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State Health Insurance Coverage: 2013, 2019, and 2023 American Community Survey Briefs Douglas Conway Issued September 2024 ACSBR-021 INTRODUCTION BACKGROUND Health insurance coverage is an important measure of our nation’s overall well-being as it provides greater access to medical care, protection from unexpected costs, and more economic stability for individuals and families. At the same time, health coverage varies over time, reflecting changes in economic conditions, demographic shifts, such as population aging, and policy changes at the federal and state levels that affect access to care. This brief examines changes in coverage across states for three age groups: children under the age of 19, working-age adults aged 19 to 64, and adults aged 65 and older. It looks at these changes from 2013 to 2019 and from 2019 to 2023, using 2013, 2019, and 2023 1-year American Community Survey (ACS) data.1 It also examines changes in the uninsured rate for the 25 most populous metropolitan areas between 2019 and 2023. These comparisons may help shed light on changes in health insurance related to important events that occurred at these intervals. 1 The U.S. Census Bureau has reviewed this data product to ensure appropriate access, use, and disclosure avoidance protection of the confidential source data used to produce this product (Data Management System [DMS] number: P-7533841, Disclosure Review Board [DRB] approval number: CBDRB-FY24-SEHSD003-082). For information on confidentiality protection, sampling error, nonsampling error, and definitions in the American Community Survey, refer to <https://www2.census.gov/programs-surveys/acs/tech_docs/ accuracy/ACS_Accuracy_of_Data_2023.pdf>. All comparative statements have undergone statistical testing and are statistically significant at the 90 percent confidence level, unless otherwise noted. Between 2013 and 2019, the implementation of several key provisions of the Patient Protection and Affordable Care Act (ACA) contributed to changes in health insurance availability and costs. Two major provisions of the ACA that may have affected uninsured rates include offering states additional funds to expand Medicaid for those under the age of 65 with incomes up to 133 percent of the federal poverty level (effective 2014) and establishing health insurance marketplaces for those seeking to purchase coverage (effective for coverage in 2014). As part of the Tax Cuts and Jobs Act in December 2017, Congress eliminated the ACA’s tax penalty for most people who were not covered by health insurance. Table 1 presents a selection of provisions of the ACA related to availability of coverage plans. Between 2019 and 2023, several factors changed the health insurance landscape, including economic and policy changes related to the COVID-19 pandemic. Federal and state governments intervened through either legislation or executive orders to help minimize losses in health insurance coverage during this period. For instance, the Families First Coronavirus Response Act mandated that states provide continuous coverage for individuals enrolled in Medicaid. This brief examines the health insurance landscape during two distinct periods of economic and policy changes. Age is another important factor in health insurance eligibility and can be a deciding factor in the major type (private or public coverage) of health insurance one chooses. For this reason, we examine health insurance in these periods by three major age categories. Children have high insurance rates because they have access to a variety of health insurance coverage types, including public plans like Medicaid and Children’s Health Insurance Program (CHIP), or private plans like dependent coverage under a parent’s employer and direct purchase options. Previous data have shown that the working- age population is the least likely to be insured of these three age categories, but also has the highest overall rate of private coverage.2 Those aged 65 and over are the most likely to be insured of all age groups and the most likely to have public coverage, 2 Amy E. Cha and Robin A. Cohen, “Demographic Variation in Health Insurance Coverage: United States, 2021,” National Health Statistics Reports, Number 177, 2022, <https://dx.doi.org/ 10.15620/ cdc:121554>, and Douglas Conway, “Health Insurance Coverage Among Young Adults Aged 19 to 34: 2018 and 2019,” American Community Survey Briefs, 2020, <www. census.gov/content/dam/Census/library/ publications/2020/acs/acsbr20-02.pdf>. Table 1. Select Provisions of the Affordable Care Act Effective Date Provision Description 2013 2013 2014 2014 2014 2014 2015 2017 2019 Marketplaces established to purchase coverage for calendar year 2014. Offered small business plans. Subsidies available for people with low income who purchase marketplace coverage. Banned exclusion from plans for preexisting conditions. Requirement to offer coverage—employers with more than 50 employees. Individual mandate—requirement for individuals to have coverage or pay a tax penalty. Enhanced federal matching for Children’s Health Insurance Program (CHIP). Tax Cuts and Jobs Act eliminated individual mandate penalty effective 2019. No tax penalty for not having insurance. Source: University of Pennsylvania and the Kaiser Family Foundation. More information can be found at <www.uphs.upenn.edu/pastoral/ events/Knadig_TIMELINE.pdf> and <www.kff.org/affordable-care-act/fact-sheet/summary-of-the-affordable-care-act/>. Figure 1. Uninsured Rate by Age: 2023 (Civilian noninstitutionalized population) 20 18 16 14 12 10 8 6 4 2 0 Percent Under 19 19 to 64 65 and older 0 5 10 15 20 25 30 35 40 45 50 55 60 65 70 75 Age Note: For information on confidentiality protection, sampling error, nonsampling error, and definitions in the American Community Survey, refer to <https://www2.census.gov/programs-surveys/acs/tech_docs/accuracy/ACS_Accuracy_of_Data_2023.pdf>. Source: U.S. Census Bureau, 2023 American Community Survey, 1-year estimates. 2 U.S. Census Bureau WHAT IS HEALTH INSURANCE COVERAGE? This brief presents state-level estimates of health insurance coverage using data from the American Community Survey (ACS). The U.S. Census Bureau conducts the ACS throughout the year; the survey asks respondents to report their coverage at the time of interview. The resulting measure of health insurance coverage, therefore, reflects an annual average of current comprehensive health insurance coverage status.1 The resulting uninsured rate measures a different concept than the measure based on the Current Population Survey Annual Social and Economic Supplement. For reporting purposes, the ACS broadly classifies health insurance coverage as private insurance or public insurance. The ACS defines private health insurance as a plan provided through an employer or a union, coverage purchased directly by an insurance company or through an exchange (such as healthcare. gov), or coverage through TRICARE. Public insurance coverage includes federal programs (such as Medicare, Medicaid, and the Children’s Health Insurance Program or CHIP), individual state health plans, and CHAMPVA (Civilian Health and Medical Program at the Department of Veterans Affairs), as well as care provided by the Department of Veterans Affairs. In the ACS, people are considered insured if they were covered by any of these types of health insurance at time of interview. People were considered uninsured if they were not covered by any of these types of health insurance at time of interview or if they only had coverage through the Indian Health Service (IHS), as IHS coverage is not considered comprehensive. 1 Comprehensive health insurance covers basic health care needs. This definition excludes single-service plans such as accident, disability, dental, vision, or prescription medicine plans. specifically Medicare, but a large percentage of this group also has both public and private coverage.3 These differences in the uninsured rates between age groups have remained relatively stable over time. Figure 1 presents a snapshot of uninsured rates by age for 2023. 3 Katherine Keisler-Starkey, Lisa Bunch, and Rachel Lindstrom, “Health Insurance Coverage in the United States: 2022,” Current Population Reports,” 2023, <www. census.gov/library/publications/2023/demo/ p60-281.html>. HIGHLIGHTS Children • The uninsured rate for children decreased in 37 states from 2013 to 2019. • Private coverage for children increased in 20 states from 2013 to 2019. • From 2019 to 2023, 24 states reported increases in public coverage. Working-Age Adults • The uninsured rate for working- age adults fell in every state and the District of Columbia from 2013 to 2019, and fell again from 2019 to 2023 in 42 states. • Between 2013 and 2019, private coverage for working-age adults increased in 44 states and the District of Columbia and did not decrease in any. • Between 2019 and 2023, public coverage increased in 36 states for working-age adults, with Oklahoma reporting the largest increase (13.7 percent to 21.0 percent). Adults Aged 65 and Older • The uninsured rate for adults aged 65 and over remained below 3 percent for all states in 2013, 2019, and 2023. It U.S. Census Bureau 3 decreased in 14 states from 2013 to 2019 and decreased in Florida from 2019 to 2023. CHILDREN UNDER THE AGE OF 19: STATE-LEVEL CHANGES IN UNINSURED, PUBLIC, AND PRIVATE COVERAGE RATES the 32 states plus the District of Columbia that expanded Medicaid reported increases in children’s public coverage during the same time. Public coverage for children increased in the United States from 37.5 percent to 38.1 percent between 2013 and 2019. Changes From 2013 to 2019 Changes From 2019 to 2023 From 2013 to 2019, the uninsured rate for children fell in the majority of states (37), increasing only in Wyoming (Figure 2). Overall, the national uninsured rate for children under the age of 19 decreased from 7.5 percent to 5.7 percent during this period. Private coverage rates for children increased in 20 states between 2013 and 2019. Private coverage rose from 58.5 percent to 60.3 percent at the national level between 2013 and 2019. Changes in private coverage may be related to economic conditions (such as employment or wages) or access to more affordable coverage through the ACA marketplace. Public coverage rates for children increased in 22 states from 2013 to 2019, and declined in eight states (Illinois, Maine, Michigan, Nebraska, South Dakota, Texas, Utah, and Wisconsin) and the District of Columbia, six of which had not expanded Medicaid during this time (Appendix Table B-2). On the other hand, 22 of Table 2. Between 2019 and 2023, the uninsured rate for children decreased in 17 states and increased in five (Figure 2). Twelve of the 17 states with decreases in the uninsured rate were in the Midwest and western part of the United States, while three of the five states with increases were in the Northeast: New York, Pennsylvania, and Rhode Island.4 The national uninsured rate for children dropped from 5.7 percent to 5.4 percent from 2019 to 2023. Public coverage for children rose in 24 states and fell in Arkansas (51.1 percent to 48.3 percent), Mississippi (51.0 percent to 48.7 percent), and Vermont (43.5 percent to 39.0 percent) between 2019 and 2023 (Appendix Table B-2). Twenty of the 24 states with increases in public coverage expanded Medicaid on or before January 1, 2022. Overall, the public coverage rate for the United States 4 Census Regions and Divisions of the United States, <https://www2.census.gov/ geo/pdfs/maps-data/maps/reference/ us_regdiv.pdf>. grew from 38.1 percent to 39.4 percent. Private coverage for children increased in nine states and declined in eight states from 2019 to 2023. Six of the nine states with increases were in the South (Appendix Table B-2). States with increases in private coverage during this time had large increases in total ACA enrollments.5 Private coverage for children remained unchanged in the United States between 2019 and 2023. Summary of Changes for Children Under the Age of 19 Thirty-seven states had decreases in the uninsured rate for children between 2013 and 2019. Seventeen of these states had increases only in public coverage rates—i.e., private coverage decreased in six and showed no change in 11 states (Table 2). By contrast, 15 states had increases only in private coverage rates, with public coverage decreasing in five and remaining stable in ten states from 2013 to 2019. Three of the 37 states where uninsured rates declined had increases in both private and public coverage—specifically, 5 Kaiser Family Foundation, “Marketplace Plan Selections by Enrollment Type,” <www. kff.org/affordable-care-act/state-indicator/ marketplace-plan-selections-by-enrollment- type-2/?dataView=1&activeTab=graph&curre ntTimeframe=1&startTimeframe=5&sortMode l=%7B%22colId%22:%22Location%22,%22sort %22:%22asc%22%7D>. Number of States Where the Uninsured Rate for Children Decreased by Changes in Public and Private Coverage: 2013 to 2019 Characteristic    Total states where uninsured     rate decreased . . . . . . . . . . . . . Public coverage increased . . . . . . . . . . . . Public coverage decreased . . . . . . . . . . . No change in public coverage . . . . . . . . Total Private coverage increased Private coverage decreased No change in private coverage 37 20 5 12 18 3 5 10 6 6 Z Z 13 11 Z 2 Z Represents zero. Source: U.S. Census Bureau, 2013 and 2019 American Community Survey, 1-year estimates. 