Uninsured & Underinsured

In order to support state and local outreach efforts, ASPE has developed state, county, and local estimates of the number of U.S. residents without health insurance and their demographic characteristics, using the most recent Census data available from the 2023 American Community Survey (ACS).

This research report describes patterns in insurance coverage and uninsurance rates in rural and urban areas, reviews non-financial challenges in accessing care faced by many rural residents, and describes disparities in health outcomes between urban and rural areas.

This issue brief shows coverage gains among young adults under the Affordable Care Act, the American Rescue Plan, and the Inflation Reduction Act. The uninsured rate among this group declined by more than half, from 31.5 percent in 2009 to 13.1 percent in 2023, as employer-sponsored dependent coverage increased by over 20 percent.

These Fact Sheets highlight health care cost savings achieved under the Inflation Reduction Act (IRA) and the Affordable Care Act (ACA) for each of the fifty states and the District of Columbia. Enrollee savings on Medicare Part D out-of-pocket costs, insulin, vaccines, and Marketplace premiums are presented.

Asian Americans, Native Hawaiians, and Pacific Islanders (AANHPIs) experienced larger relative gains in health insurance coverage than any other racial or ethnic group in the United States since the Affordable Care Act was enacted in 2010.

The uninsured rate for nonelderly Latinos decreased from 32.7 percent to 18.0 percent, from 2010 to 2022, however, Latinos are more than twice as likely to be uninsured as non-Latino Whites.

Recent legislative and administrative policy initiatives have built on the Affordable Care Act’s (ACA) expansion of health insurance coverage and improvements in access to and utilization of health care services.

Since the implementation of the Affordable Care Act’s coverage provisions, the uninsured rate among nonelderly Black Americans decreased by 10 percentage points, from 20.9 percent in 2010 to 10.8 percent in 2022.

Newly released data from the National Health Interview Survey indicates no statistically significant change in the uninsured rate from the previous three quarters of 2023 and a continued steady decline in uninsurance since 2020.

According to the most recent National Health Interview Survey data, the national uninsured rate in the third quarter of 2023 was 7.7 percent, unchanged statistically from the first two quarters of 2023.