Health Insurance Coverage in the United States: 2018
Current Population Reports
By Edward R. Berchick, Jessica C. Barnett, and Rachel D. Upton Issued November 2019 P60-267(RV) Acknowledgments Edward R. Berchick, Jessica C. Barnett, and Rachel D. Upton prepared this report under the direction of Laryssa Mykyta, Chief of the Health and Disability Statistics Branch. Sharon Stern, Assistant Division Chief for Employment Characteristics, of the Social, Economic, and Housing Statistics Division, provided overall direction. Vonda Ashton, David Watt, Susan S. Gajewski, Mallory Bane, and Nancy Hunter, of the Demographic Surveys Division, and Lisa Cheok of the Associate Directorate for Demographic Programs, processed the Current Population Survey 2019 Annual Social and Economic Supplement file. Andy Chen, Kirk E. Davis, Raymond Dowdy, Lan N. Huynh, Chandararith R. Phe, and Adam W. Reilly programmed and produced the detailed and publica- tion tables under the direction of Hung X. Pham, Chief of the Tabulation and Applications Branch. Victoria Velkoff, Chief of the American Community Survey Office, provided overall direction for the implementation of the 2018 American Community Survey. Donna M. Daily, Nicole Butler, Dameka M. Reese, and Michelle Wiland of the American Community Survey Office oversaw the data collection including con- tent, group quarters, and self-response. Kenneth B. Dawson, Reyan Azeem, and Arumugam Sutha of the Decennial Information Technology Division directed the edit and processing tasks for the 2018 1-Year American Community Survey file. Samantha Spiers, under the supervision of KeTrena Phipps and David V. Hornick, of the Demographic Statistical Methods Division, conducted the statistical review of all Current Population Survey data. Michael D. Starsinic, under the supervision of Mark Asiala, both of the Decennial Statistical Studies Division, conducted the statistical review of all American Community Survey data. Lisa Cheok of the Associate Directorate for Demographic Programs, provided overall direction for the survey implementation. Roberto Cases and Aaron Cantu of the Associate Directorate for Demographic Programs, and Charlie Carter and Agatha Jung of the Information Technology Directorate prepared and pro- grammed the computer-assisted interviewing instrument used to conduct the Annual Social and Economic Supplement. Jessica Hays and Linda Orsini prepared the maps under the direction of Kevin Hawley, Chief of the Cartographic Products and Services Branch, Geography Division. Additional people within the U.S. Census Bureau also made significant contribu- tions to the preparation of this report. Douglas Conway, Adriana Hernandez Viver, Heide Jackson, Katherine Keisler, Matthew Marlay, Amy Steinweg, Jonathan Vespa, and Susan Walsh reviewed the contents. Census Bureau field representatives and telephone interviewers collected the data. Without their dedication, the preparation of this report or any report from the Current Population Survey would be impossible. Faye Brock, Linda Chen, and Michael K. Shelton provided publication manage- ment, graphics design and composition, and editorial review for print and elec- tronic media under the direction of Janet Sweeney, Chief of the Graphic and Editorial Services Branch, Public Information Office.Linda Vaughn of the U.S. Census Bureau’s Administrative and Customer Services Division provided printing management. Health Insurance Coverage in
the United States: 2018 Issued November 2019
P60-267(RV)
U.S. Department of Commerce Wilbur Ross, Secretary
Karen Dunn Kelley, Deputy Secretary
U.S. CENSUS BUREAU Steven Dillingham, Director Suggested Citation Berchick, Edward R., Jessica C. Barnett, and Rachel D. Upton Current Population Reports, P60-267(RV), Health Insurance Coverage in the United States: 2018, U.S. Government Printing Office, Washington, DC, 2019.
U.S. CENSUS BUREAU Steven Dillingham, Director Ron S. Jarmin, Deputy Director and Chief Operating Officer Victoria A. Velkoff, Associate Director for Demographic Programs David G. Waddington, Chief, Social, Economic, and Housing Statistics Division Contents TEXT Introduction ...... 1 What Is Health Insurance Coverage? ...... 1 Highlights ...... 2 Calendar-Year Coverage in 2018 ...... 3 Change in Coverage Between 2017 and 2018 ...... 3 Coverage at the Time of Interview ...... 4 Health Insurance Coverage During the Calendar Year ...... 5 Health Insurance Coverage by Age ...... 7 Children Without Health Insurance Coverage ...... 9 Health Insurance Coverage by Selected Social and Economic Characteristics...... 9 Health Insurance Coverage by Household Income and Income-to-Poverty Ratio ...... 11 Health Insurance Coverage by Selected Demographic Characteristics...... 15 State Estimates of Health Insurance Coverage ...... 16 Health Insurance Coverage in the American Community Survey ...... 17 More Information About Health Insurance Coverage ...... 21 Additional Data and Contacts ...... 21 State and Local Estimates of Health Insurance Coverage ...... 21 Comments ...... 21 Sources of Estimates ...... 21 Statistical Accuracy ...... 21
TEXT TABLES Table 1. Number and Percentage of People by Type of Health Insurance: 2017 and 2018 ...... 3 Table 2. Percentage of People by Type of Health Insurance Coverage by Age: 2017 and 2018 ...... 6 Table 3. Percentage of People by Type of Health Insurance Coverage for Selected Ages and Characteristics: 2017 and 2018 ...... 10 Table 4. Percentage of People by Type of Health Insurance Coverage by Household Income and Income-to-Poverty Ratio: 2017 and 2018 ...... 12 Table 5. Percentage of People by Type of Health Insurance Coverage by Selected Demographic Characteristics: 2017 and 2018 ...... 14 Table 6. Number and Percentage of People Without Health Insurance Coverage by State: 2017 and 2018 ...... 19
U.S. Census Bureau Health Insurance Coverage in the United States: 2018 iii FIGURES Figure 1. Percentage of People by Type of Health Insurance Coverage and Change From 2017 to 2018 ...... 2 Figure 2. Percentage of People by Type of Coverage at the Time of Interview and Change Between 2018 and 2019 ...... 4 Figure 3. Subannual Health Insurance Coverage: 2018 ...... 5 Figure 4. Percentage of People Uninsured by Age: 2017 and 2018 ...... 7 Figure 5. Percentage of Children Under the Age of 19 Without Health Insurance Coverage by Selected Characteristics: 2017 and 2018 ...... 8 Figure 6. Uninsured Rate by Poverty Status and Medicaid Expansion of State for Adults Aged 19 to 64: 2017 to 2018 ...... 13 Figure 7. Uninsured Rate: 2008 to 2018 ...... 17 Figure 8. Uninsured Rate by State: 2018 ...... 18 Figure 9. Change in the Uninsured Rate by State: 2017 and 2018 ...... 20 Figure A1. Measuring Health Insurance Coverage With the Current Population Survey Annual Social and Economic Supplement (CPS ASEC): A History of Improvement ...... 28
APPENDIXES Appendix A. ESTIMATES OF HEALTH INSURANCE COVERAGE ...... 27 Quality of Health Insurance Coverage Estimates ...... 27 Historical Comparisons ...... 28 Comparison of Estimates of Health Insurance Coverage in 2017, Traditional Processing System and Updated Processing System ...... 29 Appendix B. REPLICATE WEIGHTS ...... 31 Appendix C. ADDITIONAL DATA AND CONTACTS ...... 33 Additional Tables ...... 33 Customized Tables ...... 33 Data.census.gov ...... 33 Public-Use Microdata ...... 33 CPS ASEC ...... 33 ACS ...... 33 Topcoding ...... 33
APPENDIX TABLES Appendix Table 1. Number of People by Type of Health Insurance Coverage by Age: 2017 and 2018 ...... 23 Appendix Table 2. Number of People by Type of Health Insurance Coverage for Selected Ages and Characteristics: 2017 and 2018 ...... 24 Appendix Table 3. Number of People by Type of Health Insurance Coverage by Household Income and Income-to-Poverty Ratio: 2017 and 2018 ...... 25 Appendix Table 4. Number of People by Type of Health Insurance Coverage by Selected Demographic Characteristics: 2017 and 2018 ...... 26
iv Health Insurance Coverage in the United States: 2018 U.S. Census Bureau Health Insurance Coverage in the United States: 2018
Introduction This report presents statistics on Community Survey (ACS), which has health insurance coverage in the a larger sample size that makes it Health insurance is a means for United States in 2018 and changes in well-suited for subnational levels of financing a person’s health care health insurance coverage between geography. expenses. While the majority of 2017 and 2018.1, 2 The statistics in people have private health insur- For the past several years, the Census this report are primarily based on ance, primarily through an employer, Bureau has been engaged in imple- information collected in the Current many others obtain coverage through menting improvements to the CPS Population Survey Annual Social and programs offered by the government. ASEC. These changes have been Economic Supplement (CPS ASEC), a Other individuals do not have health implemented in a two-step process, survey conducted by the U.S. Census insurance coverage at all (see the beginning with questionnaire design Bureau. State-level estimates are text box “What Is Health Insurance changes incorporated over the based on information from a second Coverage?”). period of 2014 to 2016 and followed Census Bureau survey, the American by more recent changes to the data Year to year, the prevalence of health processing system. This report is the insurance coverage and the distribu- ¹ For a discussion of the quality of CPS ASEC first time health insurance coverage tion of coverage types may change health insurance coverage estimates and mea- suring change over time with the CPS ASEC, see measures reflect both data collec- due to economic trends, shifts in the Appendix A. tion and processing system changes. demographic composition of the 2 The Census Bureau reviewed this data The 2017 and 2018 estimates used in population, and policy changes that product for unauthorized disclosure of confi- dential information and approved the disclosure this report are based on the updated affect access to care. avoidance practices applied to this release. CBDRB-FY19-POP001-0018. processing system, and, therefore, the
What Is Health Insurance Coverage? Health insurance coverage in the Current Population Survey Annual Social and Economic Supplement (CPS ASEC) refers to comprehensive coverage during the calendar year for the civilian, noninstitutionalized population.* For reporting purposes, the Census Bureau broadly classifies health insurance coverage as private insurance or public insurance.
