Health Insurance
How Many Americans Are Uninsured?
As of early March 2022, 8% of Americans reported not having health insurance, according to a ValuePenguin analysis of U.S. Census Bureau Household Pulse Survey data.
This percentage has decreased over the past two years — from 10.5% during late April and early May 2020 — but could swell if the COVID-19-triggered federal public health emergency expires.
The expiration of this public health emergency — which includes a continuous Medicaid enrollment requirement — could eventually lead to millions losing Medicaid coverage.
The newest ValuePenguin study examines uninsured rates at the demographic and state levels to see which Americans are already most at risk.
Key findings
- Nearly 1 in 10 Americans are uninsured. A ValuePenguin analysis of U.S. Census Bureau Household Pulse Survey data from March 2022 shows 8.0% of Americans don’t have health insurance. That’s down from 10.5% in the first survey, conducted in late April and early May 2020.
- At the demographic level, one of the largest predictors of health insurance status appears to be education. 3.3% of residents with a bachelor’s degree or higher report not having health insurance, versus 20.9% of Americans without a high school diploma.
- Large disparities in uninsured rates can also be seen across ages. Just 1.6% of Americans 65 and older don’t have health insurance, versus 13.0% of consumers 18 to 24.
- At the state level, uninsured rates are highest in the South. The four states with the highest rates of Americans without health insurance — Mississippi (14.4%), Texas (13.0%), Oklahoma (12.4%) and Georgia (12.0%) — are in the South.
- Uninsured rates are lowest in the Northeast. Rhode Island (2.4%) and Vermont (3.3%) have the lowest percentages of Americans without health insurance. They’re joined in the top four by the District of Columbia and Hawaii (both 3.8%).
8% of Americans don’t have health insurance
About 1 in 10 Americans — 8.0% — don’t have health insurance of any kind, according to a ValuePenguin analysis of U.S. Census Bureau Household Pulse Survey data from March 2022. This percentage has fallen, though, from 10.5% in the first survey, conducted in late April and early May 2020.
This is the 43rd time the Census Bureau has tracked uninsured rates in this format — dating back to that first survey conducted in late April and early May 2020.
Before the pandemic, uninsured rates among Americans younger than 65 had fallen since the implementation of the 2010 Affordable Care Act (ACA), from 18.2% in 2010 to 12.1% in 2019 — a slight climb from the previous few years, according to data from the National Center for Health Statistics. The uninsured rate among this group was lowest in 2016 at 10.4%.
These Americans are least likely to have health insurance
The ValuePenguin analysis finds certain demographics correlate more highly with one’s health insurance status. Those without a high school diploma, those in the South and younger Americans are less likely to have health insurance, according to the data.
Here’s a closer look at the demographics.
Education level
One of the largest discrepancies between Americans who have and don’t have health insurance is seen at the education level. Disparities in coverage arise when populations have lower levels of education.
Only 3.3% of residents with a bachelor’s degree or higher report not having health insurance. Those with some college or an associate degree fare better than average with a 7.6% uninsured rate but still aren’t as robustly insured as those who obtain a four-year college diploma.
More than 1 in 10 (10.6%) of those who finish high school or obtain their GED diploma but don’t attend college report being uninsured, with more than 1 in 5 (20.9%) without a high school diploma saying the same.
The American Academy of Family Physicians notes — as have others over the years — that education leads to better jobs, more money and added benefits, including health insurance.
The chicken-and-egg theory is also at play here, as academic researchers have found that low-income children with health insurance have increased rates of finishing high school and college.
Age
A difference in uninsured rates also occurs across age brackets, with newly minted adults lacking health insurance at a much higher rate than older Americans. The uninsured rate decreases steadily with age before dropping to a small fraction for people of retirement age.
