2.8 74.9 2.3 –

Ohio . . . . . . . . . . . . . . . 72.4 0.8 77.9 0.6 *5.6 59.8 1.0 65.0 0.7 *5.2

Oklahoma . . . . . . . . . . 61.7 1.6 64.9 1.6 *3.2 54.2 1.7 56.5 1.6 *2.4

Oregon . . . . . . . . . . . . . 64.6 1.5 70.2 1.5 *5.6 57.5 1.5 59.9 1.7 *2.4

Pennsylvania . . . . . . . . 75.9 0.7 80.9 0.7 *5.0 64.8 0.8 68.6 0.8 *3.8

Rhode Island . . . . . . . . 74.5 2.5 77.7 2.1 3.2 66.2 2.8 69.1 2.3 2.9

South Carolina . . . . . . . 63.9 1.5 70.1 1.3 *6.3 53.4 1.4 58.9 1.4 *5.5

South Dakota . . . . . . . . 72.1 2.8 75.6 2.5 3.5 64.0 2.6 68.2 2.8 *4.1

Tennessee . . . . . . . . . . 69.4 1.1 72.7 1.2 *3.3 55.1 1.2 58.3 1.2 *3.2

Texas . . . . . . . . . . . . . . 56.5 0.6 59.3 0.6 *2.7 50.4 0.5 52.1 0.5 *1.8

Utah . . . . . . . . . . . . . . . 75.1 1.5 77.0 1.4 1.9 71.0 1.6 72.3 1.6 1.3

Vermont . . . . . . . . . . . . 75.2 3.1 89.1 1.7 *13.9 59.2 3.1 69.7 2.4 *10.5

Virginia . . . . . . . . . . . . . 73.5 1.0 75.5 1.0 *1.9 67.8 1.1 69.6 1.0 *1.8

Washington . . . . . . . . . 69.4 1.2 70.8 1.1 1.4 60.7 1.3 62.8 1.2 *2.1

West Virginia . . . . . . . . 65.1 2.2 69.5 2.4 *4.4 54.5 2.2 59.9 2.3 *5.4

Wisconsin . . . . . . . . . . 77.3 1.0 79.4 0.9 *2.1 65.6 1.1 68.1 1.0 *2.5

Wyoming . . . . . . . . . . . 70.2 3.6 74.6 2.8 4.4 63.1 3.8 67.7 3.4 4.6

Puerto Rico . . . . . . . . . 85.6 1.1 87.2 1.2 *1.7 38.4 1.5 35.8 1.4 *–2.6

– Represents or rounds to zero.

* Statistically different from zero at the 90 percent confidence level. 1

 Data are based on a sample and are subject to sampling variability. A margin of error is a measure of an estimate’s variability. The larger the margin of error is 

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.

Source: U.S. Census Bureau, 2009 and 2011 American Community Surveys, 2009 and 2011 Puerto Rico Community Surveys.
5 U.S. Census Bureau

What Is the American Community Survey?

The American Community Survey (ACS) is a nationwide survey designed to provide communities with reliable 

and timely demographic, social, economic, and housing data for the nation, states, congressional districts, 

counties, places, and other localities every year. It has an annual sample size of about 3.3 million addresses 

across the United States and Puerto Rico and includes both housing units and group quarters (e.g., nursing 

facilities and prisons). The ACS is conducted in every county throughout the nation, and every municipio in 

Puerto Rico, where it is called the Puerto Rico Community Survey. Beginning in 2006, ACS data for 2005 were 

released for geographic areas with populations of 65,000 and greater. For information on the ACS sample 

design and other topics, visit <www.census.gov/acs/www>.

rate that were below the national 

average: California, Florida, New 

Mexico, and Texas.

Although the same number of 

states showed no change in the 

total insured rate and the privately insured rate (13), not all 

states showed a lack of change for 

both types of insurance. Arizona, 

Connecticut, Florida, Hawaii, and 

Louisiana saw increases in the 

overall insured rate but not in 

the private health insurance rate, 

while Arkansas, Mississippi, New 

Hampshire, South Dakota, and 

Washington had increases in the 

privately insured rate but not in the 

overall insured rate. The states that 

did not show a change in either 

type of insurance rate were Alaska, 

Idaho, Montana, New Mexico, North 

Dakota, Rhode Island, Utah, and 

Wyoming.

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

(

(TX

(

CA

MT

AZ

ID

(

NV

( (

KS

CO

NM

(

OR

UT

(SD

(IL

WY

(

NE (IA

FL

(

MN

(

OK

ND

(

WI

(

WA

(

GA

(

AL

(

MO

(PA

(

AR

LA

(

NC

(

MS

(

NY

(IN

(

MI

(

VA

(TN

(

KY

(SC

(

OH

(

ME

(

WV

(

VT

(

NH

(

NJ

(

MD

(

MA

CT

(

DE

RI

(

DC

AK

(PR HI

Source: U.S. Census Bureau, 2009 and 2011 American Community

Survey, 2009 and 2011 Puerto Rico Community Survey.

0 500 Miles

0 100 Miles

0 100 Miles 0 50 Miles

Percent by state

3.0 to 5.5

2.2 to 2.9

0.8 to 2.1

Less than 0.8

Change in Percentage of Young Adults Aged 19 to 25

With Private Health Insurance 

for the United States and Puerto Rico: 2009 to 2011

U.S. percent is 2.7

5.6 or more

Figure 3.

United States percentage

does not include data for 

Puerto Rico. Note: A state abbreviation surrounded by 

the " " symbol denotes the value for the

state’s change is statistically different from

zero.
U.S. Census Bureau 6

SOURCE AND ACCURACY 

The data presented in this report 

are based on the ACS sample 

interviewed in 2011. The estimates 

based on this sample approximate 

the actual values and represent the 

entire household and group quarter 

population. Sampling error is the 

difference between an estimate 

based in a sample and the corresponding value that would be 

obtained if the estimate were based 

on the entire population (as from a 

census). Measures of the sampling 

errors are provided in the form of 

margins of error for all estimates 

included in this report. All comparative statements in this report 

have undergone statistical testing, 

and comparisons are significant at 

the 90 percent level unless otherwise noted. In addition to sampling 

error, nonsampling error may be 

introduced during any of the operations used to collect and process 

survey data such as editing, reviewing, or keying data from questionnaires. For more information on 

sampling and estimation methods, 

confidentiality protection, and 

sampling and nonsampling errors, 

please see the 2011 ACS Accuracy 

of the Data document located at 

<www.census.gov/acs/www

/Downloads/data_documentation

/Accuracy/ACS_Accuracy_of

_Data_2011.pdf>.