Private Coverage Public Coverage
• Employment-based: Plan provided through an • Medicare: Federal program that helps to pay employer or union. health care costs for people aged 65 and older and for certain people under age 65 with long-term • Direct-purchase: Coverage purchased directly from disabilities. an insurance company or through a federal or state marketplace (e.g., healthcare.gov). • Medicaid: Medicaid, the Children’s Health Insurance Program (CHIP), and individual state health plans. • TRICARE: Coverage through TRICARE, formerly known as Civilian Health and Medical Program of • CHAMPVA or VA: Civilian Health and Medical the Uniformed Services. Program of the Department of Veterans Affairs, as well as care provided by the Department of Veterans Affairs and the military.
Additionally, people are considered uninsured if they only had coverage through the Indian Health Service (IHS), as IHS coverage is not considered comprehensive. For more information, see Appendix A, “Estimates of Health Insurance Coverage.”
* Comprehensive health insurance covers basic healthcare needs. This definition excludes single-service plans such as accident, disability, dental, vision, or prescription medicine plans.
U.S. Census Bureau Health Insurance Coverage in the United States: 2018 1 2017 estimates may differ from those lower than the rate in 2017 (92.1 decreased by 0.7 percentage released in September 2018. See percent) (Table 1).5 points to 17.9 percent (Figure Appendix A for more information.3 1 and Table 1).7 The rate of •• In 2018, private health insurance Medicare coverage increased by coverage continued to be more Highlights 0.4 percentage points to 17.8 prevalent than public coverage, percent.8, 9 •• In 2018, 8.5 percent of people, or covering 67.3 percent of the 27.5 million, did not have health population and 34.4 percent of •• The percentage of people with insurance at any point during the population, respectively.6 private coverage or any of the the year. The uninsured rate and Of the subtypes of health insur- three subtypes of private cover- number of uninsured increased ance coverage, employer-based age (employment-based, direct- from 2017 (7.9 percent or 25.6 insurance remained the most purchase, and TRICARE) did not 4 million) (Figure 1 and Table 1). common, covering 55.1 percent statistically change between 2017 •• The percentage of people with of the population for all or part of and 2018. the calendar year (Figure 1 and health insurance coverage for all •• The percentage of uninsured Table 1). or part of 2018 was 91.5 percent, children under the age of 19 •• Between 2017 and 2018, the increased by 0.6 percentage percentage of people with public 3 Given the effect of the new health insur- coverage decreased 0.4 percent- 7 Throughout this report, details may not ance questions introduced in 2014, the new sum to totals because of rounding. relationship categories introduced in 2015–2016, age points. The percentage of 8 This increase was partly due to growth in and the 2019 implementation of an updated people covered by Medicaid the number of people aged 65 and over. Among processing system, the CPS ASEC estimates those 65 years and older, the Medicare cover- in this report are not comparable to previously age rate did not statistically change between published estimates. See Appendix A for more 5 All comparative statements in this report 2017 and 2018. However, the percentage of the details. have undergone statistical testing, and compari- U.S. population 65 years and older increased 4 Infants born after the end of the calendar- sons are significant at the 90 percent confidence between 2017 and 2018. year reference period are excluded from level unless otherwise noted. 9 In 2018, the percentage of people covered estimates in this report, with the exception of 6 Some people may have more than one by Medicaid was not statistically different from estimates of coverage at the time of interview. coverage type during the calendar year. the percentage covered by Medicare.
Figure Percentage of People by Type of Health Insurance Coverage and Change From to (Population as of March of the following year) No statistical change between years Type of Coverage Change to
Uninsured ¡* With health insurance § –*
Any private plan ¨¦¤ –£ Employment-based –¤ Direct-purchase –¥ TRICARE ¥¨ ¡
Any public plan ¤££ –£* Medicare ¦ ¡£* Medicaid ¦§ –¦* VA and CHAMPVA Z
Z Represents zero or rounds to zero. 1 Includes CHAMPVA (Civilian Health Medical Program of the Department of Veterans Aairs), as well as care provided by the Department of Veterans Aairs and the military. * Denotes a statistically significant change between 2017 and 2018 at the 90 percent confidence level. Note: The estimates by type of coverage are not mutually exclusive; people can be covered by more than one type of health insurance during the year. For information on confidentiality protection, sampling error, nonsampling error, and definitions in the Current Population Survey, see
2 Health Insurance Coverage in the United States: 2018 U.S. Census Bureau Table 1. Number and Percentage of People by Type of Health Insurance: 2017 and 2018 (Numbers in thousands. Margins of error in thousands or percentage points as appropriate. Population as of March of the following year. For information on confidentiality protection, sampling error, nonsampling error, and definitions, see
Change in Change in 2017 2018 number percent Coverage type Margin of Margin of Margin of Margin of 2018 less 2018 less Number error¹ (±) Percent error¹ (±) Number error¹ (±) Percent error¹ (±) 2017 2017 Total ...... 322,490 135 X X 323,668 133 X X *1,178 X
Any health plan...... 296,890 622 92.1 0.2 296,206 641 91.5 0.2 –684 *–0.5
Any private plan2, 3...... 218,209 1,129 67.7 0.3 217,780 1,222 67.3 0.4 –430 –0.4 Employment-based². . . . 178,751 1,106 55.4 0.3 178,350 1,283 55.1 0.4 –401 –0.3 Direct-purchase²...... 35,499 704 11.0 0.2 34,846 647 10.8 0.2 –653 –0.2 Marketplace coverage2 . . 11,217 380 3.5 0.1 10,743 428 3.3 0.1 –474 –0.2 TRICARE2...... 8,207 549 2.5 0.2 8,537 508 2.6 0.2 330 0.1
Any public plan2, 4...... 112,151 928 34.8 0.3 111,330 962 34.4 0.3 –821 *–0.4 Medicare²...... 56,170 361 17.4 0.1 57,720 401 17.8 0.1 *1,550 *0.4 Medicaid²...... 59,814 892 18.5 0.3 57,819 891 17.9 0.3 *–1,995 *–0.7 VA or CHAMPVA2, 5. . . . . 3,229 188 1.0 0.1 3,217 182 1.0 0.1 –12 Z
Uninsured⁶...... 25,600 596 7.9 0.2 27,462 630 8.5 0.2 *1,862 *0.5 * Changes between the estimates are statistically different from zero at the 90 percent confidence level. X Not applicable. Z Represents or rounds to zero. ¹ A margin of error (MOE) is a measure of an estimate’s variability. The larger the MOE in relation to the size of the estimate, the less reliable the estimate. This number, when added to and subtracted from the estimate, forms the 90 percent confidence interval. MOEs shown in this table are based on standard errors calculated using replicate weights. For more information, see “Standard Errors and Their Use” at
points between 2017 and 2018, uninsured rate. People were consid- insurance (10.8 percent), TRICARE to 5.5 percent (Table 2). ered uninsured if, for the entire year, (2.6 percent), and VA or CHAMPVA they were not covered by any type of health care (1.0 percent) (Table 1).13, 14 •• Between 2017 and 2018, the per- health insurance.11 centage of people without health Direct-purchase insurance includes insurance coverage at the time In 2018, most people (91.5 percent) coverage obtained through a state of interview decreased in three had health insurance coverage at or federal marketplace. In 2018, states and increased in eight some point during the calendar year 3.3 percent of people, or 30.8 per- states (Figure 9 and Table 6).10 (Figure 1 and Table 1). That is, 8.5 cent of people with direct-purchase percent of people were uninsured for insurance, obtained their cover- Calendar-Year Coverage in 2018 the entire calendar year. More people age through a state or federal This report classifies health insurance had private health insurance (67.3 marketplace. coverage into three categories: over- percent) than public coverage (34.4 12 Change in Coverage Between 2017 all coverage, private coverage, and percent). and 2018 public coverage (see Text Box “What Employer-based insurance was the The percentage of people covered Is Health Insurance Coverage?”). In most common subtype of health by any type of health insurance in the CPS ASEC, people are considered insurance (55.1 percent), followed by 2018 was lower than the percent- to have coverage if they were cov- Medicaid (17.9 percent), Medicare age in 2017. This decline appears to ered by health insurance for part or (17.8 percent), direct-purchase all of the previous calendar year. This report also presents estimates of the 13 In 2018, the percentage of people with 11 Infants born after the end of the calendar- Medicare was not statistically different from the year reference period are excluded from percentage of people with Medicaid. 10 Estimates are from the 2017 and 2018 estimates in this report, with the exception of 14 The final category includes CHAMPVA American Community Survey, 1-year estimates. estimates of coverage at the time of interview. (Civilian Health and Medical Program of the For more information, see the text box “Health 12 See text box “What Is Health Insurance Department of Veterans Affairs) coverage and Insurance Coverage in the American Community Coverage?” for definitions of private and public care provided by the Department of Veterans Survey.” coverage. Affairs and the military.