4 U.S. Census Bureau Figure 2. Uninsured Rates of Children Under the Age of 19: 2023, 2019, and 2013 (Civilian noninstitutionalized population) 2023 2019 2013 2019 less 2013 change 2023 less 2019 change 0 4 8 12 16 0 4 8 12 16 UNITED STATES NORTHEAST Connecticut Maine Massachusetts New Hampshire New Jersey New York Pennsylvania Rhode Island Vermont MIDWEST Illinois Indiana Iowa Kansas Michigan Minnesota Missouri Nebraska North Dakota Ohio South Dakota Wisconsin SOUTH Alabama Arkansas Delaware District of Columbia Florida Georgia Kentucky Louisiana Maryland Mississippi North Carolina Oklahoma South Carolina Tennessee Texas Virginia West Virginia WEST Alaska Arizona California Colorado Hawaii Idaho Montana Nevada New Mexico Oregon Utah Washington Wyoming 0 0 4 8 12 16 4 8 12 16 *–1.9 *–1.0 –0.3 –0.1 –0.3 *–1.5 *–1.8 *–1.0 *–3.8 –1.2 *–0.4 *–1.4 *–1.5 –0.7 *–0.9 *–2.8 –0.6 0.0 –0.2 *–0.8 *–1.1 *–0.3 Z *–1.4 Z –0.3 *–0.2 Z *0.5 *0.7 *1.4 *–0.8 *–1.3 –0.2 *–0.5 0.5 0.3 *–1.2 *–2.0 *–4.2 1.4 0.2 –0.8 3.4 *–1.3 –0.3 –0.9 0.1 *–4.1 *–2.7 *–2.1 *–1.8 *–1.3 *–1.9 *–1.1 *–2.0 *–1.2 *–1.0 *–0.5 *–0.9 *–2.4 0.4 0.9 *1.3 0.3 0.6 Z –0.8 –0.1 *–1.0 *–0.8 –0.1 –0.1 –0.5 *–1.1 *–0.9 –0.3 –0.5 *–2.6 *–3.2 *–4.3 *–3.4 –0.4 *–4.2 *–4.4 *–7.3 *–3.4 *–2.2 *–1.6 *–3.2 *–2.5 –0.6 *–0.4 *–1.3 0.2 *1.6 0.6 –0.1 *–1.1 *–1.7 0.2 0.2 *4.3 *–3.4 * Denotes a statistically significant change between 2013 and 2019, or between 2019 and 2023, at the 90 percent confidence level. Z Represents or rounds to zero. Note: For information on expansion status, refer to Appendix Table A-1. For information on confidentiality protection, sampling error, nonsampling error, and definitions in the American Community Survey, refer to <https://www2.census.gov/programs-surveys/acs/tech_docs/accuracy/ACS_Accuracy_of_Data_2023.pdf>. Source: U.S. Census Bureau, 2013, 2019, and 2023 American Community Survey, 1-year estimates. U.S. Census Bureau 5 California, Colorado, and New York (Appendix Table B-2). From 2019 to 2023, in the 17 states where child uninsured rates declined, 11 of these states experienced increases in just public coverage—specifically, private coverage decreased in three states and did not change in eight states (Table 3). Texas was the one state that reported only an increase in private coverage (no change in public coverage), while Illinois reported an increase in both private and public coverage. No states had decreases in public coverage. WORKING-AGE ADULTS: STATE-LEVEL CHANGES IN UNINSURED, PUBLIC, AND PRIVATE COVERAGE RATES Changes From 2013 to 2019 The uninsured rate for working- age adults decreased in every state plus the District of Columbia from 2013 to 2019, with decreases ranging from 1.1 percentage points to 13.2 percentage points (Appendix Table B-4). Nationally, the uninsured rate for working-age adults declined 7.6 percentage points, from 20.5 percent in 2013 to 12.9 percent in 2019. The 11 states with the largest declines in the uninsured rate for working-age Table 3. adults (10 percentage points or more) were Medicaid expansion states. Private coverage for working-age adults increased in 44 states plus the District of Columbia from 2013 to 2019, with Florida reporting the largest increase (60.1 percent to 69.9 percent). Private coverage decreased in no states (Appendix Table B-4). Private coverage for working-age adults increased for the nation from 68.3 percent to 72.8 percent between 2019 and 2023. From 2013 to 2019, public coverage for working-age adults increased in 36 states and decreased in Maine, Texas, and Utah (Appendix Table B-4). Maine, Texas, and Utah had not expanded Medicaid during this period. Among the 36 states with increases in public coverage for working-age adults, 29 expanded Medicaid during this period. At the national level, public coverage for working-age adults increased from 14.3 percent to 17.7 percent. Working-age adults in New Mexico experienced the largest increase, from 19.1 percent to 32.5 percent, while working-age adults in Maine reported the largest decrease, from 21.8 percent to 19.3 percent. New Mexico’s increase in public coverage for the working-age population is likely due to an increase in total Medicaid enrollment during this period, as it expanded Medicaid in 2014.6 Changes From 2019 to 2023 The uninsured rate for working- age adults dropped in 42 states from 2019 to 2023, and no state had increased uninsured rates (Appendix Table B-4). At the national level, the uninsured rate for working-age adults fell 1.8 percentage points, from 12.9 percent in 2019 to 11 percent in 2023. Three of the five states where the uninsured rate for working-age adults fell by more than 3 percentage points were Medicaid expansion states. By 2023, ten states and the District of Columbia had uninsured rates of 7 percent or less for this age group (Figure 3). In 16 states, working-age adults had higher rates of private coverage in 2023 compared with 2019. In five states (Maryland, New Jersey, New York, Oklahoma, and Virginia), private coverage rates fell between 2019 and 2023 (Appendix Table B-4). At the national level, 6 Data.medicaid.gov, “State Medicaid and CHIP Applications, Eligibility Determinations, and Enrollment Data,” <https://data. medicaid.gov/dataset/6165f45b-ca93- 5bb5-9d06-db29c692a360?conditions[0] [property]=state>. Number of States Where the Uninsured Rate for Children Decreased by Changes in Public and Private Coverage: 2019 to 2023 Characteristic    Total states where uninsured    rate decreased . . . . . . . . . . . . . Public coverage increased . . . . . . . . . . . . Public coverage decreased . . . . . . . . . . . No change in public coverage . . . . . . . . Total Private coverage increased Private coverage decreased No change in private coverage 17 12 Z 5 2 1 Z 1 3 3 Z Z 12 8 Z 4 Z Represents zero. Source: U.S. Census Bureau, 2019 and 2023 American Community Survey, 1-year estimates. 6 U.S. Census Bureau Figure 3. Uninsured Rate of Working-Age Adults Aged 19 to 64 by State: 2023 (Civilian noninstitutionalized population) AK 0 500 Miles WA OR ID MT WY NV UT CA CO AZ NM HI 0 100 Miles ND SD NE TX KS OK MN IA MO AR LA ME VT NH MA CT NJ DE MD RI DC WI MI NY IL IN OH WV KY TN PA VA NC MS AL GA 0 100 Miles SC FL Percentage without health insurance coverage 14.0 or more 10.0 to 13.9 7.0 to 9.9 Less than 7.0 U.S. uninsured rate for working-age adults is 11.0 percent. A state abbreviation surrounded by the " " symbol denotes that the state expanded Medicaid eligibility on or before January 1, 2023. Note: For information on confidentiality protection, sampling error, nonsampling error, and definitions in the American Community Survey, refer to <https://www2.census.gov/programs-surveys/acs/tech-docs/accuracy/ACS-Accuracy_of_Data_2023.pdf>. Source: U.S. Census Bureau, 2023 American Community Survey, 1-year estimates. private coverage for working-age adults increased from 72.8 percent to 73.5 percent in 2023. Public coverage rates for working-age adults increased in 36 states and decreased in Arizona and Arkansas from 2019 to 2023 (Appendix Table B-4). In Oklahoma, working-age adults experienced the largest increase in public coverage, from 13.7 percent in 2019 to 21 percent in 2023. Of the states where public coverage increased, 26 of the 36 states expanded Medicaid (Table A-1). Public coverage in the United States grew from 17.7 percent to 19.5 percent from 2019 to 2023. Summary of Changes for Working-Age Adults Uninsured rates declined in all 50 states and the District of Columbia for working-age adults between 2013 and 2019; 30 states had increases in both private and public coverage, 12 had increases in private coverage only with no increase in public coverage, three had increases in private coverage while public coverage decreased, and six reported increases in just public coverage with no change in private coverage (Table 4). No state experienced a decrease in private coverage. U.S. Census Bureau 7 From 2019 to 2023, the uninsured rate for working-age adults declined in 42 states. Of these states, 27 had increases only in public coverage (private coverage decreased in four and did not change in 23). Private coverage increased in 15 states, seven of which also had an increase in public coverage, one of which had a decrease in public coverage, and seven of which had no change in public coverage (Table 5). ADULTS AGED 65 AND OLDER: STATE-LEVEL CHANGES IN UNINSURED, PUBLIC, AND PRIVATE COVERAGE RATES Changes From 2013 to 2019 Adults aged 65 and older may have coverage through Medicare alone, combinations of public and private coverage (e.g., Table 4. Medicare with private secondary Medigap plans), public coverage combinations (e.g., Medicare and Medicaid), or, in rare instances, private coverage alone if ineligible for Medicare (noncitizens or unqualified residents) or delaying Medicare enrollment.7 As a result, people in this age group have low uninsured rates, ranging from 0.1 percent to 2.1 percent in 2013 (Appendix Table B-5). The uninsured rate for adults aged 65 and older decreased in 14 states from 2013 to 2019 (Appendix Table B-6). Private coverage for those aged 65 and older dropped in 48 states from 2013 to 2019, with changes ranging from 1.4 percentage points to 8.7 percentage points 7 More information on Medigap plans can be found at <www.medicare.gov/ publications/02110-medigap-guide-health- insurance.pdf>. (Appendix Table B-6 and Figure 4). Private coverage rates for this age group ranged from 53.4 percent to 76.5 percent in 2013 among states and the District of Columbia, and from 48.8 percent to 70.5 percent in 2019. Public coverage for adults aged 65 and older decreased from 0.3 percentage points to 1.1 percentage points in 23 states and increased in three states from 2013 to 2019 (Appendix Table B-6). In 2013, public coverage for this group ranged from 92 percent to 98.4 percent among states and the District of Columbia, and from 90.6 percent to 98.3 percent in 2019. Changes From 2019 to 2023 The uninsured rate for those aged 65 and older increased in seven states from 2019 to 2023. Adults aged 65 and older in Florida Number of States Where the Uninsured Rate for Working-Age Adults Decreased by Changes in Public and Private Coverage: 2013 to 2019 Characteristic    Total states where uninsured     rate decreased . . . . . . . . . . . . . Public coverage increased . . . . . . . . . . . . Public coverage decreased . . . . . . . . . . . No change in public coverage . . . . . . . . Total Private coverage increased Private coverage decreased No change in private coverage 51 36 3 12 45 30 3 12 Z Z Z Z 6 6 Z Z Z Represents zero. Source: U.S. Census Bureau, 2013 and 2019 American Community Survey, 1-year estimates. Table 5. Number of States Where the Uninsured Rate for Working-Age Adults Decreased by Changes in Public and Private Coverage: 2019 to 2023 Characteristic    Total states where uninsured     rate decreased . . . . . . . . . . . . . Public coverage increased . . . . . . . . . . . . Public coverage decreased . . . . . . . . . . . No change in public coverage . . . . . . . . Total Private coverage increased Private coverage decreased No change in private coverage 42 34 1 7 15 7 1 7 4 4 Z Z 23 23 Z Z Z Represents zero. Source: U.S. Census Bureau, 2019 and 2023 American Community Survey, 1-year estimates. 