Only 1.6% of Americans 65 and older don’t have health insurance. However, a hefty 13.0% of young adults ages 18 to 24 are uninsured. That compares with uninsured rates of:
- 11.8% among those ages 25 to 39
- 9.3% among those 40 to 54
- 6.9% among those 55 to 64
Gender
Women have lower uninsured rates but only by a couple of percentage points.
The uninsured rate for men is 9.0% — a percentage point higher than the national average — versus 7.0% for women — a percentage point lower than the average.
Race
Hispanic/Latino and Black Americans are more often uninsured than white or Asian Americans. The data reveals that the uninsured rate is 17.0% for Hispanic/Latino Americans and 9.5% for Black Americans — both above the 8.0% national average. The percentage of uninsured Asian Americans is 6.0%, versus 5.4% among white Americans.
Research funded by the National Institutes of Health has described the barriers some groups of color often experience in accessing health insurance. It states that Hispanic groups aren’t alike in their insurance coverage profiles, with those who have settled here from different Central American regions or Puerto Rico having different rates of health insurance coverage — a phenomenon also seen in Asian American regional subgroups.
More recently, the Brookings Institution said Latinos had suffered disproportionately during the pandemic. Citing a June 2020 survey from Abriendo Puertas and Latino Decisions, Brookings pointed out that 37% of Latinos had someone in their household who lost their employer-provided health insurance coverage during the first phase of the COVID-19 crisis.
Household size
While there’s a large discrepancy between small and large households in insurance coverage rates, the average household size of 2.6 people has a lower uninsured rate than the national average.
Households of two individuals are uninsured at a rate of 5.3%, while households of three people are uninsured at 7.9% — a little below the average of 8.0%.
Meanwhile, a household of only one person has an average uninsured rate of 6.9%, but the rate jumps to 18.8% for households with seven people or more.
Children in household
If a household has children younger than 18, the uninsured rate is more likely to be above the national average.
The rate of uninsured individuals is 10.2% if there are children in the house, versus 6.7% for households without children. The average family size — a group of people related in various ways and residing together — in the U.S. is 3.23.
Household income
Household income is a big determinant, unsurprisingly, in insurance rates, as health insurance can be costly and is obtained through employment in almost 1 in 2 instances.
For those who earn less than $25,000 per year, the uninsured rate is double the national average at 16.0%, versus 2.3% for those who earn $200,000 or more.
Once the income threshold reaches $50,000 for an individual, the uninsured rate slips below the national average to 7.0%. The rates really fall once income levels reach $100,000. Uninsured rates hover around 2.4% for this more financially well-off group of Americans.
Where Americans are least likely to have health insurance
Southern states dominate the top of the list with the highest uninsured rates. Mississippi, Texas, Oklahoma and Georgia have all boosted their insured ranks during the pandemic, yet they still have a far higher percentage of uninsured people than the national average of 8.0%, with Mississippi leading at 14.4%.
Texas, which had the highest uninsured rate in the U.S. as the pandemic took hold — with more than 1 in 5 people uninsured — follows at a now-slimmer 13%. Oklahoma and Georgia are almost neck-in-neck in their proportion of uninsured citizens both now and at the beginning of the pandemic — 12.4% and 12.0%, respectively, in 2022.
There are 23 states, mostly in the South, Midwest and West, where the uninsured rate is above the 8.0% national average, according to the Census data analyzed by ValuePenguin.
One reason that some Southern states could have lower insured rates is that they haven’t expanded their Medicaid programs to working people who otherwise can’t afford a health insurance plan, according to a U.S. Department of Health and Human Services (HHS) report from February 2022.
A study published earlier by the Journal of the American Medical Association in July 2021 found that people in the South also had the highest amount of medical debt, which can also be attributed to the South’s general lack of expansion of Medicaid to those who might need it because their salaries aren’t high enough to otherwise pay for insurance.
Where Americans are most likely to have health insurance
The top five spots for the lowest uninsured rates are occupied by two Northeast states, Rhode Island and Vermont; two in the South but at the edge of the Northeast, the District of Columbia and Delaware; and Hawaii.