U.S. Census Bureau Health Insurance Coverage in the United States: 2018 3 Coverage at the Time of Interview Starting this year, the CPS ASEC April). This information describes in the calendar year, estimates of includes two types of health insur- health insurance coverage in early current coverage tend to be lower ance coverage measures: health 2019, not for the full calendar than the calendar-year estimates. insurance coverage during the year. Between early 2018 and early previous calendar year and health In early 2019, 90.9 percent of 2019, Medicaid coverage at the insurance coverage at the time of people had health insurance time of interview decreased by 0.7 the interview. The first measure, coverage at the time of interview, percentage points, and Medicare health insurance coverage at any a 0.4 percentage-point decrease coverage at the time of interview time during the previous calen- from early 2018. As the main increased. No other subtype of dar year, is used throughout this measure of coverage in the CPS coverage saw a statistically signifi- report. The second measure cap- ASEC captures whether a person cant change during this time. tures coverage held at the time of had coverage at any point in time interview (between February and
Figure Percentage of People by Type of Coverage at the Time of Interview and Change Between and (Population as of March of the calendar year) No statistical change between years Type of Coverage Change to
Uninsured * With health insurance –*
Any private plan ¤¤ – Employment-based ¥ – Direct-purchase – TRICARE ¤
Any public plan ¢ –¢ Medicare ¦ * Medicaid £¢ –£* VA and CHAMPVA Z
Z Represents zero or rounds to zero. 1 Includes CHAMPVA (Civilian Health Medical Program of the Department of Veterans Aairs), as well as care provided by the Department of Veterans Aairs and the military. * Denotes a statistically significant change between 2018 and 2019 at the 90 percent confidence level. Note: The estimates by type of coverage are not mutually exclusive; people can be covered by more than one type of health insurance. For information on confidentiality protection, sampling error, nonsampling error, and definitions in the Current Population Survey, see
4 Health Insurance Coverage in the United States: 2018 U.S. Census Bureau be driven by a 0.4 percentage-point Health Insurance Coverage During individuals held this type of coverage decrease in public health insur- the Calendar Year for 1 to 11 months during 2018.16 ance (Table 1). Medicaid coverage People may have health insurance While most people have a single type decreased by 0.7 percentage points coverage for part or all of the calen- of insurance, some people may have between 2017 and 2018.15 The rate dar year. Among the 296.2 million more than one type of coverage dur- of Medicare coverage moved in the people covered at any point during ing the calendar year. They may have opposite direction, increasing by 0.4 2018, most—96.4 percent—had health multiple types of coverage at one time percentage points. This increase was insurance coverage for all 12 months, to supplement their primary insurance partly due to growth in the number while 3.6 percent had coverage for 1 type, or they may switch coverage of people aged 65 and over and not to 11 months (Figure 3). That is, most types over the course of the year. a change in Medicare coverage for people with coverage during 2018 adults in this age range. had coverage throughout the entire The percentage of people covered by calendar year. Similarly, the majority 16 Some people may transition from one type of people with private coverage (95.2 of coverage to another type of coverage during private health insurance, or any of its the calendar year. For example, some people three subtypes (employment-based, percent) and public coverage (94.2 may switch from employer-based (which is direct-purchase, and TRICARE), did percent) were covered for the entire private) to Medicare coverage (which is public) during the calendar year. Such people would be not statistically change between 2017 calendar year. Only 4.8 and 5.8 per- considered to have full-year overall coverage. and 2018. cent of people with private and public However, they would have private coverage for coverage held that type of coverage part of the year and public coverage for part of the year. Therefore, the percentage with part- 15 Unless otherwise stated, all changes cor- for part of the year, respectively. Such year private coverage and the percentage with respond to the percentage-point difference in part-year public coverage may not sum to the coverage rates between 2017 and 2018. total with part-year overall coverage.
Figure Subannual Health Insurance Coverage (Numbers in percents Population as of March of the following year)
Full-year coverage Part-year coverage
Any health plan
Any private plan
Any public plan Medicaid
More than one type of coverage during the calendar year One type More than one type
Concurrent coverage Concurrent coverage Concurrent coverage all months to months no months
This group had more than one type of coverage during 2018, but did not have concurrent coverage within any single month.
Note: For information on confidentiality protection, sampling error, nonsampling error, and definitions in the Current Population Survey, see
U.S. Census Bureau Health Insurance Coverage in the United States: 2018 5
Z Z 1, * 0.7 less less *0.7 *0.6 *0.8 *1.0 *1.0 *0.5 (2018 Change 2017) of (±) 0.2 0.2 0.3 0.3 0.6 0.5 0.5 0.3 0.1 error² error² Margin Margin - 2018 8.5 5.5 9.3 0.9 Per 10.0 11.7 14.3 13.9 12.5 cent Uninsured⁵ of (±) 0.2 0.2 0.3 0.2 0.6 0.5 0.4 0.3 0.1 error² error² Margin Margin - 2017 7.9 9.2 5.0 8.3 1.0 Per 11.0 13.7 14.0 11.4 cent www2.census.gov/programs–surveys/cps Z 1, * less less –0.5 –0.1 *–0.8 *–1.3 *–0.6 *–1.0 *–0.8 *–0.4 (2018 Change 2017) of (±) 0.3 0.3 0.7 0.3 0.7 0.6 0.5 0.4 0.3 error² error² Margin Margin - 2018 Per 34.4 22.8 35.7 17.6 18.3 17.5 16.2 18.1 94.1 cent of (±) 0.3 0.3 0.6 0.3 0.7 0.6 0.6 0.4 0.3 error² error² Public health insurance⁴ Margin Margin - 2017 Per 34.8 23.6 37.0 18.3 18.8 18.5 16.3 18.9 94.2 cent 1, * 0.2 1.0 less less –0.1 –0.2 –0.1 –0.4 –0.4 *–1.2 *–1.3 (2018 Change 2017) 3 of (±) 0.4 0.4 0.7 0.4 0.9 0.8 0.6 0.5 0.7 Total error² error² Margin Margin - 2018 Per 67.3 70.2 61.8 73.5 69.9 71.3 73.7 75.8 52.4 cent of (±) 0.3 0.4 0.6 0.4 0.8 0.7 0.6 0.5 0.8 Any health insurance Any error² error² Private health insurance Private Margin Margin - 2017 Per 67.7 70.3 61.6 73.8 70.0 70.4 75.0 76.1 53.7 cent Z Z 1, * less less –0.7 *–0.7 *–0.6 *–0.8 *–1.0 *–1.0 *–0.5 (2018 Change 2017) of (±) 0.2 0.2 0.3 0.3 0.6 0.5 0.5 0.3 0.1 error² error² Margin Margin - 2018 Per 91.5 90.0 94.5 88.3 85.7 86.1 87.5 90.7 99.1 cent of (±) 0.2 0.2 0.3 0.2 0.6 0.5 0.4 0.3 0.1 error² error² Margin Margin - 2017 Per 92.1 90.8 95.0 89.0 86.3 86.0 88.6 91.7 99.0 cent 77,333 29,297 40,768 41,027 82,455 52,788 2018 323,668 270,881 193,548 Number mutually exclusive; people can be covered by more than one type of health insurance during the year. of health insurance than one type more by people can be covered mutually exclusive; not 77,487 29,811 40,222 40,662 83,242 51,066 2017 322,490 271,424 193,937 Number ) ...... 6 . Characteristic . * Changes between the estimates are statistically different from zero at the 90 percent confidence level. level. confidence at the 90 percent zero from different statistically are the estimates * Changes between zero. to or rounds Z Represents because of rounding. totals not sum to may ¹ Details interval. confidence the 90 percent forms the estimate, from and subtracted when added to number, This the estimate. reliable the less of the estimate, the size to the MOE in relation larger The variability. of an estimate’s (MOE) is a measure of error ² A margin or TRICARE. directly, purchased or union, coverage an employer through provided includes coverage health insurance ³ Private and the military. Affairs Veterans of by the Department provided and care Affairs), of Veterans of the Department Health and Medical Program (Civilian CHAMPVA includes Medicaid, Medicare, coverage ⁴ Public health insurance calendar year. the entire for coverage health insurance do not have if they be uninsured to considered ⁵ Individuals are Medicaid/CHIP. eligible for under the age of 19 are ⁶ Children plan. health insurance on a parent’s be a dependent be eligible to 25 may ⁷ Individuals aged 19 to are of coverage type by estimates The Note: Supplement. Annual Social and Economic Bridge File and 2019 Supplement Annual Social and Economic 2018 Survey, Population Current Bureau, Census U.S. Source: Table 2. Table and 2018 2017 Age: by Coverage of Health Insurance Type by of People Percentage and definitions, see
6 Health Insurance Coverage in the United States: 2018 U.S. Census Bureau In 2018, 14.5 percent of people with 19 (94.5 percent) and adults aged 19 and by some children receiving cov- health insurance coverage, or 42.9 to 64 (88.3 percent) (Table 2). erage through a parent or guardian’s million people, had more than one health plan.17 In 2018, 61.8 percent In 2018, 94.1 percent of adults aged type of health insurance coverage of children under the age of 19 had 65 and over were covered by a public over the course of the year. Among private health insurance, and 35.7 plan (primarily Medicare), and 52.4 this group, most people (83.8 per- percent had public coverage. percent were covered by a private cent) held more than one type of plan, which may have supplemented Unlike for adults 65 and older, coverage in each month during the their public coverage. Between 2017 between 2017 and 2018, the rates year, while 10.3 percent had more and 2018, the percentage of adults of overall health insurance cover- than one type within a single month aged 65 and over with private cover- age and public coverage decreased for just part of the year (1 to 11 age decreased by 1.3 percentage for children under the age of 19 and months). The remaining 5.9 percent points. Their rates of overall health their rate of private coverage did not held more than one type across the insurance coverage and public cover- statistically change. For children, year, but did not have multiple types age did not statistically change dur- coverage overall decreased by 0.6 of coverage within any single month. ing this time. percentage points (to 94.5 percent), and public coverage declined by 1.3 Health Insurance Coverage by Age In 2018, children under the age of percentage points (to 35.7 percent). 19 had a lower overall coverage rate Age is strongly associated with the The latter change was likely due to likelihood that a person has health than adults aged 65 and over but a insurance and the type of health higher rate than adults aged 19 to 64. insurance a person has. In 2018, Children’s coverage is likely influ- adults aged 65 and over had the enced by some children from lower income families being eligible for highest coverage rate (99.1 percent), 17 The Children’s Health Insurance Program followed by children under the age of health coverage through programs (CHIP) is a public program that provides health such as Medicaid or the Children’s insurance to children in families with income too high to qualify for Medicaid, but who are likely Health Insurance Program (CHIP), unable to afford private health insurance.