8 U.S. Census Bureau Figure 4. Private Insurance Coverage Rates for Adults Aged 65 and Older: 2023, 2019, and 2013 (Civilian noninstitutionalized population) 2023 2019 2013 0 10 20 30 40 50 60 70 80 0 10 20 30 40 50 60 70 80 0 10 20 30 40 50 60 70 80 UNITED STATES NORTHEAST Connecticut Maine Massachusetts New Hampshire New Jersey New York Pennsylvania Rhode Island Vermont MIDWEST Illinois Indiana Iowa Kansas Michigan Minnesota Missouri Nebraska North Dakota Ohio South Dakota Wisconsin SOUTH Alabama Arkansas Delaware District of Columbia Florida Georgia Kentucky Louisiana Maryland Mississippi North Carolina Oklahoma South Carolina Tennessee Texas Virginia West Virginia WEST Alaska Arizona California Colorado Hawaii Idaho Montana Nevada New Mexico Oregon Utah Washington Wyoming 2013 to 2019 change 2019 to 2023 change *–4.6 *–4.6 *–4.8 *–2.2 *–5.8 *–3.2 *–1.4 *–4.6 *–5.0 –2.8 *–5.8 *–7.5 *–8.0 *–4.7 *–5.6 *–4.2 *–7.7 *–7.4 *–8.7 *–5.4 *–7.1 *–6.2 *–4.2 *–3.9 *–5.3 –4.0 *–4.4 *–4.0 *–4.3 *–6.2 *–2.2 *–2.7 *–4.1 *–2.2 *–2.3 *–6.1 *–5.6 *–4.2 *–6.1 *–4.3 *–7.0 *–7.6 *–3.3 *–6.2 *–7.5 *–3.3 *–3.8 *–3.6 *–3.6 *–5.0 *–5.5 *–5.1 *–5.9 *–6.3 *–4.4 *–6.0 *–3.8 *–6.3 *–6.4 0.3 –0.1 *–4.0 *–4.4 *–5.1 –3.1 *–3.1 *–4.2 *–5.4 –1.4 *–2.3 *–2.2 *–5.4 *–5.4 *–4.1 *–4.6 *–3.2 *–5.4 *–5.3 *–4.5 *–4.4 *–3.7 *–7.4 –0.5 *–5.6 *–5.8 *–5.1 *–2.5 *–3.9 *–3.4 *–7.7 *–7.8 0.8 *–4.0 *–2.4 *–5.7 *–7.5 –0.8 –2.1 *–2.2 –0.6 *–5.3 *–7.5 *–6.4 –3.4 0 10 20 30 40 50 60 70 80 * Denotes a statistically significant change between 2013 and 2019, or between 2019 and 2023, at the 90 percent confidence level. Note: For information on expansion status, refer to Appendix Table A-1. For information on confidentiality protection, sampling error, nonsampling error, and definitions in the American Community Survey, refer to <https://www2.census.gov/programs-surveys/acs/tech_docs/accuracy/ACS_Accuracy_of_Data_2023.pdf>. Source: U.S. Census Bureau, 2013, 2019, and 2023 American Community Survey, 1-year estimates. U.S. Census Bureau 9 UNITED STATES NORTHEAST Connecticut Maine Massachusetts New Hampshire New Jersey New York Pennsylvania Rhode Island Vermont MIDWEST Illinois Indiana Iowa Kansas Michigan Minnesota Missouri Nebraska North Dakota Ohio South Dakota Wisconsin SOUTH Alabama Arkansas Delaware Florida Georgia Kentucky Louisiana Maryland Mississippi North Carolina Oklahoma South Carolina Tennessee Texas Virginia West Virginia WEST Alaska Arizona California Colorado Hawaii Idaho Montana Nevada New Mexico Oregon Utah Washington Wyoming District of Columbia experienced a slight decrease in the uninsured, public, and private coverage rates during this period (Appendix Table B-6). There was no change in uninsurance at the national level for adults aged 65 and older between 2019 and 2023. Private coverage for adults aged 65 and older decreased in 42 states from 2019 to 2023, ranging from 2.2 percentage points to 7.6 percentage points (Appendix Table B-6 and Figure 4). Nationally, private coverage declined for this age group, from 58 percent to 53.7 percent between 2019 and 2023. By 2023, private coverage for this age group ranged from 46.6 percent to 69.1 percent across the states and the District of Columbia. From 2019 to 2023, public coverage for adults aged 65 and older fell 1.7 percentage points to 0.4 percentage points in 35 states and increased in North Dakota and the District of Columbia (Appendix Table B-6). In 2023, public coverage Table 6. for those aged 65 and older ranged from 92.5 percent to 97.8 percent. Maryland reported the lowest public coverage in 2023, at 92.5 percent. Public coverage in the United States for adults aged 65 and older declined slightly between 2019 and 2023, from 95.9 percent to 95.2 percent. Summary of Changes for Adults Aged 65 and Older The uninsured rate for adults 65 and older declined in 14 states between 2013 and 2019. Five of these states had a decrease in both public and private coverage (Table 6), and two had an increase in public coverage with a decrease in private coverage. An additional seven states had a decrease in private coverage but no change in public coverage for this age group. While only one state had a decrease in the uninsured rate, seven states had an increase in the uninsured rate for adults aged 65 and over between 2019 and 2023. Of those seven states, six states observed a decrease in both private and public coverage for this age group. Florida was the only state that reported a decline in private coverage but not in public coverage (Table 7) for adults aged 65 and over. Because people in this age group often have more than one type of health insurance, a decrease in the uninsured rate may happen even when coverage rates are going down. A recent America Counts story presented results demonstrating that the percentage of people with only Medicare has been rising as the percentage with a combination of Medicare and private coverage has declined.8 Since 2013, the uninsured rate of adults aged 65 and older has remained low and stable, at around 8 Rachel Lindstrom, Katherine Keisler- Starkey, and Lisa Bunch, “Dual Health Insurance Coverage Declining for Adults Age 65 and Over,” U.S. Census Bureau, 2024, <www.census.gov/library/stories/2024/04/ older-adults-health-coverage.html>. Number of States Where the Uninsured Rate of Adults Aged 65 or Older Decreased by Changes in Public and Private Coverage: 2013 to 2019 Characteristic    Total states where uninsured    rate decreased . . . . . . . . . . . . . . Public coverage increased . . . . . . . . . . . . Public coverage decreased . . . . . . . . . . . No change in public coverage . . . . . . . . Total Private coverage increased Private coverage decreased No change in private coverage 14 2 5 7 Z Z Z Z 14 2 5 7 Z Z Z Z Z Represents zero. Source: U.S. Census Bureau, 2013 and 2019 American Community Survey, 1-year estimates. Table 7. Number of States Where the Uninsured Rate of Adults Aged 65 and Over Increased by Changes in Public and Private Coverage: 2019 to 2023 Characteristic    Total states where uninsured    rate increased . . . . . . . . . . . . . . Public coverage increased . . . . . . . . . . . . Public coverage decreased . . . . . . . . . . . No change in public coverage . . . . . . . . Total Private coverage increased Private coverage decreased No change in private coverage 7 Z 6 1 Z Z Z Z 7 Z 6 1 Z Z Z Z Z Represents zero. Source: U.S. Census Bureau, 2019 and 2023 American Community Survey, 1-year estimates. 10 U.S. Census Bureau Figure 5. Health Insurance Coverage for Adults Aged 65 and Older With Coverage Combinations and With Any Private Insurance: 2013, 2019, and 2023 (Civilian noninstitutionalized population) Percentage of coverage combinations of adults aged 65 and older 36.4 41.2 45.5 Public only Public and private Private only Uninsured Percentage with ANY private health insurance 62.6 58.0 53.7 59.9 54.7 49.7 1.3 2.7 2013 0.8 0.8 3.3 2019 4.0 2023 2013 2019 2023 Note: For information on confidentiality protection, sampling error, nonsampling error, and definitions in the American Community Survey, refer to <https://www2.census.gov/programs-surveys/acs/tech_docs/accuracy/ACS_Accuracy_of_Data_2023.pdf>. Source: U.S. Census Bureau, 2013, 2019, and 2023 American Community Survey, 1-year estimates. 1 percent, and the rate with any public coverage has remained high, at around 95 percent. Thus, changes in coverage types for this age group are driven by fewer people having public and private coverage concurrently (Figure 5). By 2023, more adults in this age group relied on public coverage alone as the percentage with public coverage and a private plan has decreased. UNINSURED RATES BY THREE MAJOR AGE GROUPS AMONG TOP 25 METRO AREAS: 2019 AND 2023 Children Under the Age of 19 Among the 25 most populous metropolitan areas in the country, children experienced declines in the uninsured rates in three major metros (Atlanta, Chicago, and Los Angeles) from 2019 and 2023 (Appendix Table B-8). Working-Age Adults Aged 19 to 64 Working-age adults in every major metropolitan area (except for the Baltimore and San Francisco areas) had decreases in the uninsured rate from 2019 to 2023 (Appendix Table B-8). Working-age adults in the Miami area had the largest decrease in the uninsured rate, from 21.9 percent in 2019 to 16.5 percent in 2023. This comports with the decrease in the uninsured rate in Florida of 19.5 percent in 2019 to 15.5 percent in 2023. U.S. Census Bureau 11 CHANGES IN HEALTH INSURANCE TYPES: 2022 TO 2023 This brief focuses on changes from 2013 to 2019, and from 2019 to 2023, recognizing that events over the last decade influenced the health insurance environment. An interactive data visualization accompanies this brief, allowing users to compare 2022 and 2023 estimates for specific health insurance subtypes for the three major age groups by state, recognizing that events over the past year may also have influenced the health insurance environment. Among other features, the interactive tool provides a matrix that allows users to view all statistically significant changes in insurance types for all states and for each age group, highlight a specific insurance type, filter states by the direction of change, or focus on the changes for a specific state. Public policy changes during the COVID-19 pandemic included the establishment of the Public Health Emergency that allowed Medicaid enrollees to remain covered under the continuous enrollment provision. Starting in April 2023, states began the process of terminating Medicaid coverage for enrollees who were no longer eligible. The end of this provision may have had an effect on coverage types across states. States began disenrolling people from Medicaid in different months, with some states starting in April, others in May, June, and July or later.1 At the same time, the American Community Survey collected data about health insurance coverage throughout 2023, with respondents reporting health insurance coverage status at the time of the interview. ¹ More information can be found at <www.kff.org/report-section/medicaid-enrollment-and-unwinding-tracker-overview/>and <www. census.gov/library/visualizations/interactive/health-insurance-coverage-and-type-by-state.html>. Source: U.S. Census Bureau. 12 U.S. Census Bureau CHANGES IN HEALTH INSURANCE TYPES: 2022 TO 2023—Con. Between 2022 and 2023 The uninsured rate for children increased in six states: Alabama, Louisiana, New Mexico, South Carolina, Texas, and Washington. Medicaid coverage for children declined in seven states (Arkansas, Florida, Idaho, Illinois, Maryland, Texas, and West Virginia) and increased in five (Iowa, Missouri, New Mexico, Tennessee, and Wyoming). Uninsured rates for working-age adults declined in 14 states and increased in Connecticut, Iowa, and New Jersey. Medicaid coverage for working-age adults increased in 11 states and decreased in Arkansas, Idaho, New Hampshire, and West Virginia. Private coverage for adults aged 65 and older declined in 24 states, driven by declines in direct-purchase coverage. Adults Aged 65 and Older Between 2019 and 2023, the uninsured rate for adults aged 65 and older increased slightly in the Detroit area (0.4 percent to 0.7 percent) and fell slightly in the Washington, DC, area (1.6 percent to 1.2 percent) (Appendix Table B-8). The increase in the uninsured rate in Detroit is commensurate with an increase in the uninsured in the state of Michigan. SUMMARY Most of the increases in health insurance coverage—both decreases in the uninsured rate and increases in public and private coverage for all three age groups—occurred during the ACA implementation period of 2013 to 2019. This was especially true for children and working- age adults, although increases in public coverage for children and working-age adults were quite similar in both periods. This may be attributable to additional states expanding Medicaid since 2019. Private coverage increased in more states from 2013 to 2019 than between 2019 and 2023 for working-age adults and children, and this may be a result of increases in marketplace coverage, increasing employment, and other ACA-related measures that affect private coverage. The uninsured rate for adults aged 65 and over decreased in more states between 2013 and 2019 than between 2019 and 2023, this is likely due to changes in private alone and public alone coverage and could be attributable to policies in the ACA that directly made Medicare more affordable.9 SOURCE AND ACCURACY The data presented in this brief are based on the ACS sample interviewed from January 2013 through December 2013 (2013 ACS), from January 2019 through December 2019 (2019 ACS), and from January 2023 through December 2023 (2023 ACS). The estimates based on these samples