While these states all improved throughout the pandemic in adding citizens to the insured ranks, Vermont showed some of the strongest gains from the onset of the pandemic to the most recent survey results.
The Green Mountain State went from 8.1% uninsured to 3.3% uninsured in almost two years and ranks second after Rhode Island (2.4%) among states for lowest uninsured. The nation's capital ranks third-lowest in uninsured, at 3.8%, perhaps due to the high number of federal employees there and its embrace of significant health insurance reforms to get residents covered.
Vermont and the District of Columbia are among jurisdictions that passed laws requiring individual insurance requirements that started going into effect by 2020. Vermont also utilized the federal American Rescue Plan Act in 2021 to make health insurance more affordable for those who might otherwise fall off of subsidies from the ACA due to their income levels.
Full rankings
States with the highest/lowest uninsured rates
Rank | State | Percentage in last week of survey (March 2 to March 14, 2022) | Percentage in first week of survey (April 23 to May 5, 2020) |
|---|---|---|---|
| 1 | Mississippi | 14.4% | 16.9% |
| 2 | Texas | 13.0% | 20.5% |
| 3 | Oklahoma | 12.4% | 16.6% |
| 4 | Georgia | 12.0% | 16.4% |
| 5 | Wyoming | 10.6% | 13.0% |
| 6 | Nevada | 10.5% | 12.2% |
| 7 | Idaho | 10.5% | 9.4% |
| 8 | Arkansas | 9.9% | 8.3% |
| 9 | Louisiana | 9.8% | 9.3% |
| 10 | New Mexico | 9.8% | 7.8% |
| 11 | Tennessee | 9.6% | 14.2% |
| 12 | Nebraska | 9.4% | 9.4% |
Source: ValuePenguin analysis of U.S. Census Bureau Household Pulse Survey data from March 2 to 14, 2022, and April 23 to May 5, 2020. Rankings are based on the most recent data.
Tips for finding health insurance
Although one might be hamstrung by regional or state differences in Medicaid expansion and financial challenges, there are ways to join — or stay on — the rosters of those covered by health insurance plans.
- Those who are losing other coverage, such as an employer health insurance plan, Medicaid or the Children’s Health Insurance Program (CHIP), can apply for an ACA plan under its special enrollment period. There are rules and timelines for special enrollment periods, so it’s important to apply as soon as possible after your other coverage ends, advises Robin Townsend, ValuePenguin health insurance research analyst.
- Those who don't have health insurance through their job can enroll in a plan during the open enrollment period that occurs every year, typically from Nov. 1 through Jan. 15. Shoppers can compare plans using the federal or state marketplace, and those who have a low to moderate income may qualify for subsidies to reduce the monthly cost of an insurance plan.
- For those who have nongrandfathered health insurance coverage in the individual and small group market that’s out of compliance with certain specified market reforms, the Centers for Medicare & Medicaid Services (CMS) said in a March 23 memo that health insurers will be allowed to continue these policies for policy years beginning after Oct. 1, 2022. This will remain in effect indefinitely until CMS announces otherwise.
- Check with your state insurance regulator for guidance or enrollment information. Every jurisdiction has one to help consumers navigate these issues.
- Check with USA.gov or HealthCare.gov for a guide to finding coverage under the ACA, as well as information about continuation coverage (COBRA) after a transitional event and health insurance for those with disabilities.
- Check out employers that offer benefits early and/or for part-time work.
Methodology
ValuePenguin researchers analyzed data from the U.S. Census Bureau Household Pulse Survey — fielded from March 2 to 14, 2022, and released on March 23 — to find health uninsured rates at the demographic and state levels.
This is the 43rd time the Census Bureau has released Household Pulse Survey data. We also analyzed the results from the first release — fielded from April 23 to May 5, 2020, and released on May 20 — to see how uninsured rates have changed at the demographic and state levels since the initial survey.