Figure Percentage of People Uninsured by Age and (Population as of March of the following year)
–* – – –* –* and older Age * Denotes a statistically significant change between 2017 and 2018 at the 90 percent confidence level. Note: For information on confidentiality protection, sampling error, nonsampling error, and definitions in the Current Population Survey, see
U.S. Census Bureau Health Insurance Coverage in the United States: 2018 7 a 1.2 percentage-point decrease in words, had the highest uninsured rate Among adults aged 19 to 64, the Medicaid and CHIP coverage.18 of the three broad age groups exam- population aged 19 to 25 was among ined, at 11.7 percent. the most likely to be uninsured, with Adults aged 19 to 64 had a lower rate a coverage rate of 85.7 percent and of health insurance coverage in 2018 Adults aged 19 to 64 were nonethe- an uninsured rate of 14.3 percent. In (88.3 percent) than both children less more likely than the other two general, the uninsured rate decreased and older adults. This group, in other broad age groups to be covered by as age increased (Figure 4).19 private health insurance (73.5 per- 18 The percentage-point change in the overall cent). They were also less likely to Between 2017 and 2018, the rate of coverage for children was not statistically different from the percentage-point change in have public coverage (17.6 percent). uninsured rate increased by 1.0 the rate of private coverage or the percentage- point change in the rate of Medicaid coverage. The prevalence of health insurance 19 The percentage-point change in the rate of and, therefore, the uninsured rate The percentage of people aged 19 to 25 public coverage for children was not statistically without health insurance coverage was not different from the percentage-point change in varied within the 19-to-64 age group. statistically different from the percentage of the rate of Medicaid coverage. people aged 26 to 34 without coverage.
Figure Percentage of Children Under the Age of Without Health Insurance Coverage by Selected Characteristics and (Population as of March of the following year) Total* Income-to-Poverty Ratio Below ¦ of poverty Between ¦ and ¦ of poverty At or above ¦ of poverty* Race and Hispanic Origin White¥ not Hispanic* Black Asian Hispanic (any race)* Nativity Native-born citizen* Naturalized citizen Noncitizen Region Northeast Midwest South* West Medicaid Expansion Status Non-expansion state* Expansion state
* Denotes a statistically significant change between 2017 and 2018 at the 90 percent confidence level. 1 Federal surveys give respondents the option of reporting more than one race. This figure shows data using the race-alone concept. For example, Asian refers to people who reported Asian and no other race. 2 Expansion status as of January 1, 2018. See Table 6: Number and Percentage of People Without Health Insurance Coverage by State: 2017 and 2018. Note: For information on confidentiality protection, sampling error, nonsampling error, and definitions in the Current Population Survey, see
8 Health Insurance Coverage in the United States: 2018 U.S. Census Bureau percentage point for both adults Hispanic children were more likely to full-time, year-round; or not working aged 35 to 44 and adults aged 45 to be uninsured than children from other at all during the calendar year.23 64 to 12.5 percent and 9.3 percent, races and non-Hispanic origin groups. In 2018, 89.3 percent of all work- respectively.20 The percentage of Between 2017 and 2018, the uninsured ers had health insurance coverage. people uninsured did not significantly rate increased 1.0 percentage point Full-time, year-round workers were increase or decrease for any other age for Hispanic children and 0.5 percent- more likely to be covered by health group between the ages of 19 and 64. age points for non-Hispanic Whites.22 insurance (90.5 percent) than the Children in other racial groups did population working less than full- Children Without Health Insurance not experience statistical changes in time, year-round (86.2 percent) or Coverage their uninsured rate between 2017 and nonworkers (86.9 percent) (Table In 2018, 5.5 percent of children under 2018. 3). Between 2017 and 2018, health the age of 19 did not have health insurance coverage rates for work- insurance coverage, a 0.6 percentage- Health Insurance Coverage by Selected Social and Economic ers and nonworkers decreased by 0.8 point increase from 2017. For many Characteristics percentage points and 0.7 percentage selected characteristics, the percent- points, respectively. Coverage rates age of children (under 19 years of The prevalence of health insurance also declined 0.9 percentage points age) without health insurance cover- coverage varies across certain social for both people who worked full- age was significantly higher in 2018 and economic characteristics. In 2018, time, year-round and for people who than in 2017 (Figure 5). However, individuals aged 15 to 64 with a dis- worked less than full-time, year-round. the change was not uniform across ability were more likely to be insured These percentage-point decreases groups. (90.4 percent) than were individu- were not statistically different from als with no disability (88.5 percent) one another. For example, the uninsured rate did (Table 3). not significantly change for children Workers were more likely than non- in either of the income-to-poverty People with a disability were less likely workers to be covered by private categories for families with income than people with no disability to have health insurance. In 2018, 85.1 percent less than 400 percent of poverty. private health insurance coverage and of full-time, year-round workers and However, it increased 0.7 percentage more likely to have public coverage. 68.5 percent of people who worked points for children living in families at In 2018, 44.7 percent of people with a less than full-time, year-round had or above 400 percent of poverty. In disability had private coverage, com- private coverage, compared with 51.3 both years, the percentage of children pared with 74.9 percent of adults with percent of nonworkers. without health insurance coverage no disability, a 30.2 percentage-point decreased as the income-to-poverty difference. At the same time, 53.9 Nonworkers, however, were more ratio increased. percent of adults with a disability and likely than workers to be covered by 16.0 percent with no disability had public health insurance. Specifically, Other characteristics also reveal that public coverage, a 37.9 percentage- in 2018, nonworkers were almost four the percentage of children without point difference. times as likely to have public cover- insurance and changes between 2017 age (40.2 percent) than workers (11.1 and 2018 did not occur equally across Between 2017 and 2018, coverage percent). Among the latter group, 7.2 groups. For example, children liv- decreased 1.1 percentage points for percent of people who worked full- ing in the South were more likely to people with a disability and 0.7 per- time, year-round and 21.3 percent of be uninsured than children living in centage points for people with no dis- people who worked less than full-time, other regions in the United States.21 ability. These decreases were not sta- year-round had public coverage. Between 2017 and 2018, their unin- tistically different from one another. sured rate increased 1.2 percentage Public coverage decreased by 0.6 Many adults obtain health insurance points to 7.7 percent. The uninsured percentage points for adults with coverage through their spouse, and, rate for children did not statistically no disability, but did not statistically therefore, health insurance coverage is change for any other region. change for those with a disability. related to marital status. In 2018, mar- ried adults aged 19 to 64 were more For many adults aged 15 to 64, health likely to be insured than any other insurance coverage is also related to work status, such as working full- 20 The change for people aged 35 to 44 was 23 In this report, a full-time, year-round worker not statistically different from the change for time, year-round; working less than is a person who worked 35 or more hours per people aged 45 to 64. week (full-time) and 50 or more weeks during the 21 For information about how the Census previous calendar year (year-round). For school Bureau classifies regions, see https://www2< 22 The change between 2017 and 2018 for personnel, summer vacation is counted as weeks .census.gov/geo/pdfs/maps-data/maps non-Hispanic White children was not statistically worked if they are scheduled to return to their /reference/us_regdiv.pdf>. different from the change for Hispanic children. job in the fall.
U.S. Census Bureau Health Insurance Coverage in the United States: 2018 9 * 1, 0.5 0.7 0.8 1.3 1.3 *0.8 *1.1 *0.7 *0.9 *0.7 *0.8 *0.8 *0.9 *0.7 *0.7 *0.8 *0.9 *0.7 *0.8 *2.2 *0.5 less less (2018 Change 2017) (±) 0.3 0.7 0.3 0.3 0.4 0.3 0.3 0.5 0.6 0.3 0.4 0.2 0.3 0.5 0.3 0.7 0.5 1.2 0.6 1.6 2.0 Margin Margin of error² of error² 2018 9.6 9.5 6.2 3.4 8.5 8.3 9.0 11.3 11.5 13.1 11.7 11.3 14.9 10.7 10.7 13.8 13.0 16.0 29.0 13.7 19.9 Per - cent cent confidence interval. interval. confidence cent Uninsured⁵ (±) 0.2 0.6 0.2 0.2 0.5 0.2 0.2 0.5 0.5 0.4 0.3 0.2 0.2 0.5 0.3 0.7 0.4 1.1 0.6 1.4 1.5 the 90 per Margin Margin of error² of error² 2017 8.4 8.6 5.6 2.7 7.9 9.9 7.7 8.3 10.6 10.8 12.5 11.0 10.5 14.0 10.1 12.9 12.3 15.2 26.8 12.5 18.6 Per - cent * Z 1, 0.4 less less –0.1 –0.5 –0.3 –0.6 –0.6 –0.6 –0.9 –0.4 –1.8 –1.4 *–0.4 *–0.6 *–0.6 *–0.6 *–0.6 *–0.6 *–0.7 *–1.5 *–0.4 (2018 Change 2017) (±) 0.2 0.6 0.4 0.4 0.3 0.3 1.1 0.3 0.2 0.6 0.7 0.3 0.3 1.0 0.5 0.3 1.3 0.7 0.7 2.2 1.8 Margin Margin of error² of error² 2018 7.2 8.5 5.7 24.4 34.4 18.8 53.9 16.0 11.1 21.3 40.2 17.6 12.6 25.3 21.6 17.5 36.9 19.3 15.8 34.9 29.7 Per - cent (±) 0.2 0.6 0.4 0.5 0.3 0.3 1.1 0.3 0.2 0.6 0.7 0.3 0.3 0.9 0.5 0.3 1.1 0.7 0.7 2.2 1.9 Public health insurance⁴ Margin Margin of error² of error² 2017 7.6 9.0 6.0 24.5 19.3 53.5 16.6 11.7 21.9 40.2 18.3 13.2 22.2 18.2 37.8 34.8 25.9 20.9 16.2 36.7 31.1 Per - cent * 1, 0.9 less less –0.3 –1.2 –0.3 –0.3 –0.2 –0.8 –0.2 –0.1 –0.2 –0.3 –1.2 –0.4 –0.4 –0.4 –0.3 –0.1 –1.2 –0.4 *–0.6 *–1.0 (2018 Change 2017) Total (±) 0.4 1.2 0.4 0.4 0.4 0.7 0.8 0.4 0.4 0.6 0.4 1.2 0.7 0.5 0.5 0.4 1.0 0.8 0.8 2.2 2.3 Margin Margin of error² of error² 2018 72.8 44.7 74.9 80.5 85.1 68.5 51.3 73.5 82.3 64.7 74.2 37.0 64.3 87.2 92.9 67.3 64.7 73.8 78.7 55.6 52.4 Per - cent (±) 0.4 1.2 0.3 0.3 0.3 0.7 0.7 0.4 0.4 0.6 0.4 1.0 0.6 0.5 0.5 0.3 1.0 0.7 0.9 2.2 2.0 Any health insurance Any Margin Margin 3 health insurance Private of error² of error² 2017 73.1 46.0 75.2 80.8 85.8 68.7 52.1 73.8 82.4 64.9 74.4 38.3 65.3 87.6 93.2 67.7 65.2 72.9 79.1 55.7 53.6 Per - cent * 1, less less –0.7 –0.5 –0.8 –1.3 –1.3 *–0.8 *–1.1 *–0.7 *–0.8 *–0.9 *–0.9 *–0.7 *–0.8 *–0.7 *–0.8 *–0.8 *–2.2 *–0.9 *–0.7 *–0.7 *–0.5 (2018 Change 2017) (±) 0.2 0.3 0.7 0.3 0.3 0.3 0.5 0.4 0.3 0.3 0.7 0.5 0.3 1.2 0.5 0.6 0.6 0.3 0.4 1.6 2.0 Margin Margin of error² of error² 2018 91.5 88.7 90.4 88.5 89.3 90.5 86.2 86.9 88.3 91.7 87.0 84.0 88.7 71.0 85.1 89.3 91.0 93.8 96.6 86.3 80.1 Per - cent (±) 0.2 0.2 0.6 0.2 0.2 0.2 0.5 0.5 0.2 0.3 0.7 0.4 0.2 1.1 0.5 0.5 0.6 0.4 0.3 1.4 1.5 Margin Margin of error² of error² 2017 92.1 89.4 91.6 89.2 90.1 91.4 87.1 87.5 89.0 92.3 87.7 84.8 89.5 73.2 86.0 89.9 91.7 94.4 97.3 87.5 81.4 Per - cent 3,385 4,200 15,438 43,271 55,573 18,683 65,475 15,197 44,573 24,977 17,735 39,255 22,514 2018 323,668 210,794 194,434 155,221 111,950 193,548 101,805 164,250 Number 3,331 4,249 15,683 44,725 56,436 19,241 64,629 15,159 44,774 26,179 17,683 38,441 21,890 2017 322,490 211,093 194,458 154,657 109,932 193,937 102,487 164,126 Number ...... 