describe the average values of person, household, and housing unit characteristics over the period of collection. Data presented in this brief are subject to sampling and nonsampling error. Sampling 9 Kaiser Family Foundation, “The Affordable Care Act 101,” 2024, <www.kff.org/ health-policy-101-the-affordable-care-act/>. error is the uncertainty between an estimate based on a sample and the corresponding value that would be obtained if the estimates were based on the entire population (as from a census). Measures of sampling error are provided in the form of margins of error for all estimates included in this brief. All comparative statements in this brief have undergone statistical testing, and comparisons are significant at the 90 percent confidence 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, refer to the “2023 ACS Accuracy of the Data” document at <https://www2. census.gov/programs-surveys/ acs/tech_docs/accuracy/ACS_ Accuracy_of_Data_2023.pdf>. U.S. Census Bureau 13 Table A-1. Medicaid Expansion States Year of Expansion States Medicaid Expansion States As of January 1, 2014 Arizona, Arkansas, California, Colorado, Connecticut, Delaware, District of Columbia, Hawaii, Illinois, Iowa, Kentucky, Maryland, Massachusetts, Minnesota, Nevada, New Jersey, New Mexico, New York, North Dakota, Ohio, Oregon, Rhode Island, Vermont, Washington, and West Virginia After January 1, 2014, and on or before January 1, 2015 Michigan, New Hampshire, and Pennsylvania After January 1, 2015, and on or before January 1, 2016 Alaska, Indiana, and Montana After January 1, 2016, and on or before January 1, 2017 Louisiana After January 1, 2017, and on or before January 1, 2018 No states expanded Medicaid during this period. After January 1, 2018, and on or before January 1, 2019 Virginia After January 1, 2019, and on or before January 1, 2020 Maine (coverage retroactive to July 2018), Idaho, and Utah After January 1, 2019, and on or before January 1, 2020 Nebraska After January 1, 2021, and on or before January 1, 2022 Missouri and Oklahoma After January 1, 2022, and on or before January 1, 2023 No states expanded Medicaid during this period. Source: Kaiser Family Foundation, “Status of State Medicaid Expansion Decisions: Interactive Map,” <www.kff.org/affordable-care-act/ issue-brief/status-of-state-medicaid-expansion-decisions-interactive-map/>. 14 U.S. Census Bureau . n o C — 3 2 0 2 d n a , 9 1 0 2 , 3 1 0 2 : e t a t S y b e g a r e v o C c i l b u P r o e t a v i r P h t i W , d e r u s n n U 9 1 i f o e g A e h t r e d n U n e r d l i h C f o e g a t n e c r e P l . 1 - B e b a T x d n e p p A i . 2 w w w / / : s p t t h < o t r e f e r , s n o i t i n i f e d d n a , r o r r e g n i l p m a s n o n , r o r r e g n i l p m a s , n o i t c e t o r p y t i l a i t n e d i f n o c n o n o i t a m r o f n i r o F . l n o i t a u p o p d e z i l a n o i t u t i t s n n o n n a i i l i i v C ( . ) > f d p 3 2 0 2 _ a t a D _ f o _ y c a r u c c A _ S C A / y c a r u c c a / s c o d _ h c e t / s c a / s y e v r u s - s m a r g o r p / v o g s u s n e c . e g a r e v o c c i l b u P e g a r e v o c e t a v i r P f o 1 r o r r e i n g r a M f o 1 r o r r e i n g r a M f o 1 r o r r e i n g r a M f o 1 r o r r e i n g r a M f o 1 r o r r e i n g r a M f o 1 r o r r e i n g r a M f o 1 r o r r e i n g r a M f o 1 r o r r e i n g r a M d e r u s n n U i f o 1 r o r r e i n g r a M ) ± ( 2 . 0 2 . 1 1 . 3 1 . 1 5 . 1 5 . 0 0 . 1 4 . 1 8 . 2 7 . 4 6 . 0 8 . 0 0 . 2 4 . 1 8 . 0 8 . 0 1 . 1 3 . 1 2 . 1 4 . 1 1 . 2 0 . 1 1 . 1 8 . 0 0 . 1 6 . 1 9 . 0 9 . 1 6 . 1 7 . 1 1 . 2 8 . 0 9 . 1 6 . 0 9 . 0 2 . 2 8 . 0 0 . 1 2 . 1 8 . 0 6 . 2 3 2 0 2 4 . 9 3 7 . 5 4 3 . 9 3 8 . 6 3 3 . 8 4 7 . 3 4 8 . 4 3 2 . 7 3 6 . 9 3 1 . 9 3 8 . 9 3 8 . 1 4 1 . 5 3 5 . 4 3 4 . 6 3 7 . 7 3 2 . 8 3 7 . 1 3 1 . 7 4 4 . 4 5 7 . 6 3 6 . 3 3 4 . 5 3 3 . 9 3 0 . 2 3 7 . 8 4 9 . 6 3 1 . 9 3 5 . 1 3 0 . 9 3 8 . 9 2 2 . 4 3 7 . 0 6 6 . 4 4 9 . 1 4 4 . 2 2 2 . 8 3 3 . 7 4 8 . 0 4 3 . 9 3 8 . 6 3 ) ± ( 2 . 0 2 . 1 7 . 2 0 . 1 5 . 1 4 . 0 0 . 1 3 . 1 0 . 3 8 . 3 7 . 0 8 . 0 7 . 1 8 . 1 7 . 0 9 . 0 3 . 1 1 . 1 2 . 1 2 . 1 1 . 2 0 . 1 0 . 1 7 . 0 9 . 0 6 . 1 0 . 1 3 . 2 5 . 1 3 . 1 1 . 2 8 . 0 7 . 1 7 . 0 8 . 0 4 . 2 7 . 0 0 . 1 3 . 1 6 . 0 5 . 2 9 1 0 2 1 . 8 3 7 . 4 4 7 . 8 3 4 . 7 3 1 . 1 5 7 . 2 4 3 . 2 3 7 . 6 3 7 . 9 3 9 . 2 4 6 . 0 4 2 . 9 3 5 . 3 3 3 . 6 3 4 . 5 3 1 . 3 3 6 . 6 3 7 . 9 2 4 . 4 4 2 . 1 5 3 . 5 3 8 . 4 3 6 . 4 3 5 . 7 3 4 . 1 3 0 . 1 5 7 . 2 3 0 . 2 4 4 . 7 2 0 . 3 3 4 . 8 2 5 . 1 3 0 . 7 5 3 . 1 4 4 . 1 4 5 . 0 2 3 . 6 3 3 . 3 4 6 . 7 3 1 . 8 3 2 . 3 3 ) ± ( 2 . 0 9 . 0 9 . 1 9 . 0 3 . 1 3 . 0 9 . 0 1 . 1 3 . 2 9 . 2 7 . 0 7 . 0 6 . 1 9 . 1 6 . 0 8 . 0 0 . 1 1 . 1 1 . 1 2 . 1 9 . 1 9 . 0 9 . 0 6 . 0 9 . 0 3 . 1 0 . 1 0 . 2 4 . 1 6 . 1 2 . 2 6 . 0 3 . 1 5 . 0 8 . 0 8 . 1 7 . 0 0 . 1 2 . 1 6 . 0 2 . 2 3 1 0 2 5 . 7 3 6 . 3 4 6 . 2 3 1 . 7 3 0 . 1 5 8 . 0 4 6 . 0 3 5 . 2 3 4 . 7 3 1 . 9 4 4 . 0 4 1 . 9 3 8 . 0 3 5 . 3 3 0 . 0 4 5 . 3 3 3 . 3 3 1 . 1 3 8 . 9 3 1 . 8 4 9 . 9 3 4 . 1 3 5 . 2 3 1 . 9 3 3 . 5 2 7 . 0 5 0 . 3 3 9 . 6 3 4 . 9 2 8 . 7 2 8 . 8 2 4 . 9 2 7 . 2 5 0 . 0 4 7 . 1 4 1 . 1 2 2 . 5 3 2 . 2 4 8 . 6 3 6 . 4 3 6 . 5 3 ) ± ( 2 . 0 2 . 1 8 . 2 1 . 1 3 . 1 4 . 0 1 . 1 4 . 1 9 . 2 5 . 5 7 . 0 8 . 0 8 . 1 5 . 1 8 . 0 9 . 0 1 . 1 2 . 1 1 . 1 4 . 1 4 . 2 0 . 1 0 . 1 8 . 0 1 . 1 6 . 1 0 . 1 9 . 1 5 . 1 6 . 1 0 . 2 8 . 0 8 . 1 6 . 0 9 . 0 0 . 2 8 . 0 0 . 1 3 . 1 8 . 0 8 . 2 3 2 0 2 . 6 0 6 3 . 5 5 2 . 0 6 . 7 9 5 8 . 9 4 4 . 8 5 2 . 6 6 1 . 4 6 1 . 2 6 1 . 6 6 . 7 6 5 . 7 6 5 2 . 9 6 3 . 5 6 9 . 4 6 . 7 1 6 . 7 5 6 1 . 8 6 0 . 5 5 . 4 7 4 4 . 5 6 0 . 6 6 5 . 9 6 0 . 5 6 0 . 1 7 . 7 9 4 3 . 2 6 . 7 8 5 4 . 0 7 . 0 0 6 3 . 1 7 5 . 5 6 . 7 0 4 . 9 9 5 . 5 7 5 . 1 9 7 4 . 2 6 2 . 1 5 . 0 3 6 9 . 2 6 . 7 7 6 ) ± ( 2 . 0 1 . 1 6 . 2 9 . 0 5 . 1 4 . 0 0 . 1 2 . 1 8 . 2 6 . 3 . 7 0 9 . 0 9 . 1 0 . 2 . 7 0 0 . 1 4 . 1 1 . 1 2 . 1 2 . 1 2 . 2 1 . 1 0 . 1 . 7 0 9 . 0 6 . 1 9 . 0 0 . 2 4 . 1 2 . 1 0 . 2 . 7 0 6 . 1 6 0 . 8 . 0 2 . 2 . 7 0 9 . 0 4 . 1 . 7 0 9 . 2 9 1 0 2 3 . 0 6 5 . 5 5 2 . 8 5 . 4 7 5 . 0 7 4 . 8 7 5 4 . 5 6 4 . 4 6 4 . 1 6 4 . 0 6 9 . 4 5 . 1 7 5 . 1 9 6 . 1 3 6 6 . 3 6 . 7 3 6 1 . 6 6 . 7 8 6 5 . 5 5 3 . 8 4 6 . 5 6 . 7 5 6 . 7 9 6 . 7 4 6 . 6 0 7 8 . 5 4 0 . 4 6 . 4 7 5 . 9 9 6 8 . 1 6 9 . 0 7 9 . 6 6 2 . 3 4 6 . 1 6 1 . 6 5 2 . 6 7 5 . 3 6 6 . 2 5 8 . 2 6 5 . 3 6 . 0 3 7 ) ± ( 2 . 0 0 . 1 2 . 2 9 . 0 3 . 1 3 . 0 9 . 0 2 . 1 3 . 2 . 1 3 . 7 0 8 . 0 . 7 1 8 . 1 6 0 . 9 . 0 9 . 0 2 . 1 0 . 1 2 . 1 9 . 1 9 . 0 9 . 0 6 0 . 8 . 0 3 . 1 9 . 0 8 . 1 4 . 1 6 . 1 0 . 2 6 0 . 4 . 1 6 0 . 8 . 0 8 . 1 . 7 0 0 . 1 4 . 1 . 7 0 0 . 2 5 . 8 5 5 . 5 5 . 9 9 5 0 . 4 5 . 7 6 4 3 . 4 5 . 7 3 6 3 . 6 6 4 . 2 6 1 . 6 5 3 . 0 5 . 7 3 5 . 9 9 6 3 . 1 6 . 7 8 5 2 . 1 6 . 9 7 6 1 . 6 6 . 5 7 5 8 . 9 4 9 . 0 6 . 1 7 6 . 6 0 7 8 . 1 6 8 . 2 7 9 . 4 4 2 . 3 6 5 . 6 5 2 . 8 6 . 9 9 5 3 . 0 7 . 2 7 6 4 . 2 4 . 6 0 6 4 . 4 5 8 . 5 7 2 . 3 6 3 . 1 5 8 . 0 6 1 . 5 6 1 . 4 6 . 1 0 5 . 0 0 . 1 . 7 0 9 . 0 2 . 0 4 . 0 6 0 . 6 . 1 9 . 0 3 . 0 4 . 0 . 7 0 8 . 0 3 . 0 6 0 . 4 . 0 6 0 . 4 . 0 5 . 0 8 . 0 6 0 . 3 . 0 3 . 0 4 . 0 8 . 0 6 0 . 2 . 1 6 0 . 0 . 1 9 . 0 3 . 0 9 . 0 2 . 0 4 . 0 . 7 0 4 . 0 5 . 0 5 . 0 4 . 0 1 . 1 4 . 5 9 . 3 9 . 6 6 . 8 . 7 6 2 . 3 1 . 4 4 . 3 8 . 4 3 . 1 5 7 . 4 . 6 . 0 3 6 . 6 2 . 3 9 . 5 4 . 3 6 . 5 4 . 3 3 . 4 2 . 4 . 7 4 5 . 1 . 0 3 4 . 3 0 . 6 4 . 5 8 . 6 . 7 3 9 7 . 4 . 3 1 . 4 9 . 5 8 . 2 2 . 5 6 . 3 9 . 4 5 7 . . 0 3 2 . 5 3 . 3 3 1 0 2 ) ± ( 3 2 0 2 ) ± ( . 1 0 3 . 0 3 . 1 6 0 . . 7 0 2 . 0 6 0 . 5 . 0 4 . 1 9 . 0 4 . 0 5 . 0 . 7 0 8 . 0 3 . 0 6 0 . 5 . 0 . 7 0 5 . 0 6 0 . 1 . 1 5 . 0 2 . 0 3 . 0 4 . 0 . 7 0 5 . 0 9 . 0 8 . 0 9 . 0 9 . 0 4 . 0 9 . 0 2 . 0 4 . 0 5 . 1 3 . 0 6 0 . 6 0 . 3 . 0 . 7 0 7 . 5 5 . 3 4 . 9 2 . 9 9 . 5 6 . 3 5 . 5 5 . 3 8 . 4 0 . 2 6 . 7 4 . 7 8 . 2 0 . 5 0 . 4 1 . 7 9 . 2 8 . 5 3 . 4 4 . 4 6 . 5 4 . 3 5 . 1 4 . 3 1 . 3 1 . 6 5 . 6 2 . 6 7 . 5 0 . 8 7 . 3 3 . 4 7 . 5 4 . 2 8 . 5 8 . 7 8 . 4 6 . 8 1 . 4 6 . 4 9 . 1 9 1 0 2 ) ± ( 1 . 0 5 . 0 6 . 1 7 . 0 7 . 0 2 . 0 5 . 0 5 . 0 0 . 1 1 . 1 4 . 0 5 . 0 6 . 0 0 . 1 3 . 0 5 . 0 5 . 0 6 . 0 5 . 0 4 . 0 9 . 0 5 . 0 2 . 0 2 . 0 4 . 0 8 . 0 6 . 0 4 . 1 7 . 0 1 . 1 7 . 0 4 . 0 1 . 1 2 . 0 4 . 0 2 . 1 3 . 0 5 . 0 6 . 0 3 . 0 0 . 1 3 1 0 2 5 . 7 8 . 4 0 . 2 1 4 . 2 1 1 . 6 9 . 7 8 . 8 5 . 4 7 . 4 9 . 2 7 . 1 1 1 . 0 1 2 . 3 2 . 9 4 . 4 5 . 8 4 . 4 5 . 6 4 . 6 2 . 6 9 . 5 7 . 4 6 . 1 4 . 4 9 . 5 0 . 8 1 . 7 7 . 5 6 . 0 1 3 . 5 1 0 . 4 8 . 5 1 . 9 2 . 4 8 . 6 0 . 8 5 . 5 3 . 6 5 . 5 7 . 5 6 . 0 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . e t a t S s e t a t S d e t i n U . . . . . . . . . . . . . . . . . . . . . a m a b a A l . . 2 a k s a A l . 2 a n o z i r A . 2 s a s n a k r A i 2 a n r o f i l a C . 2 o d a r o o C l . 2 t u c i t c e n n o C . . . 2 e r a w a e D l f o t c i r t s i D . . . . . . . . . . . . . . . . . . . . . . . . . . i 2 a b m u o C l . . . . . . . . . . . . . . . . . . . . . . . . . . . . . a d i r o F l i a g r o e G . . . 2 i i a w a H . 2 o h a d I 2 s i o n i l l I 2 a n a d n i I . . . . 2 a w o I s a s n a K 2 y k c u t n e K 2 a n a i s i u o L . . . . 2 e n a M i l 2 d n a y r a M . 2 s t t e s u h c a s s a M . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 n a g h c M i i . 2 a t o s e n n M i . . . . . i p p i s s i s s i M . . 2 i r u o s s i M 2 a n a t n o M 2 a k s a r b e N . . 2 a d a v e N . 2 e r i h s p m a H w e N . . . . . . . . . . . . . . . . . . . . . . . . . . 2 y e s r e J w e N i 2 o c x e M w e N . . 2 k r o Y w e N a n i l o r a C h t r o N . 2 a t o k a D h t r o N . . . . . . . . . . . . . . . . i . 2 o h O . 2 a m o h a k O l . . . 2 n o g e r O l i 2 a n a v y s n n e P 2 d n a l s I e d o h R . l e b a t f o d n e i t a d e d v o r p s e t o n t o o F U.S. Census Bureau 15 . n o C — 3 2 0 2 d n a , 9 1 0 2 , 3 1 0 2 : e t a t S y b e g a r e v o C c i l b u P r o e t a v i r P h t i W , d e r u s n n U 9 1 i f o e g A e h t r e d n U n e r d l i h C f o e g a t n e c r e P l . 1 - B e b a T x d n e p p A i . 2 w w w / / : s p t t h < o t r e f e r , s n o i t i n i f e d d n a , r o r r e g n i l p m a s n o n , r o r r e g n i l p m a s , n o i t c e t o r p y t i l a i t n e d i f n o c n o n o i t a m r o f n i r o F . l n o i t a u p o p d e z i l a n o i t u t i t s n n o n n a i i l i i v C ( . ) > f d p 3 2 0 2 _ a t a D _ f o _ y c a r u c c A _ S C A / y c a r u c c a / s c o d _ h c e t / s c a / s y e v r u s - s m a r g o r p / v o g s u s n e c . e g a r e v o c c i l b u P e g a r e v o c e t a v i r P f o 1 r o r r e i n g r a M f o 1 r o r r e i n g r a M f o 1 r o r r e i n g r a M f o 1 r o r r e i n g r a M f o 1 r o r r e i n g r a M f o 1 r o r r e i n g r a M f o 1 r o r r e i n g r a M f o 1 r o r r e i n g r a M d e r u s n n U i f o 1 r o r r e i n g r a M ) ± ( 1 . 1 8 . 1 0 . 1 6 . 0 0 . 1 7 . 2 0 . 1 9 . 0 0 . 2 0 . 1 0 . 3 3 2 0 2 1 . 4 4 1 . 9 2 6 . 2 4 8 . 6 3 8 . 7 1 0 . 9 3 1 . 2 3 2 . 9 3 0 . 6 4 8 . 3 3 6 . 3 3 ) ± ( 2 . 1 1 . 2 2 . 1 5 . 0 0 . 1 9 . 2 9 . 0 1 . 1 0 . 2 8 . 0 7 . 2 9 1 0 2 5 . 2 4 4 . 9 2 7 . 0 4 9 . 6 3 4 . 6 1 5 . 3 4 0 . 9 2 0 . 9 3 4 . 7 4 1 . 1 3 0 . 4 2 ) ± ( 0 . 1 8 . 1 9 . 0 5 . 0 9 . 0 6 . 2 7 . 0 8 . 0 8 . 1 8 . 0 7 . 2 3 1 0 2 9 . 2 4 5 . 3 3 5 . 1 4 8 . 9 3 6 . 9 1 8 . 4 4 4 . 6 2 7 . 5 3 7 . 3 4 8 . 3 3 0 . 7 2 ) ± ( 0 . 1 8 . 1 1 . 1 5 . 0 2 . 1 3 . 2 9 . 0 0 . 1 0 . 2 0 . 1 6 . 3 3 2 0 2 6 . 5 5 9 . 8 6 . 4 7 5 0 . 5 5 . 6 9 7 9 . 3 6 5 . 8 6 5 . 3 6 . 3 7 5 . 0 9 6 2 . 5 6 ) ± ( 2 . 1 0 . 2 1 . 1 5 . 0 1 . 1 8 . 2 9 . 0 1 . 1 1 . 2 8 . 0 . 1 3 9 1 0 2 0 . 6 5 5 . 6 6 . 7 8 5 9 . 2 5 3 . 8 7 2 . 0 6 2 . 9 6 5 . 2 6 4 . 4 5 8 . 9 6 1 . 8 6 ) ± ( 0 . 1 9 . 1 9 . 0 4 . 0 9 . 0 . 7 2 8 . 0 8 . 0 8 . 1 8 . 0 4 . 2 3 1 0 2 ) ± ( 3 2 0 2 5 . 3 5 3 . 5 6 4 . 6 5 4 . 9 4 . 7 3 7 . 5 7 5 5 . 0 7 3 . 2 6 . 7 4 5 3 . 6 6 5 . 1 7 6 0 . 3 . 1 5 . 0 3 . 0 . 7 0 8 . 0 4 . 0 4 . 0 6 0 . 4 . 0 0 . 2 1 . 6 0 7 . 6 . 5 9 . 1 1 6 . 6 1 . 2 6 . 4 3 . 3 . 0 3 1 . 4 2 7 . ) ± ( 6 0 . 4 . 1 5 . 0 3 . 0 . 7 0 . 7 0 4 . 0 3 . 0 6 0 . 3 . 0 8 . 1 9 1 0 2 8 . 5 8 . 7 0 . 5 7 . 2 1 3 . 8 1 . 2 9 . 4 1 . 3 5 . 3 8 . 3 6 . 0 1 ) ± ( 6 . 0 0 . 1 5 . 0 3 . 0 7 . 0 0 . 1 3 . 0 5 . 0 9 . 0 3 . 0 1 . 1 3 1 0 2 0 . 7 4 . 6 0 . 6 3 . 3 1 9 . 9 3 . 3 8 . 5 3 . 6 0 . 6 9 . 4 0 . 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . e t a t S a n i l o r a C h t u o S . . . . . . . a t o k a D h t u o S . . . . . . . . . . . . . . . . e e s s e n n e T . . . . . . . . . . . s a x e T . 2 h a t U 2 t n o m r e V . i i 2 a n g r i V 2 n o t g n h s a W i i i . 