6 ...... 7 Characteristic Public health insurance coverage includes Medicaid, Medicare, CHAMPVA (Civilian Health and Medical Program of the Department of Veterans Affairs), and care provided by the Department of Veterans Affairs and the military. Affairs Veterans of by the Department provided and care Affairs), of Veterans of the Department Health and Medical Program (Civilian CHAMPVA includes Medicaid, Medicare, coverage Public health insurance The sum of those with and without a disability does not equal the total because disability status is not defined for individuals in the U.S. armed forces. forces. U.S. armed for individuals in the is not defined status because disability does not equal the total sum of those with and without a disability The Individuals are considered to be uninsured if they do not have health insurance coverage for the entire calendar year. the entire for coverage health insurance do not have if they be uninsured to considered Individuals are Private health insurance includes coverage provided through an employer or union, coverage purchased directly, or TRICARE. directly, purchased or union, coverage an employer through provided includes coverage health insurance Private A margin of error (MOE) is a measure of an estimate’s variability. The larger the MOE in relation to the size of the estimate, the less reliable the estimate. This number, when added to and subtracted from the estimate, forms forms the estimate, from and subtracted when added to number, This the estimate. reliable the less of the estimate, the size to the MOE in relation larger The variability. of an estimate’s (MOE) is a measure of error A margin The combined category “married” includes three individual categories: “married, civilian spouse present,” “married, U.S. armed forces spouse present,” and “married, spouse absent.” and “married, spouse absent.” spouse present,” armed forces “married, U.S. “married, civilian spouse present,” individual categories: “married” includes three category combined The Details may not sum to totals because of rounding. totals not sum to may Details Note: The estimates by type of coverage are not mutually exclusive; people can be covered by more than one type of health insurance during the year. of health insurance than one type more by people can be covered not mutually exclusive; are of coverage type by estimates The Note: Supplement. Annual Social and Economic Bridge File and 2019 Supplement Annual Social and Economic 2018 Survey, Population Current Bureau, Census U.S. Source: * Changes between the estimates are statistically different from zero at the 90 percent confidence level. confidence at the 90 percent zero from different statistically are the estimates * Changes between 1 2 3 4 5 6 7 Associate’s degree Associate’s Disability Status Disability no disability With Experience Work All workers less Worked than full-time, year-round old 64 years 19 to Total, Marital Status Married Separated Educational Attainment No high school diploma no Some college, degree degree Bachelor’s or Graduate degree professional Total, 15 to 64 years old 64 years 15 to Total, full-time, Worked year-round at Did not work 1 week least Widowed Divorced married Never old 64 years 26 to Total, High school graduate (includes equivalency) Total Table 3. Table and 2018 2017 and Characteristics: Ages Selected for Coverage of Health Insurance Type by of People Percentage and definitions, see < https://www2.census.gov/programs-surveys/cps nonsampling error, sampling error, protection, on confidentiality information For year. of the following as of March Population points. in percentage of error in thousands. Margins (Numbers /techdocs/cpsmar19.pdf>) a disability With
10 Health Insurance Coverage in the United States: 2018 U.S. Census Bureau marital status group, at 91.7 percent. points).27 For high school graduates, lowest category and 12.4 percent for People who were separated were the this change was mainly driven by the highest. least likely to be insured (80.1 per- a 1.0 percentage-point decrease in These differences in private and cent) (Table 3). In 2018, 84.0 percent private coverage to 64.3 percent. For public coverage varied more for of people who were never married, the other three education categories lower income groups than for higher 86.3 percent of people who were with a decrease in overall coverage, income groups. The private health widowed, and 87.0 percent of people neither private nor public coverage insurance coverage rate for people who were divorced were covered by statistically changed between the two in households in the second-lowest health insurance.24 years. income category (household income Between 2017 and 2018, coverage Public coverage decreased by 1.5 of $25,000 to $49,999) was 23.2 decreased for married adults (by 0.7 percentage points to 19.3 percent percentage points higher than the percentage points) and for people for people with some college (no rate for the lowest income category who were never married (by 0.8 degree), but their overall coverage (below $25,000). In contrast, the percentage points).25 None of the rate (89.3 percent) did not statisti- rate of private coverage for people remaining marital status groups had cally change.28 in households with incomes in the a statistically significant change in highest income category ($150,000 their rate of overall coverage during Health Insurance Coverage by or more) was 4.3 percentage points this time. Household Income and Income-to- higher than for the second-highest Poverty Ratio income category (between $125,000 Health insurance coverage is also In 2018, people in households with and $149,999). For public coverage, related to the highest level of edu- lower income had lower health insur- these differences were 17.8 percent- cation attained: people with higher ance coverage rates than people in age points for the lowest two catego- levels of educational attainment households with higher income. In ries and 3.6 percentage points for the are more likely to have health insur- 2018, 86.2 percent of people in house- highest two, with the lower groups ance coverage than people with less holds with an annual income of less having higher coverage rates. education. In 2018, 96.6 percent of than $25,000 had health insurance the population aged 26 to 64 with a The overall percentage of people coverage, compared with 96.8 percent graduate or professional degree had with health insurance coverage of people in households with income health insurance coverage, compared decreased between 2017 and 2018 of $150,000 or more (Table 4).29 with 93.8 percent of the popula- for four income groups: people in tion with a bachelor’s degree, 85.1 People in households with lower households with income of $50,000 percent of high school graduates, and income also had lower rates of pri- to $74,999 (1.1 percentage points), 71.0 percent of the population with vate coverage and higher rates of people in households with income of no high school diploma (Table 3).26 public coverage. For example, 24.7 $100,000 to $124,999 (0.7 percent- percent of people in households with age points), people in households Between 2017 and 2018, four educa- incomes below $25,000, the low- with income of $125,000 to $149,999 tional attainment groups experienced est income category, had private (1.3 percentage points), and peo- a decrease in their overall coverage coverage in 2018, compared with ple in households with income of rate: people with no high school 91.2 percent of people with incomes $150,000 or more (0.6 percentage diploma (2.2 percentage points), of $150,000 or more, the highest points). These differences spanned high school graduates (0.9 percent- income category. Public cover- from the middle to top of the income age points), people with a bachelor’s age rates were 71.2 percent for the distribution and were not statistically degree (0.7 percentage points), and different from one another. people with a graduate or profes- sional degree (0.7 percentage Between 2017 and 2018, the percent- 27 The change in overall coverage for people with no high school diploma was significantly age of people with private coverage different from the change in overall coverage decreased for four income groups 24 In 2018, the coverage rate of people who for people with a bachelor’s degree. The other were widowed was not statistically different decreases were not statistically different from across the income distribution. from the coverage rate of people who were one another. People in households with income of divorced. 28 While overall coverage and private cover- 25 The change in the overall coverage rate age did not statistically change for people less than $25,000 had a decrease of for married adults was not statistically different with some college (no degree), their direct- 1.5 percentage points to 24.7 per- from the change in the overall coverage rate for purchase coverage and Medicaid coverage rates those who were never married. decreased and their employment-based cover- cent. The private coverage rate for 26 Educational attainment groups are defined age rate increased. people in households with income 29 based on the highest level of schooling an indi- The 2017 income estimates are inflation- of $125,000 to $149,999 decreased vidual has attained. adjusted and presented in 2018 dollars.
U.S. Census Bureau Health Insurance Coverage in the United States: 2018 11 * 1, 0.5 0.1 0.5 0.4 0.4 0.6 0.1 less less *1.1 *0.7 *1.3 *0.6 *1.0 *0.8 *0.5 *0.5 (2018
Change 2017) (±) 0.2 0.6 0.5 0.5 0.5 0.5 0.6 0.3 0.2 0.6 0.6 0.6 0.5 0.4 0.2 Margin Margin of error² of error² - 2018 8.5 7.1 5.6 4.9 3.2 8.5 8.1 3.4 Per 13.8 12.3 10.7 16.3 15.6 13.6 10.8 cent Uninsured⁵ (±) 0.2 0.6 0.5 0.5 0.5 0.5 0.5 0.2 0.2 0.7 0.6 0.6 0.5 0.5 0.2 Margin Margin of error² of error² - 2017 7.9 9.7 6.6 4.9 3.6 2.6 7.9 7.1 2.7 Per 13.3 12.2 15.9 15.2 13.0 10.7 cent * Z Z 1, 0.4 0.4 0.1 0.5 0.4 less less *1.3 –0.4 –0.6 –0.1 –0.6 *–1.1 *–0.4 *–0.4 (2018 Change 2017) (±) 0.3 0.7 0.8 0.8 0.8 0.8 0.8 0.5 0.3 0.9 0.7 0.8 0.8 0.7 0.3 Margin Margin of error² of error² - 2018 Per 34.4 71.2 53.4 35.9 24.5 19.0 16.0 12.4 34.3 66.8 65.8 54.4 36.2 27.7 18.5 cent (±) 0.3 0.8 0.7 0.7 0.8 0.8 0.9 0.5 0.3 1.0 0.8 0.8 0.8 0.7 0.3 Public health insurance⁴ Margin Margin of error² of error² - 2017 Per 34.8 70.8 53.8 34.6 25.1 19.0 15.6 12.4 34.7 66.8 65.7 55.0 37.3 27.2 18.1 cent * Z 1, 0.9 less less –0.5 –1.0 –0.8 –0.8 –0.4 –0.4 *–1.5 *–1.2 *–1.9 *–1.2 *–1.0 *–1.3 *–1.3 (2018 Change 2017) 3 Total (±) 0.4 0.8 0.8 0.8 0.8 0.8 0.9 0.4 0.4 0.8 0.7 0.9 0.8 0.8 0.3 Margin Margin of error² of error² - 2018 Per 67.3 24.7 47.9 65.9 78.5 84.2 86.9 91.2 67.3 22.0 24.7 41.6 64.4 75.1 89.2 cent (±) 0.3 0.7 0.8 0.8 0.8 0.8 0.8 0.4 0.3 0.8 0.7 0.8 0.9 0.8 0.2 Any health insurance Any Private health insurance Private Margin Margin of error² of error² - 2017 Per 67.7 26.2 47.9 67.2 79.0 85.2 88.9 92.4 67.7 22.8 25.7 42.3 63.5 76.4 90.5 cent * 1, less less –0.5 –0.1 –0.5 –0.4 –0.4 –0.6 –0.1 *–1.1 *–0.7 *–1.3 *–0.6 *–1.0 *–0.8 *–0.5 *–0.5 (2018 Change 2017) (±) 0.2 0.6 0.5 0.5 0.5 0.5 0.6 0.3 0.2 0.6 0.6 0.6 0.5 0.4 0.2 Margin Margin of error² of error² - 2018 Per 91.5 86.2 87.7 89.3 92.9 94.4 95.1 96.8 91.5 83.7 84.4 86.4 89.2 91.9 96.6 cent (±) 0.2 0.6 0.5 0.5 0.5 0.5 0.5 0.2 0.2 0.7 0.6 0.6 0.5 0.5 0.2 Margin Margin of error² of error² - 2017 Per 92.1 86.7 87.8 90.3 93.4 95.1 96.4 97.4 92.1 84.1 84.8 87.0 89.3 92.9 97.3 cent 43,320 59,133 55,304 44,539 34,142 23,291 63,939 38,056 58,204 55,302 50,632 43,624 2018 323,668 323,172 135,559 Number 45,388 61,072 53,665 43,645 32,895 22,674 63,151 39,431 60,694 55,850 50,666 42,721 2017 322,490 321,907 133,239 Number . . .
......
. .
. . . Characteristic Private health insurance includes coverage provided through an employer or union, coverage purchased directly, or TRICARE. directly, purchased or union, coverage an employer through provided includes coverage health insurance Private Details may not sum to totals because of rounding. totals not sum to may Details * Changes between the estimates are statistically different from zero at the 90 percent confidence level. confidence at the 90 percent zero from different statistically are the estimates * Changes between zero. to or rounds Z Represents 1 interval. confidence the 90 percent forms the estimate, from and subtracted when added to number, This the estimate. reliable the less of the estimate, the size to the MOE in relation larger The variability. of an estimate’s (MOE) is a measure of error ² A margin 3 and the military. Affairs Veterans of by the Department provided and care Affairs), of Veterans of the Department Health and Medical Program (Civilian CHAMPVA includes Medicaid, Medicare, coverage ⁴ Public health insurance calendar year. the entire for coverage health insurance do not have if they be uninsured to considered ⁵ Individuals are during the year. of health insurance than one type more by people can be covered not mutually exclusive; are of coverage type by estimates The Note: Supplement. Annual Social and Economic Bridge File and 2019 Supplement Annual Social and Economic 2018 Survey, Population Current Bureau, Census U.S. Source: Table 4. 4. Table and 2018 2017 Ratio: and Income-to-Poverty Household Income by Coverage of Health Insurance Type by of People Percentage and definitions, see
12 Health Insurance Coverage in the United States: 2018 U.S. Census Bureau by 1.9 percentage points to 86.9 coverage did not change for any Another way to consider economic percent. People in households with other income group.30 resources is to look at coverage by income at or above $150,000 had a the income-to-poverty ratio. People decrease of 1.2 percentage points 30 The change in private coverage for in families are classified as being in people in households with income of less than to 91.2 percent. People in house- $25,000 was not statistically different from the poverty if their family income is less holds with income of $50,000 to change for people in households with income than their poverty threshold.31 People of $50,000 to $74,999, income of $125,000 to $74,999 had a 1.2 percentage-point $149,999, and income at or above $150,000. who live alone or with nonrelatives decrease in private coverage to 65.9 The change in private coverage for people have a poverty status that is defined in households with income of $50,000 to percent, but also a 1.3 percentage- $74,999 was not statistically different from the point increase in public coverage. change for people in households with income of 31 The Office of Management and Budget determined the official definition of poverty in The percentage of people with public $125,000 to $149,999 and income at or above $150,000. Statistical Policy Directive 14. Appendix B of the The change in private coverage for people report Income and Poverty in the United States: in households with income of $125,000 to 2018 provides a more detailed description of $149,999 was not statistically different from the how the Census Bureau calculates poverty; see change for people in households with income at
Figure Uninsured Rate by Poverty Status and Medicaid Expansion of State for Adults Aged to to (Civilian noninstitutionalized population) Expansion states Non-expansion states
Percentage-point change in uninsured rate between and
– * Denotes a statistically significant difference at the 90 percent level. 1 Medicaid expansion status as of January 1, 2018. For a list of expansion and non-expansion states, see Table 6: Number and Percentage of People Without Health Insurance Coverage by State: 2017 to 2018. Note: For information on confidentiality protection, sampling error, nonsampling error, and definitions in the Current Population Survey, see
U.S. Census Bureau Health Insurance Coverage in the United States: 2018 13 *
Z 1, 1.4 0.2 0.4 0.5 less less *0.5 *0.3 *0.4 *0.7 *0.6 *0.5 *0.7 *1.0 *0.6 *1.6 *0.4 *1.6 *0.9 *2.3 *0.5 (2018 Change 2017)
(±) 0.2 0.2 0.3 0.3 0.5 3.4 0.4 0.2 0.4 0.2 0.7 0.2 0.2 0.5 0.6 0.6 0.2 0.6 0.6 1.0 Margin Margin of error² of error² - 2018 8.5 7.9 7.6 5.3 5.2 8.4 9.6 7.7 9.1 8.2 5.4 9.7 6.8 6.8 8.8 Per 13.1 11.1 17.8 18.9 28.6 cent Uninsured⁵ (±) 0.2 0.2 0.2 0.3 0.4 2.6 0.4 0.2 0.4 0.2 0.5 0.2 0.2 0.5 0.7 0.6 0.2 0.6 0.6 1.0 Margin Margin of error² of error² - 2017 7.9 7.3 7.3 4.8 4.5 7.9 9.6 6.9 8.1 7.7 5.2 9.3 6.4 6.4 7.8 Per 11.7 10.4 16.2 17.4 26.2 cent * 1, 0.8 0.2 0.5 less less –0.2 –0.3 –0.4 –0.5 –0.3 –0.2 –0.3 –0.1 –0.7 –0.5 –0.1 *–0.4 *–1.2 *–2.1 *–1.0 *–0.5 *–0.4 (2018 Change 2017) (±) 0.3 0.4 0.4 0.7 1.0 4.6 0.5 0.4 0.6 0.5 1.2 0.3 0.3 0.9 1.1 0.8 0.3 0.7 1.0 1.0 Margin Margin of error² of error² - 2018 Per 34.4 32.9 34.4 35.6 38.0 42.4 40.6 33.2 35.3 32.0 42.4 33.8 33.2 41.2 26.1 36.5 34.9 31.2 36.4 26.2 cent (±) 0.3 0.3 0.4 0.6 1.0 5.2 0.6 0.3 0.6 0.4 1.2 0.3 0.3 0.9 1.2 0.7 0.3 0.8 1.0 1.0
Public health insurance⁴ Margin Margin of error² of error² - 2017 Per 34.8 33.3 34.6 36.8 40.2 41.5 40.9 33.6 35.7 32.3 42.6 34.1 33.3 41.9 26.6 37.5 35.4 30.9 35.9 26.3 cent * 1, 0.2 0.7 0.5 0.7 less less –0.3 –0.2 –3.1 –0.8 –0.3 –0.8 –0.3 –0.1 –0.2 –1.3 –0.4 *–0.8 *–0.5 *–1.1 *–1.6 *–2.1 (2018 Change 2017) 3 Total (±) 0.4 0.4 0.4 0.7 1.0 5.1 0.6 0.4 0.7 0.5 1.3 0.4 0.4 1.1 1.3 1.0 0.4 0.9 1.0 1.1 Margin Margin of error² of error² - 2018 Per 67.3 68.7 72.0 62.0 59.7 50.0 61.5 68.1 63.4 70.9 62.0 69.3 74.8 55.4 73.1 49.6 69.1 56.0 64.0 48.4 cent (±) 0.3 0.4 0.4 0.6 1.0 4.9 0.7 0.4 0.7 0.5 1.1 0.4 0.4 1.0 1.4 0.9 0.4 0.8 1.0 1.1 Any health insurance Any Private health insurance Private Margin Margin of error² of error² - 2017 Per 67.7 69.0 72.2 61.8 59.0 53.1 62.4 68.4 62.9 71.6 62.9 69.9 75.1 55.5 72.4 50.7 69.3 57.7 65.4 50.5 cent * Z 1, less less –1.4 –0.2 –0.4 –0.5 *–0.5 *–0.3 *–0.4 *–0.7 *–0.6 *–0.5 *–0.7 *–1.0 *–0.6 *–1.6 *–0.4 *–1.6 *–0.9 *–2.3 *–0.5 (2018 Change 2017) (±) 0.2 0.2 0.3 0.3 0.5 3.4 0.4 0.2 0.4 0.2 0.7 0.2 0.2 0.5 0.6 0.6 0.2 0.6 0.6 1.0 Margin Margin of error² of error² - 2018 Per 91.5 92.1 92.4 94.7 94.8 86.9 88.9 91.6 90.4 92.3 90.9 91.8 94.6 90.3 93.2 82.2 93.2 81.1 91.2 71.4 cent (±) 0.2 0.2 0.2 0.3 0.4 2.6 0.4 0.2 0.4 0.2 0.5 0.2 0.2 0.5 0.7 0.6 0.2 0.6 0.6 1.0 Margin Margin of error² of error² - 2017 Per 92.1 92.7 92.7 95.2 95.5 88.3 89.6 92.1 90.4 93.1 91.9 92.3 94.8 90.7 93.6 83.8 93.6 82.6 92.2 73.8 cent 1,069 83,508 71,750 22,720 61,264 42,300 42,758 19,770 59,925 45,820 22,296 23,524 2018 323,668 261,336 281,369 104,716 176,653 247,472 194,679 277,848 Number 1,113 83,539 71,971 22,922 60,419 43,032 42,461 19,498 59,033 45,433 21,880 23,553 2017 322,490 260,958 279,458 103,823 175,635 247,193 195,183 277,057 Number .