2 a n g r i V t s e W . . . . . . . . n i s n o c s i W i . g n m o y W f o e z i s e h t o t n o i t a e r n l i r o r r e i f o n g r a m e h t r e g r a l e h T . y t i l i b a i r a v ’ s e t a m i t s e n a f o e r u s a e m a s i r o r r e i f o n g r a m A . y t i l i b a i r a v g n i l p m a s o t j t c e b u s e r a d n a l e p m a s a n o d e s a b e r a a t a D 1 . l a v r e t n i e c n e d i f n o c t n e c r e p 0 9 e h t s m r o f r o r r e i f o n g r a m e h t , e t a m i t s e e h t m o r f d e t c a r t b u s d n a o t d e d d a n e h W e t a m . i t s e e h t l e b a i l e r s s e l e h t , e t a m i t s e e h t . 3 2 0 2 , 1 y r a u n a J e r o f e b r o n o y t i l i b g i i l i i e d a c d e M d e d n a p x e e t a t S 2 . s e t a m i t s e r a e y - 1 , y e v r u S y t i n u m m o C n a c i r e m A 3 2 0 2 d n a , 9 1 0 2 , 3 1 0 2 , u a e r u B s u s n e C . . S U : e c r u o S 16 U.S. Census Bureau Appendix Table B-2. Change in Uninsured, Private, and Public Coverage Rates for Children Under the Age of 19: 2013, 2019, and 2023—Con. (Civilian noninstitutionalized population. For information on confidentiality protection, sampling error, nonsampling error, and definitions, refer to <https://www2.census.gov/programs-surveys/acs/tech_docs/accuracy/ACS_Accuracy_of_Data_2023.pdf>) Uninsured Private coverage Public coverage State 2013 to 2019 change Margin of error1 (±) 2019 to 2023 change Margin of error1 (±) 2013 to 2019 change Margin of error1 (±) 2019 to 2023 change Margin of error1 (±) 2013 to 2019 change Margin of error1 (±) 2019 to 2023 change Margin of error1 (±) United States . . . . . . Alabama . . . . . . . . . . Alaska² . . . . . . . . . . . . Arizona² . . . . . . . . . . . Arkansas² . . . . . . . . . California² . . . . . . . . . Colorado² . . . . . . . . . Connecticut² . . . . . . . Delaware² . . . . . . . . . District of Columbia² . . . . . . . . Florida . . . . . . . . . . . . Georgia . . . . . . . . . . . Hawaii² . . . . . . . . . . . . Idaho² . . . . . . . . . . . . . Illinois² . . . . . . . . . . . . Indiana² . . . . . . . . . . . Iowa². . . . . . . . . . . . . . Kansas . . . . . . . . . . . . Kentucky² . . . . . . . . . Louisiana² . . . . . . . . . Maine² . . . . . . . . . . . . Maryland² . . . . . . . . . Massachusetts² . . . . . Michigan² . . . . . . . . . . Minnesota² . . . . . . . . Mississippi . . . . . . . . . Missouri² . . . . . . . . . . Montana² . . . . . . . . . . Nebraska² . . . . . . . . . Nevada² . . . . . . . . . . . New Hampshire² . . . New Jersey² . . . . . . . New Mexico² . . . . . . . New York² . . . . . . . . . North Carolina . . . . . North Dakota² . . . . . Ohio² . . . . . . . . . . . . . Oklahoma². . . . . . . . . Oregon² . . . . . . . . . . . Pennsylvania² . . . . . . Rhode Island² . . . . . . *–1.9 *–1.3 *–2.6 *–3.2 –0.3 *–4.3 *–3.4 *–1.0 0.1 –0.9 *–4.1 *–2.7 –0.4 *–4.2 *–0.4 *–1.4 *–1.5 –0.7 *–2.1 *–1.8 –0.3 *–1.3 –0.1 *–0.9 *–2.8 *–1.9 –0.6 *–4.4 Z *–7.3 –0.3 *–1.5 *–3.4 *–1.8 *–1.1 –0.2 *–0.8 *–2.0 *–2.2 *–1.0 *–3.8 Footnotes provided at end of table. 0.1 0.6 2.1 0.9 1.0 0.2 0.8 0.7 1.7 1.4 0.6 0.7 1.0 1.3 0.4 0.7 0.7 0.9 0.7 0.7 1.4 0.6 0.3 0.4 0.6 1.1 0.8 1.7 1.1 1.4 1.1 0.5 1.4 0.3 0.5 1.9 0.5 0.8 0.8 0.4 1.3 *–0.3 0.4 *–2.5 –0.6 0.9 *–0.4 *–1.3 Z Z –0.8 –0.1 *–1.0 0.2 *1.6 *–0.8 *–1.3 0.5 –0.2 *–0.8 –0.1 *–1.4 *1.3 Z *–0.5 0.3 –0.1 *–1.2 0.6 *–2 –0.1 –0.3 –0.2 0.2 *0.5 –0.5 *–4.2 0.2 *–1.1 *–1.1 *0.7 *1.4 0.1 0.6 1.6 0.9 1.1 0.2 0.7 0.8 2.1 1.2 0.5 0.7 1.0 1.1 0.4 0.8 0.6 0.9 0.6 0.8 1.3 0.7 0.3 0.4 0.5 1.0 0.7 1.5 1.0 1.3 1.3 0.5 1.2 0.3 0.6 1.7 0.5 0.8 0.7 0.5 1.3 *1.7 Z –1.8 *3.4 0.3 *3.4 *1.7 *–1.9 –1.0 4.3 *4.5 *3.4 –0.8 1.8 *4.9 *2.5 *–1.7 *2.6 *–2.0 –1.4 *4.6 –1.4 –0.9 *2.9 *–2.2 0.9 0.8 0.9 1.7 1.9 0.6 –0.2 0.8 *1.0 *1.8 0.4 0.3 *1.4 *2.0 *–1.6 *8.8 0.3 1.5 3.4 1.3 2.0 0.5 1.3 1.7 3.7 4.8 0.9 1.2 2.5 2.7 1.0 1.3 1.7 1.6 1.5 1.7 2.9 1.4 1.3 1.0 1.2 2.1 1.3 2.7 2.0 2.0 2.8 1.0 2.2 0.9 1.1 2.8 1.0 1.4 2.0 0.9 3.5 0.3 –0.3 2.0 *2.3 *2.8 0.6 0.8 –0.3 0.7 5.7 *1.9 –0.4 0.1 2.1 *1.2 *–2.0 –0.4 –0.5 –0.5 –1.0 –0.2 0.3 –0.3 0.4 0.4 *3.9 *–1.6 1.3 0.5 –1.8 0.4 *–1.4 *–2.5 *–1.7 *1.3 2.9 *–1.1 *–1.4 0.2 –0.6 *–5.3 0.3 1.6 3.8 1.4 2.0 0.6 1.5 1.9 4.1 6.6 0.9 1.2 2.6 2.5 1.1 1.3 1.8 1.7 1.6 1.9 3.2 1.4 1.4 1.0 1.4 2.3 1.4 2.7 2.0 2.0 2.8 1.1 2.5 0.9 1.2 3.0 1.1 1.3 1.9 1.0 4.0 *0.6 1.1 *6.1 0.3 0.1 *2.0 *1.6 *4.2 2.3 –6.2 0.1 0.1 *2.6 *2.8 *–4.7 –0.4 *3.3 –1.4 *4.6 *3.1 *–4.6 *3.3 *2.0 *–1.6 *6.1 0.4 –0.4 *5.1 *–2.0 *5.2 –0.5 *2.1 *4.3 *1.4 –0.3 –0.6 *1.0 Z 0.8 *3.6 –2.4 0.3 1.5 3.3 1.3 2.0 0.5 1.4 1.8 3.7 4.8 1.0 1.1 2.4 2.6 0.9 1.2 1.7 1.6 1.6 1.6 2.8 1.3 1.4 1.0 1.2 2.0 1.4 3.0 2.0 2.1 3.0 1.0 2.2 0.9 1.1 3.0 1.0 1.4 1.8 0.9 3.3 *1.3 1.0 0.6 –0.6 *–2.8 *1.0 *2.6 0.4 –0.1 –3.8 –0.8 *2.7 1.6 –1.8 *1.1 *4.6 1.6 *2.0 *2.7 *3.1 1.4 –1.2 0.8 *1.8 0.6 *–2.3 *4.2 –2.9 *4.1 *6.0 1.4 *2.6 *3.7 *3.3 0.5 2.0 *1.9 *4.0 *3.2 *1.2 *3.7 U.S. Census Bureau 0.3 1.7 4.1 1.5 2.1 0.6 1.5 1.9 4.0 6.1 0.9 1.2 2.7 2.3 1.1 1.2 1.7 1.7 1.7 1.8 3.0 1.4 1.5 1.1 1.4 2.3 1.3 2.9 2.2 2.1 2.9 1.1 2.6 0.9 1.2 3.3 1.0 1.5 1.8 1.0 3.6 17 Appendix Table B-2. Change in Uninsured, Private, and Public Coverage Rates for Children Under the Age of 19: 2013, 2019, and 2023—Con. (Civilian noninstitutionalized population. For information on confidentiality protection, sampling error, nonsampling error, and definitions, refer to <https://www2.census.gov/programs-surveys/acs/tech_docs/accuracy/ACS_Accuracy_of_Data_2023.pdf>) Uninsured Private coverage Public coverage State 2013 to 2019 change Margin of error1 (±) 2019 to 2023 change Margin of error1 (±) 2013 to 2019 change Margin of error1 (±) 2019 to 2023 change Margin of error1 (±) 2013 to 2019 change Margin of error1 (±) 2019 to 2023 change Margin of error1 (±) South Carolina . . . . . South Dakota . . . . . . Tennessee . . . . . . . . . Texas . . . . . . . . . . . . . . Utah² . . . . . . . . . . . . . Vermont² . . . . . . . . . . Virginia² . . . . . . . . . . . Washington² . . . . . . . West Virginia² . . . . . . Wisconsin . . . . . . . . . Wyoming . . . . . . . . . . *–1.2 1.4 *–1.0 *–0.5 *–1.6 –1.2 *–0.9 *–3.2 *–2.4 *–1.1 *4.6 0.9 1.8 0.7 0.5 1.0 1.2 0.5 0.6 1.1 0.5 2.2 0.3 –0.8 0.6 *–0.9 *–1.7 Z –0.3 0.2 –0.5 0.3 *–3.4 0.8 1.9 0.7 0.5 1.0 1.0 0.6 0.5 0.9 0.5 2.7 *2.4 1.2 *2.2 *3.5 *4.6 2.7 *–1.3 0.2 –0.3 *3.6 –3.4 1.6 2.8 1.4 0.7 1.4 3.9 1.2 1.3 2.8 1.1 3.9 –0.3 2.4 –1.3 *2.1 1.3 *3.7 –0.7 1.0 *3.0 –0.8 –2.9 1.6 2.7 1.5 0.7 1.6 3.7 1.3 1.5 2.9 1.3 4.7 –0.3 *–4.1 –0.8 *–2.9 *–3.3 –1.3 *2.6 *3.3 *3.7 *–2.8 –3.0 1.5 2.8 1.5 0.7 1.3 3.9 1.1 1.3 2.7 1.1 3.8 1.5 –0.3 *1.9 –0.1 1.4 *–4.6 *3.1 0.2 –1.4 *2.8 *9.6 1.6 2.8 1.5 0.8 1.5 3.9 1.3 1.4 2.8 1.2 4.0 * Denotes a statistically significant change at the 90 percent confidence level. Z Represents or rounds to zero. 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 in relation to the size of the estimate, the less reliable the estimate. When added to and subtracted from the estimate, the margin of error forms the 90 percent confidence interval. ² State expanded Medicaid eligibility on or before January 1, 2023. Note: Differences are calculated with unrounded numbers, which may produce different results from using the rounded values in the table. Source: U.S. Census Bureau, 2013, 2019, and 2023 American Community Survey, 1-year estimates. 18 U.S. Census Bureau . n o C — 3 2 0 2 d n a , 9 1 0 2 , 3 1 0 2 : e t a t S y b e g a r e v o C c i l b u P r o e t a v i r P h t i W , i d e r u s n n U 4 6 o t 9 1 d e g A s t l u d A e g A - g n i k r o W f o e g a t n e c r e P . l 3 - B e b a T x d n e p p A i . . s u s n e c 2 w w w / / : s p t t h < o t r e f e r , s n o i t i n i f e d d n a , r o r r e g n i l p m a s n o n , r o r r e g n i l p m a s , n o i t c e t o r p y t i l a i t n e d i f n o c n o n o i t a m r o f n i r o F . l n o i t a u p o p d e z i l a n o i t u t i t s n n o n n a i i l i i v C ( . ) > f d p 3 2 0 2 _ a t a D _ f o _ y c a r u c c A _ S C A / y c a r u c c a / s c o d _ h c e t / s c a / s y e v r u s - s m a r g o r p / v o g f o 1 r o r r e i n g r a M e g a r e v o c c i l b u P f o 1 r o r r e i n g r a M f o 1 r o r r e i n g r a M f o 1 r o r r e i n g r a M e g a r e v o c e t a v i r P f o 1 r o r r e i n g r a M f o 1 r o r r e i n g r a M f o 1 r o r r e i n g r a M f o 1 r o r r e i n g r a M d e r u s n n U i f o 1 r o r r e i n g r a M ) ± ( 1 . 0 4 . 0 2 . 1 5 . 0 6 . 0 2 . 0 4 . 0 7 . 0 2 . 1 7 . 1 2 . 0 3 . 0 9 . 0 8 . 0 4 . 0 4 . 0 6 . 0 5 . 0 6 . 0 7 . 0 9 . 0 5 . 0 5 . 0 3 . 0 4 . 0 7 . 0 4 . 0 9 . 0 6 . 0 7 . 0 8 . 0 3 . 0 1 . 1 3 . 0 4 . 0 0 . 1 3 . 0 5 . 0 7 . 0 3 . 0 1 . 1 3 2 0 2 5 . 9 1 6 . 7 1 2 . 3 2 8 . 9 1 1 . 4 2 8 . 4 2 7 . 7 1 0 . 1 2 4 . 1 2 5 . 0 2 9 . 4 1 3 . 4 1 4 . 1 2 8 . 7 1 3 . 8 1 2 . 0 2 2 . 9 1 3 . 2 1 8 . 8 2 6 . 0 3 6 . 2 2 3 . 8 1 4 . 2 2 1 . 4 2 2 . 8 1 1 . 9 1 9 . 6 1 0 . 2 2 7 . 4 1 1 . 0 2 7 . 3 1 7 . 6 1 2 . 3 3 1 . 7 2 4 . 6 1 8 . 2 1 7 . 1 2 0 . 1 2 8 . 3 2 6 . 0 2 1 . 2 2 ) ± ( 1 . 0 5 . 0 3 . 1 4 . 0 6 . 0 2 . 0 5 . 0 5 . 0 3 . 1 4 . 1 2 . 0 3 . 0 8 . 0 7 . 0 3 . 0 3 . 0 5 . 0 4 . 0 6 . 0 6 . 0 8 . 0 4 . 0 5 . 0 3 . 0 3 . 0 7 . 0 3 . 0 0 . 1 5 . 0 6 . 0 8 . 0 3 . 0 0 . 1 3 . 0 3 . 0 0 . 1 3 . 0 3 . 0 6 . 0 3 . 0 1 . 1 9 1 0 2 7 . 7 1 6 . 6 1 1 . 1 2 5 . 0 2 1 . 5 2 3 . 2 2 0 . 6 1 7 . 0 2 9 . 9 1 5 . 1 2 0 . 4 1 7 . 2 1 3 . 7 1 3 . 2 1 5 . 6 1 9 . 6 1 9 . 7 1 9 . 0 1 2 . 7 2 3 . 7 2 3 . 9 1 3 . 7 1 9 . 0 2 9 . 1 2 3 . 6 1 9 . 7 1 3 . 3 1 0 . 1 2 0 . 0 1 4 . 7 1 1 . 4 1 7 . 4 1 5 . 2 3 9 . 3 2 8 . 4 1 2 . 2 1 3 . 0 2 7 . 3 1 2 . 1 2 2 . 9 1 5 . 0 2 Z ) ± ( 4 . 0 8 . 0 4 . 0 5 . 0 2 . 0 3 . 0 5 . 0 0 . 1 2 . 1 2 . 0 3 . 0 7 . 0 6 . 0 2 . 0 3 . 0 4 . 0 4 . 0 4 . 0 3 . 0 8 . 0 3 . 0 4 . 0 3 . 0 3 . 0 6 . 0 3 . 0 6 . 0 4 . 0 5 . 0 6 . 0 2 . 0 6 . 0 3 . 0 2 . 0 6 . 0 3 . 0 4 . 0 5 . 0 2 . 0 8 . 0 3 1 0 2 3 . 4 1 8 . 5 1 8 . 2 1 7 . 6 1 7 . 6 1 5 . 4 1 9 . 1 1 2 . 5 1 0 . 9 1 4 . 2 2 8 . 3 1 7 . 1 1 8 . 4 1 8 . 1 1 5 . 3 1 1 . 3 1 3 . 3 1 1 . 0 1 3 . 6 1 6 . 5 1 8 . 1 2 0 . 3 1 5 . 0 2 2 . 7 1 0 . 4 1 0 . 8 1 3 . 3 1 2 . 2 1 4 . 9 6 . 0 1 9 . 9 7 . 0 1 1 . 9 1 9 . 9 1 8 . 3 1 7 . 8 6 . 5 1 0 . 4 1 6 . 4 1 4 . 4 1 0 . 5 1 ) ± ( 1 . 0 5 . 0 4 . 1 6 . 0 7 . 0 2 . 0 5 . 0 8 . 0 4 . 1 6 . 1 4 . 0 4 . 0 9 . 0 8 . 0 4 . 0 6 . 0 7 . 0 6 . 0 6 . 0 7 . 0 8 . 0 5 . 0 5 . 0 4 . 0 5 . 0 8 . 0 5 . 0 2 . 1 8 . 0 9 . 0 9 . 0 4 . 0 2 . 1 3 . 0 5 . 0 0 . 1 4 . 0 6 . 0 7 . 0 3 . 0 2 . 1 3 2 0 2 5 . 3 7 9 . 4 7 3 . 9 6 5 . 0 7 . 9 7 6 . 6 9 6 . 1 7 7 0 . 4 7 0 . 4 7 4 . 8 7 6 . 3 7 0 . 4 7 . 1 0 8 . 7 4 7 9 . 5 7 3 . 4 7 3 . 8 7 8 . 9 7 2 . 8 6 3 . 4 6 8 . 3 7 . 4 7 7 0 . 8 7 8 . 3 7 . 6 9 7 0 . 1 7 3 . 6 7 9 . 0 7 . 7 0 8 8 . 0 7 . 7 2 8 8 . 5 7 8 . 9 5 4 . 0 7 1 . 5 7 1 . 5 8 6 . 3 7 . 7 7 6 . 7 2 7 8 . 6 7 5 . 6 7 ) ± ( . 1 0 6 0 . 5 . 1 5 . 0 8 . 0 2 . 0 5 . 0 6 0 . 5 . 1 4 . 1 4 . 0 5 . 0 9 . 0 9 . 0 4 . 0 4 . 0 . 7 0 6 0 . 6 0 . . 7 0 8 . 0 5 . 0 4 . 0 4 . 0 4 . 0 0 . 1 5 . 0 2 . 1 6 0 . . 7 0 0 . 1 4 . 0 0 . 1 3 . 0 4 . 0 2 . 1 4 . 0 6 0 . . 7 0 3 . 0 3 . 1 9 1 0 2 8 . 2 7 2 . 3 7 4 . 8 6 . 6 7 6 1 . 6 6 . 7 9 6 6 . 6 7 1 . 4 7 4 . 5 7 . 7 7 7 . 9 9 6 9 . 1 7 1 . 1 8 5 . 5 7 5 . 5 7 6 . 4 7 . 7 8 7 5 . 9 7 0 . 8 6 4 . 3 6 0 . 4 7 1 . 8 7 5 . 8 7 8 . 3 7 . 7 9 7 1 . 6 6 8 . 5 7 1 . 2 7 5 . 1 8 . 6 0 7 . 9 9 7 6 . 6 7 2 . 8 5 3 . 2 7 9 . 2 7 2 . 3 8 8 . 3 7 . 6 9 6 8 . 2 7 8 . 6 7 . 7 7 7 ) ± ( . 1 0 6 0 . 3 . 1 5 . 0 . 7 0 2 . 0 5 . 0 . 7 0 3 . 1 1 . 1 3 . 0 4 . 0 9 . 0 1 . 1 3 . 0 5 . 0 5 . 0 6 0 . 6 0 . . 7 0 0 . 1 5 . 0 4 . 0 3 . 0 4 . 0 8 . 0 5 . 0 1 . 1 . 7 0 8 . 0 0 . 1 4 . 0 9 . 0 3 . 0 4 . 0 0 . 1 4 . 0 5 . 0 6 0 . 3 . 0 2 . 1 3 1 0 2 3 . 8 6 4 . 8 6 . 4 7 6 9 . 2 6 . 0 3 6 6 . 3 6 2 . 2 7 9 . 3 7 8 . 1 7 4 . 2 7 . 1 0 6 3 . 5 6 2 . 9 7 9 . 8 6 4 . 0 7 4 . 0 7 3 . 8 7 6 . 5 7 8 . 6 6 2 . 3 6 2 . 6 6 3 . 6 7 . 7 7 7 4 . 0 7 0 . 8 7 1 . 1 6 5 . 1 7 5 . 8 6 . 4 7 7 2 . 5 6 . 1 7 7 . 7 2 7 . 7 7 5 0 . 8 6 9 . 6 6 9 . 0 8 5 . 1 7 . 7 4 6 . 4 7 6 3 . 5 7 0 . 2 7 ) ± ( . 1 0 4 . 0 9 . 0 4 . 0 5 . 0 . 1 0 3 . 0 5 . 0 0 . 1 . 7 0 3 . 0 3 . 0 5 . 0 6 0 . 2 . 0 3 . 0 4 . 0 5 . 0 3 . 0 4 . 0 5 . 0 3 . 0 3 . 0 2 . 0 2 . 0 . 7 0 4 . 0 8 . 0 6 0 . 6 0 . 6 0 . 3 . 0 . 7 0 2 . 0 3 . 0 . 7 0 2 . 0 4 . 0 4 . 0 2 . 0 . 7 0 3 2 0 2 0 . 1 1 9 . 2 1 1 . 4 1 5 . 3 1 4 . 2 1 0 9 . 2 . 9 1 . 8 3 . 9 5 . 3 5 . 5 1 4 . 4 1 . 6 1 4 . 2 1 8 . 8 1 9 . 1 7 . 9 . 1 1 7 7 . . 0 0 1 6 . 8 5 . 8 5 . 3 4 . 6 . 7 5 2 . 5 1 . 6 0 1 9 . 1 1 8 . 8 6 . 4 1 . 7 6 2 . 0 1 3 . 3 1 8 . 6 3 . 3 1 1 . 6 4 . 8 1 . 6 1 0 . 8 1 7 . 1 . 6 ) ± ( . 1 0 5 . 0 1 . 1 4 . 0 6 0 . . 1 0 3 . 0 4 . 0 8 . 0 8 . 0 3 . 0 4 . 0 6 0 . 8 . 0 3 . 0 3 . 0 4 . 0 5 . 0 4 . 0 4 . 0 . 7 0 3 . 0 2 . 0 2 . 0 3 . 0 . 7 0 5 . 0 8 . 0 6 0 . 6 0 . . 7 0 3 . 0 8 . 