. .
. . .
. . . . 6 . . . s between the estimates are statistically different from zero at the 90 percent confidence level. Z Represents or rounds to zero. to rounds or Represents Z level. confidence at the 90 percent zero from different statistically are the estimates s between
. . . . Characteristic . . . Private health insurance includes coverage provided through an employer or union, coverage purchased directly, or TRICARE. or TRICARE. directly, purchased or union, coverage an employer through provided includes coverage health insurance Private A margin of error (MOE) is a measure of an estimate’s variability. The larger the MOE in relation to the size of the estimate, the less reliable the estimate. This number, when added to and subtracted from the estimate, forms the forms the estimate, from and subtracted when added to number, This the estimate. reliable the less of the estimate, the size to the MOE in relation larger The variability. of an estimate’s (MOE) is a measure of error A margin * Change because of rounding. totals not sum to ¹ Details may 2 3 and the military. Affairs Veterans by the Department of provided and care Affairs) of the Department Veterans Health and Medical Program (Civilian CHAMPVA includes Medicaid, Medicare, coverage ⁴ Public health insurance calendar year. the entire for coverage health insurance do not have if they be uninsured to considered ⁵ Individuals are and Metropolitan see “About information, more For areas. statistical and micropolitan outside of metropolitan and territory areas statistical includes both micropolitan category areas” statistical “Outside metropolitan ⁶ The Asian and no reported be defined as those who such as Asian may A group possible. are group race of defining a basic ways two Therefore, than one race. more the option of reporting respondents give now surveys ⁷ Federal during the year. than one type of health insurance more by people can be covered not mutually exclusive; are type of coverage by estimates The Note: urce: U.S. Census Bureau, Current Population Survey, 2018 Annual Social and Economic Supplement Bridge File and 2019 Annual Social and Economic Supplement. Annual Social and Economic Supplement Bridge File and 2019 Annual Social and Economic 2018 Survey, Population Current Bureau, Census U.S. urce: Table 5. 5. Table and 2018 2017 Characteristics: Demographic Selected by Coverage of Health Insurance Type by of People Percentage and definitions, see
14 Health Insurance Coverage in the United States: 2018 U.S. Census Bureau *
Z 1, 1.4 0.2 0.4 0.5 less less *0.5 *0.3 *0.4 *0.7 *0.6 *0.5 *0.7 *1.0 *0.6 *1.6 *0.4 *1.6 *0.9 *2.3 *0.5 based on their own income. The same time, the public coverage rate Health Insurance Coverage (2018 Change 2017) income-to-poverty ratio compares a decreased by 1.1 percentage points by Selected Demographic
family’s or an unrelated individual’s for people in families with income Characteristics (±) 0.2 0.2 0.3 0.3 0.5 3.4 0.4 0.2 0.4 0.2 0.7 0.2 0.2 0.5 0.6 0.6 0.2 0.6 0.6 1.0 income with the applicable threshold. from 200 to 299 percent of poverty
Margin Margin Many people obtain health insurance of error² of error²
- (to 36.2 percent).
2018 coverage through a family member’s
8.5 7.9 7.6 5.3 5.2 8.4 9.6 7.7 9.1 8.2 5.4 9.7 6.8 6.8 8.8 Health insurance coverage is gen- Per 13.1 11.1 17.8 18.9 28.6 cent plan. The Census Bureau classifies erally higher for people in higher The Affordable Care Act provided the Uninsured⁵ living arrangements into three types: (±) 0.2 0.2 0.2 0.3 0.4 2.6 0.4 0.2 0.4 0.2 0.5 0.2 0.2 0.5 0.7 0.6 0.2 0.6 0.6 1.0 income-to-poverty ratio groups. In option for states to expand Medicaid families, unrelated subfamilies, and Margin Margin 2018, people in poverty (the popu- eligibility to people whose income- of error² of error² 35
- unrelated individuals. Families are 2017 lation living below 100 percent of to-poverty ratio fell under a particular 7.9 7.3 7.3 4.8 4.5 7.9 9.6 6.9 8.1 7.7 5.2 9.3 6.4 6.4 7.8 Per 11.7 10.4 16.2 17.4 26.2 cent the largest of these categories (80.7 poverty) were least likely to have threshold. For adults aged 19 to 64,
* percent of the noninfant population 1, health insurance coverage (83.7 per- the relationship between poverty 0.8 0.2 0.5 less less –0.2 –0.3 –0.4 –0.5 –0.3 –0.2 –0.3 –0.1 –0.7 –0.5 –0.1 *–0.4 *–1.2 *–2.1 *–1.0 *–0.5 *–0.4 in 2018), followed by unrelated indi- (2018 cent), while people living at or above status, health insurance coverage Change 2017) viduals (18.9 percent), and unrelated 400 percent of poverty were most in 2018, and the change in cover- (±) 0.3 0.4 0.4 0.7 1.0 4.6 0.5 0.4 0.6 0.5 1.2 0.3 0.3 0.9 1.1 0.8 0.3 0.7 1.0 1.0 subfamilies (0.3 percent). likely to have coverage (96.6 percent) age between 2017 and 2018 may be Margin Margin of error² of error² (Table 4). Between 2017 and 2018, related to the state of residence and In 2018, people living in families had - 2018
Per overall health insurance coverage whether or not that state expanded 34.4 32.9 34.4 35.6 38.0 42.4 40.6 33.2 35.3 32.0 42.4 33.8 33.2 41.2 26.1 36.5 34.9 31.2 36.4 26.2 cent a higher health insurance coverage decreased 1.0 percentage point for Medicaid eligibility (Figure 6).34 rate (92.1 percent) than unrelated (±) 0.3 0.3 0.4 0.6 1.0 5.2 0.6 0.3 0.6 0.4 1.2 0.3 0.3 0.9 1.2 0.7 0.3 0.8 1.0 1.0 people in families with income from individuals (88.9 percent) and people Public health insurance⁴
Margin Margin Changes in the uninsured rate of error² of error² 300 to 399 percent of poverty and living in unrelated subfamilies (86.9 -
2017 between 2017 and 2018 varied by 0.8 percentage points for people in 36
Per percent) (Table 5). Between 2017 34.8 33.3 34.6 36.8 40.2 41.5 40.9 33.6 35.7 32.3 42.6 34.1 33.3 41.9 26.6 37.5 35.4 30.9 35.9 26.3 cent poverty status and state Medicaid families with income at or above 400 and 2018, coverage decreased for *
1, 32 expansion status. For people living 0.2 0.7 0.5 0.7
less less percent of poverty. During this time, –0.3 –0.2 –3.1 –0.8 –0.3 –0.8 –0.3 –0.1 –0.2 –1.3 –0.4 people living in families (0.5 percent- *–0.8 *–0.5 *–1.1 *–1.6 *–2.1
(2018 at or above 400 percent of pov- Change 2017) the overall health insurance coverage age points) and unrelated individu- erty, the uninsured rate increased in 3 rate did not statistically change for als (0.6 percentage points).37 People Total (±) 0.4 0.4 0.4 0.7 1.0 5.1 0.6 0.4 0.7 0.5 1.3 0.4 0.4 1.1 1.3 1.0 0.4 0.9 1.0 1.1 both states that expanded Medicaid any other income-to-poverty group. living in families were the only group Margin Margin
of error² of error² eligibility on or before January 1, -
2018 that experienced a change in public Public coverage continued to be 2018 (“expansion states”), and in Per 67.3 68.7 72.0 62.0 59.7 50.0 61.5 68.1 63.4 70.9 62.0 69.3 74.8 55.4 73.1 49.6 69.1 56.0 64.0 48.4 cent coverage during this time; their rate most prevalent for the population states that did not expand Medicaid of public coverage decreased by 0.4 (±) 0.3 0.4 0.4 0.6 1.0 4.9 0.7 0.4 0.7 0.5 1.1 0.4 0.4 1.0 1.4 0.9 0.4 0.8 1.0 1.1 in poverty (66.8 percent) and least eligibility (“non-expansion states”). 38 Any health insurance Any percentage points to 32.9 percent. Private health insurance Private Margin Margin prevalent for the population with The uninsured rate increased by 0.6 of error² of error²
- There were no statistically significant 2017 income-to-poverty ratios at or above percentage points in expansion states Per 67.7 69.0 72.2 61.8 59.0 53.1 62.4 68.4 62.9 71.6 62.9 69.9 75.1 55.5 72.4 50.7 69.3 57.7 65.4 50.5 cent changes in the percentage of people 400 percent of poverty (18.5 percent) (to 3.5 percent) and 1.7 percentage * Z 1, in 2018. points for non-expansion states (to less less –1.4 –0.2 –0.4 –0.5 *–0.5 *–0.3 *–0.4 *–0.7 *–0.6 *–0.5 *–0.7 *–1.0 *–0.6 *–1.6 *–0.4 *–1.6 *–0.9 *–2.3 *–0.5 (2018 6.2 percent) for this group. In non- Change 2017) The prevalence of types of insurance expansion states, the uninsured rate 35 Families are defined as groups of two or (±) 0.2 0.2 0.3 0.3 0.5 3.4 0.4 0.2 0.4 0.2 0.7 0.2 0.2 0.5 0.6 0.6 0.2 0.6 0.6 1.0 changed for some income-to-poverty did not change for any other poverty more related people where one of them is the
Margin Margin groups between 2017 and 2018. householder. Family members must be related of error² of error² group. However, in expansion states, by birth, marriage, or adoption and reside - 2018 Private coverage decreased by 1.3 the uninsured rate increased by 1.5 together. Unrelated subfamilies are family units Per 91.5 92.1 92.4 94.7 94.8 86.9 88.9 91.6 90.4 92.3 90.9 91.8 94.6 90.3 93.2 82.2 93.2 81.1 91.2 71.4 cent percentage points for people in fami- that reside with, but are not related to, the percentage points for those living in lies with income from 300 to 399 per- householder. For example, unrelated subfamilies (±) 0.2 0.2 0.2 0.3 0.4 2.6 0.4 0.2 0.4 0.2 0.5 0.2 0.2 0.5 0.7 0.6 0.2 0.6 0.6 1.0 poverty and by 0.8 percentage points could include a married couple with or without cent of poverty and people in families children, or a single parent with one or more Margin Margin of error² of error² for those living between 100 to 399 never-married children under 18 years old living -