0 2 . 0 3 . 0 8 . 0 3 . 0 5 . 0 4 . 0 2 . 0 8 . 0 9 1 0 2 9 . 2 1 0 . 5 1 8 . 5 1 4 . 5 1 1 . 3 1 9 . 0 1 7 . 0 1 3 . 8 3 . 9 4 . 4 5 . 9 1 9 . 5 9 . 8 1 5 . 6 1 5 . 0 1 6 . 1 1 3 . 7 1 . 9 1 . 3 1 1 . 3 1 6 . 1 1 3 . 8 2 . 4 3 . 8 9 . 6 5 . 9 1 2 . 4 1 8 . 1 1 7 . 1 1 5 . 5 1 9 . 8 1 . 1 1 6 . 4 1 5 . 7 4 . 6 1 2 . 8 1 . 9 5 . 0 2 3 . 0 1 9 . 7 9 . 5 ) ± ( 1 . 0 5 . 0 2 . 1 4 . 0 7 . 0 2 . 0 5 . 0 6 . 0 9 . 0 7 . 0 3 . 0 4 . 0 6 . 0 1 . 1 3 . 0 4 . 0 4 . 0 5 . 0 5 . 0 5 . 0 7 . 0 4 . 0 2 . 0 3 . 0 3 . 0 7 . 0 4 . 0 0 . 1 7 . 0 8 . 0 8 . 0 3 . 0 8 . 0 2 . 0 4 . 0 0 . 1 2 . 0 5 . 0 5 . 0 2 . 0 9 . 0 3 1 0 2 5 . 0 2 4 . 0 2 0 . 4 2 6 . 3 2 3 . 4 2 1 . 4 2 9 . 8 1 3 . 3 1 0 . 3 1 7 . 8 9 . 8 2 7 . 9 1 . 6 2 2 . 3 2 6 . 8 1 3 . 9 1 7 . 1 1 6 . 7 1 8 . 0 2 4 . 4 2 1 . 6 1 3 . 5 2 . 4 1 1 . 6 1 9 . 0 1 0 . 5 2 5 . 8 1 1 . 3 2 3 . 6 1 1 . 7 2 6 . 5 1 8 . 8 1 1 . 7 2 2 . 5 1 8 . 2 2 5 . 3 1 8 . 5 1 8 . 4 2 4 . 1 2 7 . 3 1 4 . 6 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . e t a t S s e t a t S d e t i n U . . . . . . . . . . . . . . . . . . . . . a m a b a A l . . ² a k s a A l . ² a n o z i r A ² s a s n a k r A i ² a n r o f i l a C ² o d a r o o C l . ² t u c i t c e n n o C . . . ² e r a w a e D l f o t c i r t s i D . . . . . . . . . . . . . . . . . . . . . . . . . . i ² a b m u o C l . . . . . . . . . . . . . . . . . . . . . . . . . . . . . a d i r o F l i a g r o e G . ² i i a w a H . . . ² o h a d I ² s i o n i l l I ² a n a d n i I . . . . ² a w o I s a s n a K ² y k c u t n e K ² a n a i s i u o L . . . ² e n a M i l ² d n a y r a M . ² s t t e s u h c a s s a M . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ² n a g h c M i i ² a t o s e n n M i . . . . . i p p i s s i s s i M . ² i r u o s s i M . ² a n a t n o M ² a k s a r b e N . . ² a d a v e N ² e r i h s p m a H w e N . . . . . . . . . . . . . . . . . . . . . . . . ² y e s r e J w e N i . ² o c x e M w e N . . . ² k r o Y w e N a n i l o r a C h t r o N ² a t o k a D h t r o N . . . . . . . . . . . . . . . . i ² o h O . ² a m o h a k O l . . . ² n o g e r O l i ² a n a v y s n n e P ² d n a l s I e d o h R . l e b a t f o d n e i t a d e d v o r p s e t o n t o o F U.S. Census Bureau 19 . n o C — 3 2 0 2 d n a , 9 1 0 2 , 3 1 0 2 : e t a t S y b e g a r e v o C c i l b u P r o e t a v i r P h t i W , i d e r u s n n U 4 6 o t 9 1 d e g A s t l u d A e g A - g n i k r o W f o e g a t n e c r e P . l 3 - B e b a T x d n e p p A i . . s u s n e c 2 w w w / / : s p t t h < o t r e f e r , s n o i t i n i f e d d n a , r o r r e g n i l p m a s n o n , r o r r e g n i l p m a s , n o i t c e t o r p y t i l a i t n e d i f n o c n o n o i t a m r o f n i r o F . l n o i t a u p o p d e z i l a n o i t u t i t s n n o n n a i i l i i v C ( . ) > f d p 3 2 0 2 _ a t a D _ f o _ y c a r u c c A _ S C A / y c a r u c c a / s c o d _ h c e t / s c a / s y e v r u s - s m a r g o r p / v o g f o 1 r o r r e i n g r a M e g a r e v o c c i l b u P f o 1 r o r r e i n g r a M f o 1 r o r r e i n g r a M f o 1 r o r r e i n g r a M e g a r e v o c e t a v i r P f o 1 r o r r e i n g r a M f o 1 r o r r e i n g r a M f o 1 r o r r e i n g r a M f o 1 r o r r e i n g r a M d e r u s n n U i f o 1 r o r r e i n g r a M ) ± ( 5 . 0 9 . 0 4 . 0 2 . 0 5 . 0 4 . 1 4 . 0 3 . 0 0 . 1 4 . 0 0 . 1 3 2 0 2 7 . 7 1 9 . 2 1 1 . 7 1 3 . 1 1 1 . 0 1 1 . 3 2 6 . 8 1 0 . 9 1 9 . 8 2 1 . 7 1 6 . 1 1 ) ± ( 5 . 0 0 . 1 3 . 0 2 . 0 4 . 0 2 . 1 3 . 0 4 . 0 0 . 1 4 . 0 8 . 0 9 1 0 2 2 . 6 1 6 . 1 1 5 . 7 1 3 . 0 1 3 . 8 2 . 3 2 1 . 4 1 0 . 8 1 8 . 9 2 3 . 5 1 2 . 1 1 ) ± ( 4 . 0 6 . 0 3 . 0 1 . 0 4 . 0 1 . 1 3 . 0 3 . 0 7 . 0 4 . 0 8 . 0 3 1 0 2 3 . 5 1 5 . 2 1 5 . 6 1 7 . 0 1 1 . 9 1 . 3 2 0 . 0 1 2 . 2 1 6 . 9 1 3 . 5 1 0 . 9 ) ± ( 5 . 0 9 . 0 6 . 0 3 . 0 6 . 0 4 . 1 4 . 0 4 . 0 1 . 1 4 . 0 5 . 1 3 2 0 2 5 . 4 7 . 0 0 8 9 . 3 7 5 . 0 7 6 . 2 8 5 . 5 7 . 7 7 7 4 . 6 7 . 7 7 6 . 0 0 8 . 4 7 7 ) ± ( . 7 0 1 . 1 5 . 0 3 . 0 6 0 . 4 . 1 5 . 0 5 . 0 2 . 1 5 . 0 . 7 1 9 1 0 2 0 . 2 7 . 9 7 7 6 . 1 7 1 . 8 6 2 . 2 8 4 . 3 7 8 . 8 7 3 . 6 7 5 . 5 6 . 9 9 7 8 . 5 7 ) ± ( . 7 0 0 . 1 5 . 0 3 . 0 . 7 0 3 . 1 4 . 0 4 . 0 9 . 0 4 . 0 4 . 1 3 1 0 2 5 . 5 6 8 . 5 7 . 0 7 6 0 . 2 6 0 . 5 7 . 1 0 7 9 . 5 7 3 . 1 7 0 . 4 6 0 . 5 7 8 . 5 7 ) ± ( 4 . 0 8 . 0 4 . 0 2 . 0 5 . 0 6 0 . 3 . 0 3 . 0 6 0 . 3 . 0 3 . 1 3 2 0 2 2 . 3 1 3 . 1 1 3 . 3 1 . 7 1 2 . 1 0 1 0 . 5 . 7 8 9 . 8 1 9 . 6 . 6 6 . 5 1 ) ± ( 5 . 0 9 . 0 4 . 0 3 . 0 6 0 . . 7 0 4 . 0 4 . 0 6 0 . 3 . 0 . 7 1 9 1 0 2 1 . 6 1 2 . 4 1 9 . 4 1 5 . 4 2 1 . 2 1 7 . 6 0 . 1 1 5 . 9 1 . 8 0 . 0 1 6 . 6 1 ) ± ( 5 . 0 8 . 0 4 . 0 3 . 0 6 . 0 8 . 0 4 . 0 4 . 0 8 . 0 3 . 0 3 . 1 3 1 0 2 2 . 3 2 1 . 6 1 2 . 0 2 0 . 0 3 6 . 8 1 4 . 0 1 3 . 7 1 9 . 9 1 8 . 0 2 9 . 2 1 3 . 9 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . e t a t S a n i l o r a C h t u o S . . . . . . . a t o k a D h t u o S . . . . . . . . . . . . . . . . e e s s e n n e T . . . . . . . . . . . s a x e T ² h a t U ² t n o m r e V i . ² a n g r i V i ² n o t g n h s a W i i i . ² a n g r i V t s e W . . . . . . . . n i s n o c s i W i . g n m o y W e h t f o e z i s e h t o t n o i t a e r n l i r o r r e i f o n g r a m e h t r e g r a l e h T . y t i l i b a i r a v ’ s e t a m i t s e n a f o e r u s a e m a s i r o r r e i f o n g r a m A . y t i l i b a i r a v g n i l p m a s o t j t c e b u s e r a d n a l e p m a s a n o d e s a b e r a a t a D 1 . l a v r e t n i e c n e d i f n o c t n e c r e p 0 9 e h t s m r o f r o r r e i f o n g r a m e h t , e t a m i t s e e h t m o r f d e t c a r t b u s d n a o t d e d d a n e h W e t a m . i t s e e h t l e b a i l e r s s e l e h t , e t a m i t s e . o r e z o t s d n u o r r o s t n e s e r p e R Z . s e t a m i t s e r a e y - 1 , y e v r u S y t i n u m m o C n a c i r e m A 3 2 0 2 d n a , 9 1 0 2 , 3 1 0 2 , u a e r u B s u s n e C . . S U : e c r u o S . 3 2 0 2 , 1 y r a u n a J e r o f e b r o n o y t i l i b g i i l i i e d a c d e M d e d n a p x e e t a t S 2 20 U.S. Census Bureau Appendix Table B-4. Changes in Uninsured, Private, and Public Coverage Rates for Working–Age Adults Aged 19 to 64 by State: 2013, 2019, and 2023—Con. (Civilian noninstitutionalized population. For information on confidentiality protection, sampling error, nonsampling error, and definitions, refer to <https://www2.census.gov/programs–surveys/acs/tech_docs/accuracy/ACS_Accuracy_of_Data_2023.pdf>) Uninsured Private coverage Public coverage State 2013 to 2019 change Margin of error1 (±) 2019 to 2023 change Margin of error1 (±) 2013 to 2019 change Margin of error1 (±) 2019 to 2023 change Margin of error1 (±) 2013 to 2019 change Margin of error1 (±) 2019 to 2023 change Margin of error1 (±) United States . . . . . . *–7.6 Alabama . . . . . . . . . . Alaska² . . . . . . . . . . . . Arizona² . . . . . . . . . . . Arkansas² . . . . . . . . . California² . . . . . . . . . Colorado² . . . . . . . . . Connecticut² . . . . . . . Delaware² . . . . . . . . . District of Columbia² . . . . . . . . Florida . . . . . . . . . . . . Georgia . . . . . . . . . . . Hawaii² . . . . . . . . . . . . Idaho² . . . . . . . . . . . . . Illinois² . . . . . . . . . . . . Indiana² . . . . . . . . . . . Iowa². . . . . . . . . . . . . . Kansas . . . . . . . . . . . . Kentucky² . . . . . . . . . Louisiana² . . . . . . . . . Maine² . . . . . . . . . . . . Maryland² . . . . . . . . . Massachusetts² . . . . . Michigan² . . . . . . . . . . Minnesota² . . . . . . . . Mississippi . . . . . . . . . Missouri² . . . . . . . . . . Montana² . . . . . . . . . . Nebraska² . . . . . . . . . Nevada² . . . . . . . . . . . New Hampshire² . . . New Jersey² . . . . . . . New Mexico² . . . . . . . New York² . . . . . . . . . North Carolina . . . . . North Dakota² . . . . . Ohio² . . . . . . . . . . . . . Oklahoma². . . . . . . . . Oregon² . . . . . . . . . . . Pennsylvania² . . . . . . Rhode Island² . . . . . . *–5.4 *–8.2 *–8.1 *–11.2 *–13.2 *–8.1 *–5.0 *–3.7 *–4.3 *–9.4 *–7.1 *–3.8 *–6.6 *–8.1 *–7.7 *–4.4 *–4.5 *–11.7 *–11.3 *–4.5 *–5.8 *–1.1 *–7.8 *–4.0 *–5.5 *–4.3 *–11.3 *–4.6 *–11.5 *–6.7 *–7.7 *–12.5 *–7.7 *–6.4 *–5.3 *–6.8 *–4.3 *–11.1 *–5.8 *–10.6 Footnotes provided at end of table. 0.1 0.7 1.6 0.6 0.9 0.2 0.6 0.7 1.2 1.1 0.4 0.6 0.8 1.4 0.4 0.5 0.6 0.7 0.6 0.7 1.0 0.5 0.3 0.4 0.5 1.0 0.6 1.3 0.9 0.9 1.1 0.5 1.2 0.3 0.5 1.3 0.3 0.7 0.7 0.3 1.2 *–1.8 *–2.1 *–1.7 *–1.9 –0.7 *–1.9 *–1.5 –0.1 –0.1 –0.9 *–4.0 *–2.8 *–1.6 *–4.1 *–1.6 *–2.5 –0.1 *–1.3 *–1.3 *–3.1 *–3.1 0.1 *–0.7 *–1.9 *–1.2 *–4.4 *–3.6 0.2 *–2.9 *–0.9 *–2.2 *–1.0 *–1.4 *–0.7 *–3.1 *–2.1 *–0.7 *–4.4 *–2.2 *–0.8 0.2 0.1 0.6 1.4 0.6 0.8 0.2 0.5 0.7 1.3 1.1 0.4 0.5 0.7 1.0 0.4 0.5 0.6 0.7 0.5 0.6 0.9 0.5 0.3 0.3 0.4 1.0 0.6 1.1 0.8 0.8 0.9 0.5 1.1 0.2 0.5 1.1 0.3 0.6 0.6 0.3 1.1 *4.6 *4.8 1.0 *4.7 *3.0 *6.0 *4.4 0.1 *3.6 *5.3 *9.7 *6.6 *1.9 *6.6 *5.1 *4.2 0.4 *4.0 *1.2 0.2 *7.8 *1.8 *0.8 *3.3 *1.8 *5.1 *4.3 *3.7 *4.2 *5.4 *2.8 *4.0 0.5 *4.3 *6.0 *2.2 *2.2 *4.8 *5.3 *1.5 *5.8 0.2 0.8 2.0 0.7 1.1 0.3 0.7 0.9 2.0 1.8 0.5 0.6 1.3 1.5 0.5 0.7 0.8 0.9 0.9 1.0 1.3 0.7 0.6 0.5 0.6 1.3 0.7 1.6 1.0 1.1 1.4 0.5 1.3 0.4 0.6 1.6 0.5 0.8 0.9 0.5 1.8 *0.7 *1.7 0.9 *2.9 *1.8 –0.1 0.5 –0.1 –1.4 0.7 *3.7 *2.0 –1.0 –0.8 0.4 –0.3 –0.5 0.3 0.3 0.9 –0.2 *–0.8 –0.6 0.0 –0.1 *4.8 0.6 –1.3 –0.8 0.2 *2.8 *–0.8 *1.6 *–1.9 *2.2 *2.0 –0.1 *–1.9 –0.1 –0.1 –1.3 0.2 0.8 2.0 0.8 1.1 0.3 0.7 1.0 2.0 2.1 0.5 0.6 1.3 1.2 0.5 0.7 1.0 0.8 0.9 1.0 1.2 0.7 0.7 0.5 0.6 1.3 0.7 1.7 1.0 1.1 1.4 0.6 1.5 0.4 0.6 1.6 0.5 0.8 1.0 0.5 1.8 *3.4 *0.7 *8.3 *3.9 *8.3 *7.7 *4.1 *5.5 0.9 –0.9 0.2 *1.0 *2.5 0.5 *3.1 *3.8 *4.6 *0.9 *10.9 *11.7 *–2.5 *4.4 0.5 *4.7 *2.3 –0.1 Z *8.8 0.7 *6.8 *4.2 *3.9 *13.4 *4.0 *1.0 *3.4 *4.8 –0.3 *6.6 *4.7 *5.6 0.1 0.6 1.5 0.6 0.8 0.3 0.6 0.7 1.6 1.8 0.3 0.4 1.1 1.0 0.3 0.5 0.7 0.6 0.7 0.7 1.1 0.5 0.6 0.4 0.5 0.9 0.5 1.2 0.7 0.8 1.0 0.4 1.2 0.4 0.4 1.2 0.4 0.5 0.8 0.4 1.4 *1.7 *1.0 *2.1 *–0.8 *–1.0 *2.5 *1.7 0.3 1.6 –1.0 *0.9 *1.5 *4.2 *5.5 *1.7 *3.3 *1.4 *1.3 *1.5 *3.3 *3.3 *1.0 *1.5 *2.1 *1.9 *1.2 *3.6 1.0 *4.7 *2.7 –0.3 *2.0 0.6 *3.2 *1.6 0.6 *1.4 *7.3 *2.6 *1.4 1.5 U.S. Census Bureau 0.1 0.7 1.8 0.6 0.8 0.3 0.7 0.9 1.8 2.2 0.3 0.4 1.2 1.1 0.5 0.6 0.8 0.6 0.9 0.9 1.2 0.6 0.7 0.5 0.5 1.0 0.5 1.3 0.8 0.9 1.1 0.4 1.5 0.4 0.5 1.4 0.5 0.6 0.9 0.4 1.6 21 Appendix Table B-4. Changes in Uninsured, Private, and Public Coverage Rates for Working–Age Adults Aged 19 to 64 by State: 2013, 2019, and 2023—Con. (Civilian noninstitutionalized population. For information on confidentiality protection, sampling error, nonsampling error, and definitions, refer to <https://www2.census.gov/programs–surveys/acs/tech_docs/accuracy/ACS_Accuracy_of_Data_2023.pdf>) Uninsured Private coverage Public coverage State 2013 to 2019 change Margin of error1 (±) 2019 to 2023 change Margin of error1 (±) 2013 to 2019 change Margin of error1 (±) 2019 to 2023 change Margin of error1 (±) 2013 to 2019 change Margin of error1 (±) 2019 to 2023 change Margin of error1 (±) South Carolina . . . . . South Dakota . . . . . . Tennessee . . . . . . . . . Texas . . . . . . . . . . . . . . Utah² . . . . . . . . . . . . . Vermont² . . . . . . . . . . Virginia² . . . . . . . . . . . Washington² . . . . . . . West Virginia² . . . . . . Wisconsin . . . . . . . . . Wyoming . . . . . . . . . . *–7.1 *–1.8 *–5.3 *–5.5 *–6.5 *–3.7 *–6.3 *–10.4 *–10.8 *–4.9 *–2.7 0.7 1.2 0.6 0.4 0.8 1.1 0.5 0.5 1.0 0.5 2.2 *–2.9 *–2.9 *–1.6 *–2.8 *–1.9 *–1.7 *–2.3 *–0.6 *–0.9 *–1.5 –1.0 0.7 1.1 0.6 0.4 0.8 0.9 0.5 0.5 0.9 0.4 2.2 *6.5 *2.1 *4.6 *6.1 *7.2 *3.4 *2.9 *5.0 *1.5 *4.8 Z 0.9 1.5 0.7 0.4 0.9 1.9 0.6 0.6 1.5 0.6 2.2 *2.5 *2.0 *2.3 *2.4 0.3 *2.1 *–1.1 0.1 *2.2 0.1 1.6 0.9 1.5 0.8 0.4 0.9 2.0 0.6 0.6 1.6 0.6 2.3 *0.9 –0.9 *1.0 *–0.4 *–0.8 0.1 *4.0 *5.8 *10.2 –0.1 *2.2 0.6 1.2 0.5 0.2 0.6 1.7 0.4 0.5 1.2 0.5 1.2 *1.4 1.3 –0.3 *1.1 *1.9 –0.1 *4.5 *1.0 –1.0 *1.9 0.4 0.7 1.3 0.5 0.2 0.6 1.9 0.5 0.5 1.4 0.5 1.3 * Denotes a statistically significant change at the 90 percent confidence level. Z Represents or rounds to zero. 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 in relation to the size of the estimate, the less reliable the estimate. When added to and subtracted from the estimate, the margin of error forms the 90 percent confidence interval. ² State expanded Medicaid eligibility on or before January 1, 2023. Note: Differences are calculated with unrounded numbers, which may produce different results from using the rounded values in the table. Source: U.S. Census Bureau, 2013, 2019, and 2023 American Community Survey, 1–year estimates. 22 U.S. Census Bureau . . s u s n e c 2 w w w / / : s p t t h < o t r e f e r , s n o i t i n i f e d d n a , r o r r e g n i l p m a s n o n , r o r r e g n i l p m a s , n o i t c e t o r p y t i l a i t n e d i f n o c n o n o i t a m r o f n i r o F . l n o i t a u p o p d e z i l a n o i t u t i t s n n o n n a i i l i i v C ( . ) > f d p 3 2 0 2 _ a t a D _ f o _ y c a r u c c A _ S C A / y c a r u c c a / s c o d _ h c e t / s c a / s y e v r u s - s m a r g o r p / v o g . n o C — 3 2 0 2 d n a , 9 1 0 2 , 3 1 0 2 : e t a t S y b e g a r e v o C c i l b u P r o e t a v i r P h t i W , i l d e r u s n n U r e d O d n a 5 6 d e g A s t l u d A f o e g a t n e c r e P . l 5 - B e b a T x d n e p p A i f o 1 r o r r e i n g r a M e g a r e v o c c i l b u P f o 1 r o r r e i n g r a M f o 1 r o r r e i n g r a M e g a r e v o c e t a v i r P f o 1 r o r r e i n g r a M f o 1 r o r r e i n g r a M f o 1 r o r r e i n g r a M f o 1 r o r r e i n g r a M f o 1 r o r r e i n g r a M d e r u s n n U i f o 1 r o r r e i n g r a M ) ± ( 1 . 0 3 . 0 8 . 0 3 . 0 5 . 0 2 . 0 4 . 0 4 . 0 9 . 0 3 . 1 2 . 0 3 . 0 7 . 0 5 . 0 3 . 0 3 . 0 3 . 0 5 . 0 3 . 0 4 . 0 6 . 0 4 . 0 5 . 0 2 . 0 3 . 0 4 . 0 3 . 0 5 . 0 6 . 0 6 . 0 6 . 0 4 . 0 5 . 0 2 . 0 2 . 0 6 . 0 2 . 0 3 . 0 4 . 0 2 . 0 1 . 1 3 2 0 2 2 . 5 9 6 . 6 9 8 . 5 9 6 . 5 9 1 . 7 9 5 . 3 9 3 . 5 9 4 . 4 9 1 . 6 9 3 . 3 9 3 . 5 9 0 . 5 9 3 . 4 9 1 . 7 9 2 . 4 9 2 . 6 9 8 . 6 9 5 . 5 9 0 . 7 9 2 . 6 9 6 . 6 9 5 . 2 9 2 . 3 9 7 . 6 9 9 . 5 9 2 . 7 9 4 . 6 9 2 . 7 9 4 . 5 9 5 . 4 9 0 . 5 9 1 . 3 9 3 . 6 9 2 . 5 9 4 . 6 9 6 . 7 9 6 . 5 9 6 . 6 9 4 . 6 9 8 . 5 9 7 . 4 9 ) ± ( 1 . 0 3 . 0 2 . 1 3 . 0 4 . 0 2 . 0 3 . 0 5 . 0 5 . 0 8 . 1 2 . 0 3 . 0 7 . 0 4 . 0 2 . 0 3 . 0 3 . 0 4 . 0 3 . 0 5 . 0 6 . 0 4 . 0 4 . 0 2 . 0 3 . 0 4 . 0 3 . 0 4 . 0 4 . 0 6 . 0 6 . 0 3 . 0 5 . 0 3 . 0 2 . 0 8 . 0 2 . 0 4 . 0 4 . 0 2 . 0 7 . 0 9 1 0 2 9 . 5 9 3 . 7 9 3 . 5 9 6 . 6 9 4 . 7 9 4 . 4 9 9 . 5 9 8 . 4 9 8 . 7 9 6 . 0 9 9 . 5 9 0 . 6 9 4 . 5 9 7 . 7 9 2 . 5 9 2 . 7 9 5 . 7 9 7 . 6 9 9 . 7 9 2 . 6 9 9 . 6 9 6 . 3 9 5 . 4 9 5 . 7 9 8 . 6 9 9 . 7 9 3 . 7 9 7 . 7 9 6 . 6 9 4 . 5 9 5 . 6 9 5 . 4 9 5 . 6 9 9 . 4 9 1 . 7 9 6 . 6 9 7 . 6 9 5 . 6 9 7 . 6 9 6 . 6 9 5 . 5 9 Z ) ± ( 3 . 0 6 . 1 3 . 0 4 . 0 2 . 0 3 . 0 4 . 0 6 . 0 3 . 1 2 . 0 3 . 0 6 . 0 7 . 0 3 . 0 2 . 0 3 . 0 4 . 0 2 . 0 4 . 0 5 . 0 4 . 0 3 . 0 2 . 0 3 . 0 4 . 0 3 . 0 4 . 0 5 . 0 6 . 0 6 . 0 3 . 0 6 . 0 2 . 0 2 . 0 8 . 0 2 . 0 3 . 0 3 . 0 2 . 0 7 . 0 3 1 0 2 3 . 6 9 5 . 7 9 1 . 4 9 8 . 6 9 1 . 8 9 5 . 4 9 4 . 6 9 7 . 5 9 0 . 7 9 0 . 2 9 9 . 5 9 2 . 6 9 4 . 5 9 2 . 7 9 6 . 5 9 8 . 7 9 4 . 8 9 5 . 7 9 7 . 7 9 8 . 5 9 3 . 7 9 4 . 4 9 2 . 5 9 9 . 7 9 1 . 7 9 0 . 8 9 5 . 7 9 9 . 7 9 1 . 7 9 2 . 4 9 4 . 6 9 8 . 4 9 0 . 6 9 7 . 5 9 7 . 7 9 2 . 7 9 0 . 7 9 5 . 7 9 6 . 7 9 9 . 6 9 6 . 6 9 ) ± ( 2 . 0 9 . 0 5 . 2 9 . 0 1 . 1 3 . 0 9 . 0 9 . 0 0 . 2 8 . 2 5 . 0 8 . 0 4 . 1 2 . 1 6 . 0 8 . 0 1 . 1 3 . 1 9 . 0 0 . 1 7 . 1 9 . 0 9 . 0 5 . 0 8 . 0 1 . 1 8 . 0 8 . 1 5 . 1 3 . 1 7 . 1 7 . 0 4 . 1 5 . 0 8 . 0 5 . 2 6 . 0 9 . 0 0 . 1 6 . 0 1 . 2 3 2 0 2 . 7 3 5 . 4 7 5 6 . 2 6 8 . 9 4 . 0 0 5 . 4 7 4 . 9 9 4 6 . 2 5 5 . 3 6 1 . 1 6 6 . 6 4 . 7 1 5 . 1 9 6 4 . 4 5 6 . 4 5 1 . 4 5 2 . 9 5 . 0 9 5 2 . 5 5 8 . 0 5 . 7 2 5 2 . 8 6 0 . 1 6 . 7 3 6 2 . 5 6 3 . 0 5 . 6 0 5 . 1 7 5 9 . 6 5 6 . 6 4 . 1 0 6 8 . 6 5 . 1 3 5 0 . 4 5 1 . 4 5 0 . 8 6 6 . 3 5 2 . 6 5 2 . 3 5 6 . 8 5 5 . 4 5 ) ± ( . 1 0 0 . 1 5 . 2 . 7 0 3 . 1 3 . 0 0 . 1 0 . 1 8 . 1 . 1 3 5 . 0 9 . 0 4 . 1 . 7 1 6 0 . 0 . 1 1 . 1 3 . 1 0 . 1 3 . 1 5 . 1 8 . 0 9 . 0 5 . 0 . 7 0 3 . 1 9 . 0 6 . 1 3 . 1 2 . 1 8 . 1 8 . 0 4 . 1 5 . 0 5 . 0 1 . 2 5 . 0 9 . 0 0 . 1 5 . 0 0 . 2 9 1 0 2 0 . 8 5 3 . 1 6 8 . 1 6 8 . 3 5 4 . 4 5 8 . 9 4 6 . 5 5 . 6 9 5 6 . 8 6 2 . 4 6 . 7 9 4 9 . 5 5 8 . 9 6 9 . 1 6 . 7 9 5 . 7 9 5 4 . 4 6 0 . 5 6 . 6 0 6 2 . 2 5 3 . 0 6 5 . 0 7 3 . 4 6 . 0 0 7 . 6 9 6 5 . 2 5 . 7 6 5 2 . 9 5 . 7 0 6 8 . 8 4 3 . 6 6 . 1 0 6 8 . 3 5 . 8 7 5 5 . 9 5 . 7 7 6 8 . 9 5 6 . 1 6 6 . 8 5 1 . 6 6 1 . 8 5 ) ± ( . 1 0 8 . 0 . 7 2 . 7 0 2 . 1 3 . 0 1 . 1 1 . 1 9 . 1 . 0 3 5 . 0 9 . 0 8 . 1 . 7 1 6 0 . 9 . 0 0 . 1 2 . 1 9 . 0 1 . 1 . 7 1 . 7 0 . 7 0 5 . 0 . 7 0 3 . 1 9 . 0 9 . 1 3 . 1 4 . 1 . 7 1 . 7 0 6 . 1 5 . 0 8 . 0 9 . 1 . 7 0 8 . 0 0 . 1 4 . 0 2 . 2 3 1 0 2 6 . 2 6 6 . 5 6 3 . 6 6 2 . 8 5 3 . 8 5 4 . 3 5 . 0 3 6 2 . 4 6 8 . 3 7 2 . 8 6 0 . 4 5 8 . 9 5 4 . 0 7 . 4 7 6 4 . 5 6 . 2 7 6 4 . 2 7 . 7 9 6 9 . 4 6 4 . 8 5 1 . 5 6 . 7 2 7 6 . 6 6 5 . 5 7 8 . 3 7 2 . 5 5 3 . 4 6 1 . 5 6 2 . 8 6 9 . 3 5 1 . 2 7 3 . 3 6 3 . 6 5 2 . 9 5 . 7 3 6 5 . 6 7 2 . 5 6 8 . 3 6 2 . 6 6 . 7 0 7 2 . 3 6 Z ) ± ( . 1 0 5 . 0 2 . 0 2 . 0 . 1 0 . 1 0 2 . 0 4 . 0 4 . 0 . 1 0 . 1 0 3 . 0 2 . 0 . 1 0 . 1 0 . 1 0 3 . 0 . 1 0 2 . 0 2 . 0 . 1 0 . 1 0 . 1 0 . 1 0 2 . 0 . 1 0 2 . 0 3 . 0 4 . 0 . 1 0 2 . 0 3 . 0 . 1 0 . 1 0 2 . 0 . 1 0 2 . 0 . 1 0 . 1 0 4 . 0 8 . 0 4 . 0 3 . 1 9 . 0 6 0 . 1 . 1 6 0 . 8 . 0 8 . 0 . 7 0 0 . 1 1 . 1 5 . 0 5 . 0 8 . 0 4 . 0 4 . 0 8 . 0 5 . 0 6 0 . 4 . 0 8 . 0 . 7 0 4 . 0 3 . 0 6 0 . 4 . 0 4 . 0 6 0 . 5 . 1 2 . 0 2 . 1 9 . 0 8 . 0 8 . 0 4 . 0 5 . 0 . 7 0 4 . 0 6 0 . 8 . 0 3 2 0 2 Z ) ± ( . 1 0 6 0 . 2 . 0 2 . 0 . 1 0 2 . 0 2 . 0 2 . 0 5 . 0 . 1 0 2 . 0 2 . 0 2 . 0 . 1 0 . 1 0 . 1 0 2 . 0 . 1 0 2 . 0 . 1 0 2 . 0 . 1 0 . 1 0 . 1 0 . 1 0 . 1 0 . 1 0 . 1 0 4 . 0 . 1 0 2 . 0 3 . 0 . 1 0 . 1 0 3 . 0 . 1 0 2 . 0 2 . 0 . 1 0 3 . 0 8 . 0 4 . 0 8 . 0 8 . 0 5 . 0 0 . 1 6 . 0 6 . 0 3 . 0 8 . 0 1 . 1 0 . 1 6 . 0 4 . 0 8 . 0 5 . 0 4 . 0 6 . 0 3 . 0 7 . 0 1 . 0 0 . 1 4 . 0 3 . 0 3 . 0 3 . 0 5 . 0 2 . 0 2 . 0 3 . 1 2 . 0 0 . 1 9 . 0 8 . 0 7 . 0 5 . 0 5 . 0 7 . 0 6 . 0 5 . 0 5 . 0 9 1 0 2 Z ) ± ( 2 . 0 5 . 0 2 . 0 2 . 0 1 . 0 2 . 0 2 . 0 4 . 0 4 . 0 2 . 0 2 . 0 4 . 0 5 . 0 2 . 0 1 . 0 1 . 0 1 . 0 1 . 0 2 . 0 1 . 0 2 . 0 1 . 0 1 . 0 2 . 0 1 . 0 1 . 0 2 . 0 3 . 0 5 . 0 1 . 0 2 . 0 4 . 0 1 . 0 1 . 0 1 . 0 1 . 0 1 . 0 1 . 0 1 . 0 2 . 0 0 . 1 5 . 0 1 . 1 9 . 0 4 . 0 8 . 1 7 . 0 9 . 0 0 . 1 4 . 0 7 . 1 3 . 1 0 . 1 9 . 0 3 . 1 5 . 0 3 . 0 4 . 0 4 . 0 0 . 1 2 . 0 4 . 1 4 . 0 5 . 0 5 . 0 2 . 0 5 . 0 4 . 0 7 . 0 1 . 2 1 . 0 6 . 1 6 . 1 0 . 1 6 . 0 2 . 0 5 . 0 7 . 0 4 . 0 6 . 0 3 . 0 3 1 0 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . e t a t S s e t a t S d e t i n U . . . . . . . . . . . . . . . . . . . . . a m a b a A l . . 2 a k s a A l . 2 a n o z i r A ² s a s n a k r A i ² a n r o f i l a C ² o d a r o o C l . ² t u c i t c e n n o C . . . ² e r a w a e D l f o t c i r t s i D . . . . . . . . . . . . . . . . . . . . . . . . . . i ² a b m u o C l . . . . . . . . . . . . . . . . . . . . . . . . . . . . . a d i r o F l i a g r o e G . ² i i a w a H . . . ² o h a d I ² s i o n i l l I ² a n a d n i I . . . . ² a w o I s a s n a K ² y k c u t n e K ² a n a i s i u o L . . . ² e n a M i l ² d n a y r a M . ² s t t e s u h c a s s a M . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ² n a g h c M i i ² a t o s e n n M i . . . . . i p p i s s i s s i M . ² i r u o s s i M . ² a n a t n o M ² a k s a r b e N . . ² a d a v e N ² e r i h s p m a H w e N . . . . . . . . . . . . . . . . . . . . . . . . ² y e s r e J w e N i . ² o c x e M w e N . . . ² k r o Y w e N a n i l o r a C h t r o N ² a t o k a D h t r o N . . . . . . . . . . . . . . . . i ² o h O . ² a m o h a k O l . . . ² n o g e r O l i ² a n a v y s n n e P ² d n a l s I e d o h R . l e b a t f o d n e i t a d e d v o r p s e t o n t o o F U.S. Census Bureau 23 . . s u s n e c 2 w w w / / : s p t t h < o t r e f e r , s n o i t i n i f e d d n a , r o r r e g n i l p m a s n o n , r o r r e g n i l p m a s , n o i t c e t o r p y t i l a i t n e d i f n o c n o n o i t a m r o f n i r o F . l n o i t a u p o p d e z i l a n o i t u t i t s n n o n n a i i l i i v C ( . ) > f d p 3 2 0 2 _ a t a D _ f o _ y c a r u c c A _ S C A / y c a r u c c a / s c o d _ h c e t / s c a / s y e v r u s - s m a r g o r p / v o g . n o C — 3 2 0 2 d n a , 9 1 0 2 , 3 1 0 2 : e t a t S y b e g a r e v o C c i l b u P r o e t a v i r P h t i W , i l d e r u s n n U r e d O d n a 5 6 d e g A s t l u d A f o e g a t n e c r e P . l 5 - B e b a T x d n e p p A i f o 1 r o r r e i n g r a M e g a r e v o c c i l b u P f o 1 r o r r e i n g r a M f o 1 r o r r e i n g r a M e g a r e v o c e t a v i r P f o 1 r o r r e i n g r a M f o 1 r o r r e i n g r a M f o 1 r o r r e i n g r a M f o 1 r o r r e i n g r a M f o 1 r o r r e i n g r a M d e r u s n n U i f o 1 r o r r e i n g r a M ) ± ( 3 . 0 8 . 0 2 . 0 3 . 0 6 . 0 6 . 0 3 . 0 3 . 0 4 . 0 3 . 0 0 . 1 3 2 0 2 3 . 7 9 1 . 7 9 7 . 6 9 7 . 3 9 5 . 4 9 6 . 6 9 7 . 4 9 7 . 4 9 8 . 7 9 8 . 6 9 9 . 6 9 ) ± ( 3 . 0 7 . 0 3 . 0 3 . 0 5 . 0 6 . 0 3 . 0 3 . 0 4 . 0 3 . 0 5 . 0 9 1 0 2 5 . 7 9 7 . 6 9 1 . 7 9 3 . 4 9 3 . 5 9 5 . 7 9 7 . 5 9 7 . 5 9 2 . 8 9 5 . 7 9 3 . 8 9 ) ± ( 3 . 0 6 . 0 3 . 0 2 . 0 6 . 0 8 . 0 3 . 0 3 . 0 3 . 0 2 . 0 1 . 1 3 1 0 2 9 . 7 9 8 . 7 9 7 . 7 9 1 . 5 9 5 . 6 9 2 . 7 9 0 . 6 9 5 . 6 9 4 . 8 9 0 . 8 9 1 . 7 9 ) ± ( 0 . 1 1 . 2 9 . 0 5 . 0 3 . 1 0 . 2 8 . 0 8 . 0 6 . 1 7 . 0 8 . 2 3 2 0 2 9 . 6 5 . 1 9 5 0 . 2 5 3 . 8 4 . 7 2 5 . 0 0 6 6 . 1 6 . 2 7 5 . 7 7 5 0 . 5 5 9 . 8 5 ) ± ( 9 . 0 2 . 2 8 . 0 5 . 0 5 . 1 2 . 2 . 7 0 . 7 0 4 . 1 8 . 0 9 . 2 9 1 0 2 9 . 0 6 2 . 9 5 6 . 6 5 5 . 1 5 2 . 0 6 6 . 3 6 . 0 7 6 6 . 3 6 . 0 3 6 4 . 1 6 4 . 2 6 ) ± ( 0 . 1 . 7 1 8 . 0 5 . 0 4 . 1 9 . 1 . 7 0 9 . 0 3 . 1 . 7 0 8 . 2 3 1 0 2 2 . 3 6 2 . 6 6 . 7 2 6 . 1 7 5 1 . 4 6 4 . 6 6 2 . 1 7 . 0 7 6 . 1 9 6 . 6 7 6 2 . 0 7 ) ± ( . 1 0 3 . 0 . 1 0 . 1 0 2 . 0 2 . 0 2 . 0 . 1 0 . 1 0 . 1 0 2 . 0 5 . 0 5 . 0 6 0 . 9 . 1 6 0 . 2 . 0 9 . 0 . 7 0 2 . 0 4 . 0 2 . 0 3 2 0 2 ) ± ( . 1 0 2 . 0 . 1 0 2 . 0 3 . 0 . 1 0 2 . 0 . 1 0 3 . 0 . 1 0 . 1 0 5 . 0 3 . 0 5 . 0 8 . 1 9 . 0 2 . 0 9 . 0 7 . 0 4 . 0 3 . 0 1 . 0 9 1 0 2 ) ± ( 1 . 0 4 . 0 1 . 0 2 . 0 3 . 0 2 . 0 2 . 0 2 . 0 1 . 0 1 . 0 3 . 0 6 . 0 5 . 0 5 . 0 0 . 2 8 . 0 3 . 0 1 . 1 8 . 0 2 . 0 3 . 0 3 . 0 3 1 0 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . e t a t S a n i l o r a C h t u o S . . . . . . . a t o k a D h t u o S . . . . . . . . . . . . . . . . e e s s e n n e T . . . . . . . . . . . s a x e T ² h a t U ² t n o m r e V i . ² a n g r i V i ² n o t g n h s a W i i i . ² a n g r i V t s e W . . . . . . . . n i s n o c s i W i . g n m o y W e h t f o e z i s e h t o t n o i t a e r n l i r o r r e i f o n g r a m e h t r e g r a l e h T . y t i l i b a i r a v ’ s e t a m i t s e n a f o e r u s a e m a s i r o r r e i f o n g r a m A . y t i l i b a i r a v g n i l p m a s o t j t c e b u s e r a d n a l e p m a s a n o d e s a b e r a a t a D 1 . l a v r e t n i e c n e d i f n o c t n e c r e p 0 9 e h t s m r o f r o r r e i f o n g r a m e h t , e t a m i t s e e h t m o r f d e t c a r t b u s d n a o t d e d d a n e h W e t a m . i t s e e h t l e b a i l e r s s e l e h t , e t a m i t s e . o r e z o t s d n u o r r o s t n e s e r p e R Z . s e t a m i t s e r a e y - 1 , y e v r u S y t i n u m m o C n a c i r e m A 3 2 0 2 d n a , 9 1 0 2 , 3 1 0 2 , u a e r u B s u s n e C . . S U : e c r u o S . 3 2 0 2 , 1 y r a u n a J e r o f e b r o n o y t i l i b g i i l i i e d a c d e M d e d n a p x e e t a t S ² 24 U.S. Census Bureau Appendix Table B-6. Changes in Uninsured, Private, and Public Coverage Rates for Adults Aged 65 and Older by State: 2013, 2019, and 2023—Con. (Civilian noninstitutionalized population. For information on confidentiality protection, sampling error, nonsampling error, and definitions, refer to <https://www2.census.gov/programs-surveys/acs/tech_docs/accuracy/ACS_Accuracy_of_Data_2023.pdf>) Uninsured Private coverage Public coverage State 2013 to 2019 change Margin of error1 (±) 2019 to 2023 change Margin of error1 (±) 2013 to 2019 change Margin of error1 (±) 2019 to 2023 change Margin of error1 (±) 2013 to 2019 change Margin of error1 (±) 2019 to 2023 change Margin of error1 (±) United States . . . . . . Alabama . . . . . . . . . . Alaska² . . . . . . . . . . . . Arizona² . . . . . . . . . . . Arkansas² . . . . . . . . . California² . . . . . . . . . Colorado² . . . . . . . . . Connecticut² . . . . . . . Delaware² . . . . . . . . . District of Columbia² . . . . . . . . Florida . . . . . . . . . . . . Georgia . . . . . . . . . . . Hawaii² . . . . . . . . . . . . Idaho² . . . . . . . . . . . . . Illinois² . . . . . . . . . . . . Indiana² . . . . . . . . . . . Iowa². . . . . . . . . . . . . . Kansas . . . . . . . . . . . . Kentucky² . . . . . . . . . Louisiana² . . . . . . . . . Maine² . . . . . . . . . . . . Maryland² . . . . . . . . . Massachusetts² . . . . . Michigan² . . . . . . . . . . Minnesota² . . . . . . . . Mississippi . . . . . . . . . Missouri² . . . . . . . . . . Montana² . . . . . . . . . . Nebraska² . . . . . . . . . Nevada² . . . . . . . . . . . New Hampshire² . . . New Jersey² . . . . . . . New Mexico² . . . . . . . New York² . . . . . . . . . North Carolina . . . . . North Dakota² . . . . . Ohio² . . . . . . . . . . . . . Oklahoma². . . . . . . . . Oregon² . . . . . . . . . . . Pennsylvania² . . . . . . Rhode Island² . . . . . . *–0.2 –0.1 –0.2 –0.1 0.2 *–0.8 –0.1 –0.3 *–0.7 0.4 *–0.5 *–0.4 –0.4 –0.5 *–0.5 Z Z 0.2 –0.1 –0.3 –0.1 *–0.4 0.1 *–0.2 *–0.2 0.1 Z –0.2 *–0.6 *–0.9 0.1 *–0.5 *–0.7 *–0.2 0.1 *0.3 Z Z 0.2 *–0.1 0.1 Footnotes provided at end of table. Z 0.2 0.8 0.2 0.3 0.1 0.2 0.3 0.4 0.7 0.2 0.3 0.4 0.5 0.2 0.2 0.2 0.3 0.2 0.3 0.1 0.3 0.1 0.1 0.2 0.2 0.2 0.2 0.3 0.6 0.2 0.3 0.5 0.1 0.2 0.3 0.1 0.2 0.2 0.1 0.3 Z Z 0.5 0.1 Z 0.1 Z 0.2 *0.5 –0.1 *–0.2 0.1 –0.1 0.1 Z Z Z 0.2 0.2 –0.1 *0.3 –0.2 *0.2 *0.1 Z *0.3 –0.1 0.1 *0.5 0.2 Z 0.1 Z Z 0.1 –0.1 Z Z –0.2 *0.2 0.3 Z 0.2 0.7 0.2 0.3 0.1 0.2 0.3 0.4 0.7 0.1 0.2 0.4 0.3 0.2 0.2 0.2 0.4 0.2 0.2 0.2 0.2 0.2 0.1 0.1 0.2 0.2 0.2 0.3 0.5 0.2 0.3 0.4 0.1 0.2 0.3 0.1 0.2 0.2 0.1 0.5 *–4.6 *–4.2 *–4.5 *–4.4 *–3.9 *–3.7 *–7.4 *–4.6 *–5.3 –4.0 *–4.4 *–4.0 –0.5 *–5.6 *–5.8 *–7.5 *–8.0 *–4.7 *–4.3 *–6.2 *–4.8 *–2.2 *–2.2 *–5.6 *–4.2 *–2.7 *–7.7 *–5.8 *–7.4 *–5.1 *–5.8 *–3.2 *–2.5 *–1.4 *–4.1 *–8.7 *–5.4 *–2.2 *–7.7 *–4.6 *–5,0 0.2 1.3 3.7 1.0 1.8 0.5 1.5 1.5 2.6 4.3 0.7 1.2 2.3 2.4 0.9 1.3 1.5 1.8 1.4 1.7 2.3 1.1 1.2 0.7 1.0 1.9 1.2 2.5 1.8 1.8 2.4 1.1 2.1 0.7 1.0 2.8 0.8 1.2 1.4 0.7 3.0 *–4.3 *–4.0 0.8 *–4.0 *–4.4 *–2.4 *–5.7 *–7.0 *–5.1 –3.1 *–3.1 *–4.2 –0.8 *–7.5 *–5.0 *–5.5 *–5.1 *–5.9 *–5.4 –1.4 *–7.6 *–2.3 *–3.3 *–6.3 *–4.4 *–2.2 *–6.0 –2.1 *–3.8 *–2.2 *–6.2 *–3.3 –0.6 *–3.8 *–5.4 0.3 *–6.3 *–5.4 *–5.3 *–7.5 *–3.6 0.2 1.3 3.5 1.2 1.7 0.5 1.3 1.3 2.7 4.2 0.7 1.2 2.0 2.1 0.9 1.3 1.5 1.8 1.4 1.7 2.2 1.2 1.2 0.8 1.1 1.8 1.1 2.4 1.9 1.7 2.5 1.1 2.0 0.8 1.0 3.3 0.8 1.3 1.4 0.8 2.9 *–0.4 –0.2 1.2 –0.2 *–0.7 –0.1 *–0.5 *–0.9 *0.8 –1.4 Z –0.2 Z 0.5 *–0.4 *–0.6 *–0.9 *–0.7 0.2 0.4 –0.4 *–0.7 *–0.7 *–0.5 –0.3 –0.1 –0.2 –0.2 –0.4 *1.3 0.1 –0.3 0.5 *–0.8 *–0.6 –0.6 *–0.4 *–1.0 *–0.9 *–0.3 *–1.1 0.1 0.4 2.0 0.4 0.6 0.3 0.5 0.7 0.8 2.2 0.3 0.4 1.0 0.8 0.4 0.3 0.5 0.5 0.4 0.6 0.7 0.6 0.5 0.3 0.4 0.5 0.4 0.6 0.6 0.8 0.9 0.5 0.8 0.3 0.3 1.1 0.3 0.5 0.5 0.3 1.0 *–0.7 *–0.7 0.4 *–1.0 –0.3 *–0.9 *–0.6 –0.3 *–1.7 *2.7 *–0.6 *–1.0 *–1.1 *–0.6 *–1.0 *–1.0 *–0.7 *–1.2 *–0.9 Z –0.2 *–1.1 *–1.3 *–0.8 *–0.9 *–0.7 *–0.9 –0.5 *–1.3 *–0.9 *–1.5 *–1.4 –0.2 0.3 *–0.8 *1.0 *–1.0 0.1 –0.3 *–0.7 –0.9 U.S. Census Bureau 0.1 0.5 1.4 0.4 0.6 0.3 0.5 0.7 1.0 2.2 0.3 0.4 1.0 0.6 0.4 0.4 0.5 0.6 0.4 0.6 0.8 0.6 0.6 0.3 0.4 0.5 0.4 0.6 0.7 0.8 0.9 0.5 0.7 0.3 0.3 1.0 0.3 0.5 0.5 0.3 1.3 25 Appendix Table B-6. Changes in Uninsured, Private, and Public Coverage Rates for Adults Aged 65 and Older by State: 2013, 2019, and 2023—Con. (Civilian noninstitutionalized population. For information on confidentiality protection, sampling error, nonsampling error, and definitions, refer to <https://www2.census.gov/programs-surveys/acs/tech_docs/accuracy/ACS_Accuracy_of_Data_2023.pdf>) Uninsured Private coverage Public coverage State 2013 to 2019 change Margin of error1 (±) 2019 to 2023 change Margin of error1 (±) 2013 to 2019 change Margin of error1 (±) 2019 to 2023 change Margin of error1 (±) 2013 to 2019 change Margin of error1 (±) 2019 to 2023 change Margin of error1 (±) South Carolina . . . . . South Dakota . . . . . . Tennessee . . . . . . . . . Texas . . . . . . . . . . . . . . Utah² . . . . . . . . . . . . . Vermont² . . . . . . . . . . Virginia² . . . . . . . . . . . Washington² . . . . . . . West Virginia² . . . . . . Wisconsin . . . . . . . . . Wyoming . . . . . . . . . . –0.1 –0.2 Z –0.2 0.2 –0.1 –0.2 –0.1 0.2 Z –0.2 0.2 0.4 0.2 0.2 0.5 0.2 0.3 0.2 0.3 0.1 0.3 0.1 0.2 0.1 0.2 –0.3 0.1 Z Z –0.2 0.1 0.1 0.2 0.4 0.2 0.2 0.4 0.2 0.2 0.2 0.3 0.1 0.2 *–2.3 *–7.1 *–6.1 *–5.6 *–3.9 –2.8 *–4.2 *–3.4 *–6.1 *–6.2 *–7.8 1.4 2.8 1.2 0.7 2.1 2.9 1.0 1.1 1.9 1.1 4.0 *–4.1 –0.1 *–4.6 *–3.2 *–7.5 *–3.6 *–5.4 *–6.4 *–5.3 *–6.4 –3.4 1.3 3.1 1.2 0.7 2.0 3.0 1.1 1.1 2.2 1.0 4.1 –0.4 *–1.1 *–0.5 *–0.8 *–1.1 0.3 –0.3 *–0.8 –0.2 *–0.6 *1.2 0.5 0.9 0.4 0.3 0.8 1.0 0.4 0.4 0.5 0.3 1.2 –0.2 0.4 *–0.4 *–0.6 *–0.8 *–0.9 *–1.0 *–0.9 –0.5 *–0.7 *–1.4 0.4 1.0 0.4 0.4 0.8 0.9 0.4 0.4 0.5 0.4 1.1 * Denotes a statistically significant change at the 90 percent confidence level. Z Represents or rounds to zero. 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 in relation to the size of the estimate, the less reliable the estimate. When added to and subtracted from the estimate, the margin of error forms the 90 percent confidence interval. ² State expanded Medicaid eligibility on or before January 1, 2023. Note: Differences are calculated with unrounded numbers, which may produce different results from using the rounded values in the table. Source: U.S. Census Bureau, 2013, 2019, and 2023 American Community Survey, 1-year estimates. 26 U.S. Census Bureau Appendix Table B-7. Percentage Without Health Insurance Coverage by Three Major Age Groups Among Top 25 Metropolitan Area: 2019 and 2023 (Civilian noninstitutionalized population. For information on confidentiality protection, sampling error, nonsampling error, and definitions, refer to <https://www2.census.gov/programs-surveys/acs/tech_docs/accuracy/ACS_Accuracy_of_Data_2023.pdf>) Metropolitan area Children under 19 Working–age adults aged 19 to 64 Adults aged 65 and older Change 2019 to 2023 2019 2023 Change 2019 to 2019 2023 2023 2019 2023 Change 2019 to 2023 Atlanta-Sandy Springs-Alpharetta, GA . . . . . . . . . . . . . . . Baltimore-Columbia-Towson, MD . . . . . . . . . . . . . . . . . . . . Boston-Cambridge-Newton, MA-NH . . . . . . . . . . . . . . . . . Charlotte-Concord-Gastonia, NC-SC . . . . . . . . . . . . . . . . . Chicago-Naperville-Elgin, IL-IN-WI . . . . . . . . . . . . . . . . . . Dallas-Fort Worth-Arlington, TX . . . . . . . . . . . . . . . . . . . . Denver-Aurora-Lakewood, CO . . . . . . . . . . . . . . . . . . . . . . Detroit-Warren-Dearborn, MI . . . . . . . . . . . . . . . . . . . . . . . Houston-The Woodlands-Sugar Land, TX . . . . . . . . . . . . Los Angeles-Long Beach-Anaheim, CA . . . . . . . . . . . . . . Miami-Fort Lauderdale-Pompano Beach, FL . . . . . . . . . . Minneapolis-St. Paul-Bloomington, MN-WI . . . . . . . . . . . New York-Newark-Jersey City, NY-NJ-PA . . . . . . . . . . . . Orlando-Kissimmee-Sanford, FL . . . . . . . . . . . . . . . . . . . . Philadelphia-Camden-Wilmington, PA-NJ-DE-MD . . . . . Phoenix-Mesa-Chandler, AZ . . . . . . . . . . . . . . . . . . . . . . . . Portland-Vancouver-Hillsboro, OR-WA . . . . . . . . . . . . . . . Riverside-San Bernardino-Ontario, CA . . . . . . . . . . . . . . . San Antonio-New Braunfels, TX . . . . . . . . . . . . . . . . . . . . . San Diego-Chula Vista-Carlsbad, CA . . . . . . . . . . . . . . . . . San Francisco-Oakland-Berkeley, CA . . . . . . . . . . . . . . . . Seattle-Tacoma-Bellevue, WA . . . . . . . . . . . . . . . . . . . . . . . St. Louis, MO-IL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Tampa-St. Petersburg-Clearwater, FL . . . . . . . . . . . . . . . . Washington-Arlington-Alexandria, DC-VA-MD-WV . . . . 7.6 3.1 1.5 5.7 4.3 12.8 5.2 3.1 13.3 4.0 8.7 2.6 3.1 6.6 3.2 9.1 3.7 4.1 3.7 9.1 3.9 2.4 2.8 6.6 4.5 6.6 3.6 1.7 5.7 3.2 12.0 4.2 2.6 12.9 3.1 7.8 2.9 3.2 6.4 3.7 8.2 3.6 4.3 9.3 3.4 2.4 2.6 3.5 6.8 4.6 –1.0 0.5 0.2 –0.1 –1.1 –0.8 –1.0 –0.6 –0.4 –0.9 –1.0 0.4 0.2 –0.2 0.4 –0.9 –0.1 0.3 0.1 –0.5 –0.1 –0.2 –0.1 0.2 0.1 17.4 6.5 4.4 15.1 11.4 22.3 10.1 7.9 25.8 13.1 21.9 6.3 9.7 17.1 7.8 15.0 9.2 12.9 9.4 22.5 11.3 5.8 8.0 18.4 10.0 15.2 6.6 3.5 13.1 9.6 20.0 9.2 6.4 23.7 10.1 16.4 5.1 8.6 13.6 6.9 13.1 7.4 11.2 18.7 8.1 5.6 7.4 7.2 14.8 9.1 –2.2 0.1 –0.9 –1.9 –1.9 –2.3 –0.9 –1.5 –2.1 –3.0 –5.6 –1.2 –1.1 –3.5 –0.9 –1.9 –1.9 –1.6 –3.8 –3.2 –0.2 –0.7 –2.2 –3.6 –0.9 1.1 0.7 0.5 1.1 1.0 1.9 0.9 0.4 2.8 1.4 2.0 0.3 1.2 1.4 0.5 1.0 0.8 1.1 0.4 1.4 0.9 0.8 1.0 1.0 1.6 1.4 0.6 0.6 1.0 1.1 2.1 0.8 0.7 3.0 1.3 1.7 0.4 1.2 1.3 0.6 1.0 0.5 1.3 1.5 1.0 0.9 0.8 0.3 1.0 1.2 0.3 –0.1 0.2 –0.1 0.1 0.2 –0.1 0.3 0.2 –0.1 –0.3 0.1 Z –0.1 0.2 Z –0.3 0.2 Z Z 0.1 –0.1 –0.1 Z –0.4 * Denotes a statistically significant change at the 90 percent confidence level. Z Represents or rounds to zero. 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 in relation to the size of the estimate, the less reliable the estimate. When added to and subtracted from the estimate, the margin of error forms the 90 percent confidence interval. Note: Differences are calculated with unrounded numbers, which may produce different results from using the rounded values in the table. Metropolitan Statistical Areas are organized by alphabetical order and not in order of population rank. Source: U.S. Census Bureau, 2019 and 2023 American Community Survey, 1-year estimates. U.S. Census Bureau 27 Appendix Table B-8. Margins of Error for Population Without Health Insurance Coverage by Three Major Age Groups Among Top 25 Metropolitan Area: 2019 and 2023 (Civilian noninstitutionalized population. For information on confidentiality protection, sampling error, nonsampling error, and definitions, refer to <https://www2.census.gov/programs-surveys/acs/tech_docs/accuracy/ACS_Accuracy_of_Data_2023.pdf>) Metropolitan area Children under 19 Working-age adults aged 19 to 64 Adults aged 65 and older Change 2019 to 2023 margin of error1 (±) 2019 mar- gin of error1 (±) 2023 mar- gin of error1 (±) Change 2019 to 2023 margin of error1 (±) Change 2019 to 2023 margin of error1 (±) 2019 margin of error1 (±) 2023 margin of error1 (±) 2019 margin of error1 (±) 2023 margin of error1 (±) Atlanta-Sandy Springs-Alpharetta, GA . . . . . . . . . . . . . . . Baltimore-Columbia-Towson, MD . . . . . . . . . . . . . . . . . . . . Boston-Cambridge-Newton, MA-NH . . . . . . . . . . . . . . . . . Charlotte-Concord-Gastonia, NC-SC . . . . . . . . . . . . . . . . . Chicago-Naperville-Elgin, IL-IN-WI . . . . . . . . . . . . . . . . . . Dallas-Fort Worth-Arlington, TX . . . . . . . . . . . . . . . . . . . . Denver-Aurora-Lakewood, CO . . . . . . . . . . . . . . . . . . . . . . Detroit-Warren-Dearborn, MI . . . . . . . . . . . . . . . . . . . . . . . Houston-The Woodlands-Sugar Land, TX . . . . . . . . . . . . Los Angeles-Long Beach-Anaheim, CA . . . . . . . . . . . . . . Miami-Fort Lauderdale-Pompano Beach, FL . . . . . . . . . . Minneapolis-St. Paul-Bloomington, MN-WI . . . . . . . . . . . New York-Newark-Jersey City, NY-NJ-PA . . . . . . . . . . . . Orlando-Kissimmee-Sanford, FL . . . . . . . . . . . . . . . . . . . . Philadelphia-Camden-Wilmington, PA-NJ-DE-MD . . . . . Phoenix-Mesa-Chandler, AZ . . . . . . . . . . . . . . . . . . . . . . . . Portland-Vancouver-Hillsboro, OR-WA . . . . . . . . . . . . . . . Riverside-San Bernardino-Ontario, CA . . . . . . . . . . . . . . . San Antonio-New Braunfels, TX . . . . . . . . . . . . . . . . . . . . . San Diego-Chula Vista-Carlsbad, CA . . . . . . . . . . . . . . . . . San Francisco-Oakland-Berkeley, CA . . . . . . . . . . . . . . . . Seattle-Tacoma-Bellevue, WA . . . . . . . . . . . . . . . . . . . . . . . St. Louis, MO-IL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Tampa-St. Petersburg-Clearwater, FL . . . . . . . . . . . . . . . . Washington-Arlington-Alexandria, DC-VA-MD-WV . . . . 0.8 0.7 0.3 0.8 0.4 0.7 0.8 0.5 0.8 0.3 0.7 0.5 0.2 1.0 0.4 0.7 0.6 0.5 0.6 1.2 0.6 0.4 0.5 0.9 0.5 0.6 0.7 0.3 0.6 0.3 0.8 0.6 0.4 0.7 0.3 0.7 0.5 0.2 1.0 0.6 0.8 0.7 0.6 1.1 0.6 0.4 0.6 0.7 0.9 0.5 0.9 1.0 0.4 1.0 0.5 1.1 1.0 0.6 1.0 0.4 1.0 0.7 0.3 1.4 0.7 1.1 1.0 0.7 1.6 0.8 0.6 0.8 0.9 1.3 0.7 0.5 0.5 0.3 0.5 0.3 0.5 0.5 0.4 0.6 0.2 0.7 0.4 0.2 0.9 0.4 0.5 0.5 0.5 0.5 1.0 0.5 0.3 0.5 0.8 0.4 0.4 0.5 0.3 0.6 0.3 0.4 0.4 0.3 0.6 0.2 0.5 0.3 0.2 0.7 0.3 0.5 0.6 0.5 0.9 0.5 0.4 0.3 0.5 0.6 0.3 0.7 0.7 0.4 0.8 0.4 0.7 0.7 0.5 0.8 0.3 0.9 0.5 0.3 1.2 0.5 0.7 0.8 0.7 1.3 0.7 0.5 0.6 0.7 1.0 0.5 0.2 0.2 0.2 0.3 0.2 0.3 0.3 0.1 0.5 0.2 0.2 0.1 0.1 0.6 0.1 0.2 0.3 0.3 0.2 0.4 0.3 0.2 0.2 0.4 0.3 0.2 0.2 0.2 0.3 0.2 0.3 0.3 0.2 0.4 0.2 0.3 0.1 0.1 0.4 0.2 0.2 0.3 0.3 0.4 0.2 0.3 0.2 0.1 0.2 0.2 0.3 0.3 0.2 0.4 0.2 0.5 0.4 0.2 0.7 0.2 0.4 0.2 0.2 0.7 0.2 0.3 0.4 0.4 0.6 0.4 0.4 0.3 0.2 0.4 0.4 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 in relation to the size of the estimate, the less reliable the estimate. When added to and subtracted from the estimate, the margin of error forms the 90 percent confidence interval. Note: Metropolitan Statistical Areass are organized by alphabetical order and not in order of population rank. Source: U.S. Census Bureau, 2019 and 2023 American Community Survey, 1-year estimates. 28 U.S. Census Bureau