2017 with income at or above 400 percent percent of poverty (to 16.9 percent in a household. An unrelated subfamily may also Per 92.1 92.7 92.7 95.2 95.5 88.3 89.6 92.1 90.4 93.1 91.9 92.3 94.8 90.7 93.6 83.8 93.6 82.6 92.2 73.8 cent of poverty (to 75.1 percent and 89.2 include people such as partners, roommates, and 12.7 percent, respectively). percent, respectively).33 During the or resident employees and their spouses and/ or children. The number of unrelated subfam-
1,069 ily members is included in the total number of 83,508 71,750 22,720 61,264 42,300 42,758 19,770 59,925 45,820 22,296 23,524 2018 323,668 261,336 281,369 104,716 176,653 247,472 194,679 277,848 Number household members, but is not included in the 32 The change in the overall coverage rate for count of family members. The remainder of the people in families with income from 300 to 399 population is classified as unrelated individuals. 36 1,113 percent of poverty was not statistically different In 2018, the health insurance coverage rate 83,539 71,971 22,922 60,419 43,032 42,461 19,498 59,033 45,433 21,880 23,553 2017 322,490 260,958 279,458 103,823 175,635 247,193 195,183 277,057 Number from the change in the overall coverage rate for of unrelated individuals was not statistically dif- people in families with income at or above 400 ferent from the coverage rate of people living in
. 34
percent of poverty. Thirty-one states and the District of unrelated subfamilies. .
. 33 37
. . The percentage-point change in the Columbia expanded Medicaid eligibility on The change in overall coverage for people .
. . private coverage rate for people in families with or before January 1, 2018. For a list of the living in families was not statistically different . . 6
. income from 300 to 399 percent of poverty was states and their Medicaid expansion status as from the change for unrelated individuals. . .
s between the estimates are statistically different from zero at the 90 percent confidence level. Z Represents or rounds to zero. to rounds or Represents Z level. confidence at the 90 percent zero from different statistically are the estimates s between 38
. .
. not statistically different from the change in the of January 1, 2018, see Table 6: Number and The change in public coverage for people
. private coverage rate for people in families with Percentage of People Without Health Insurance living in families was not statistically different
Characteristic income at or above 400 percent of poverty. Coverage by State: 2017 and 2018. from their change in overall coverage. . . . Private health insurance includes coverage provided through an employer or union, coverage purchased directly, or TRICARE. or TRICARE. directly, purchased or union, coverage an employer through provided includes coverage health insurance Private A margin of error (MOE) is a measure of an estimate’s variability. The larger the MOE in relation to the size of the estimate, the less reliable the estimate. This number, when added to and subtracted from the estimate, forms the forms the estimate, from and subtracted when added to number, This the estimate. reliable the less of the estimate, the size to the MOE in relation larger The variability. of an estimate’s (MOE) is a measure of error A margin * Change because of rounding. totals not sum to ¹ Details may 2 3 and the military. Affairs Veterans by the Department of provided and care Affairs) of the Department Veterans Health and Medical Program (Civilian CHAMPVA includes Medicaid, Medicare, coverage ⁴ Public health insurance calendar year. the entire for coverage health insurance do not have if they be uninsured to considered ⁵ Individuals are and Metropolitan see “About information, more For areas. statistical and micropolitan outside of metropolitan and territory areas statistical includes both micropolitan category areas” statistical “Outside metropolitan ⁶ The Asian and no reported be defined as those who such as Asian may A group possible. are group race of defining a basic ways two Therefore, than one race. more the option of reporting respondents give now surveys ⁷ Federal during the year. than one type of health insurance more by people can be covered not mutually exclusive; are type of coverage by estimates The Note: urce: U.S. Census Bureau, Current Population Survey, 2018 Annual Social and Economic Supplement Bridge File and 2019 Annual Social and Economic Supplement. Annual Social and Economic Supplement Bridge File and 2019 Annual Social and Economic 2018 Survey, Population Current Bureau, Census U.S. urce: Table 5. 5. Table and 2018 2017 Characteristics: Demographic Selected by Coverage of Health Insurance Type by of People Percentage and definitions, see
U.S. Census Bureau Health Insurance Coverage in the United States: 2018 15 with private coverage in any of these In 2018, 73.1 percent of Asians and insurance coverage rate for the three types of living arrangements. 55.4 percent of Blacks had private native-born population (93.2 percent) coverage. was larger than that of the foreign- In 2018, 94.6 percent of non-Hispanic born population (81.1 percent), Whites had health insurance cover- Rates of public coverage followed a which includes naturalized citizens age, higher than the coverage rate different pattern than private cover- (91.2 percent) and noncitizens (71.4 for Asians (93.2 percent), Blacks age rates. In 2018, the public cover- percent) (Table 5). These coverage (90.3 percent), and Hispanics (82.2 age rate was the highest for Blacks rates were all statistically lower than percent) (Table 5).39 (41.2 percent), followed by Hispanics the rates in 2017. (36.5 percent), and non-Hispanic Hispanics, who had the lowest rate Whites (33.2 percent). Asians had the Specifically, between 2017 and 2018, of overall health insurance cover- lowest rate of health insurance cover- the percentage of the native-born age, also had the lowest rate of age through public programs, at 26.1 population with health insurance cov- private coverage, at 49.6 percent. percent in 2018. erage decreased by 0.4 percentage Non-Hispanic Whites were among points. Public coverage decreased the most likely to have private health Between 2017 and 2018, the over- 0.5 percentage points for the native- insurance in 2018, at 74.8 percent. all health insurance coverage rate born population, and private cover- decreased by 1.6 percentage points age did not statistically change.42 39 Federal surveys give respondents the for Hispanics, but did not statisti- option of reporting more than one race. cally change for the other three race The foreign-born population expe- Therefore, two basic ways of defining a race 40 group are possible. A group, such as Asian, groups. Hispanics experienced rienced a 1.6 percentage-point may be defined as those who reported Asian decreases in both their private cover- decrease in their overall coverage. and no other race (the race-alone or single- race concept) or as those who reported Asian, age rate (1.1 percentage points) and This was driven by a 1.6 percentage- regardless of whether they also reported public coverage rate (1.0 percentage point decrease in private coverage; another race (the race-alone-or-in-combination 41 concept). The body of this report (text, figures, point) between 2017 and 2018. the public coverage rate for the and tables) shows data using the first approach foreign-born population did not sta- Neither the rates of private coverage (race alone). Use of the single-race population tistically change.43 does not imply that it is the preferred method nor public coverage changed for any of presenting or analyzing data. The Census Bureau uses a variety of approaches. other race group during this time. State Estimates of Health Insurance In this report, the term “non-Hispanic White” Coverage refers to people who are not Hispanic and Health insurance status is also related who reported White and no other race. The Census Bureau uses non-Hispanic Whites as the to nativity. In 2018, the overall health The ACS, which has a larger sample comparison group for other race groups and size than the CPS ASEC, provides an Hispanics. estimate of health insurance cover- Since Hispanics may be any race, data in this 40 The small sample size of the Asian popula- report for Hispanics overlap with data for race tion and the fact that the CPS does not use age at the time of the interview (see groups. Being Hispanic was reported by 15.7 separate population controls for weighting the text box, “Health Insurance Coverage percent of White householders who reported Asian sample to national totals, contributes to only one race, 5.3 percent of Black household- the large variances surrounding estimates for in the American Community Survey”). ers who reported only one race, and 2.0 percent this group. As a result, the CPS may be unable The larger sample size offers an of Asian householders who reported only one to detect statistically significant differences race. between some estimates for the Asian popula- Data users should exercise caution when tion. The ACS, based on a larger sample of the interpreting aggregate results for the Hispanic population, is a better source for estimating and 42 The change in overall coverage for the population or for race groups because these identifying changes for small subgroups of the native-born population was not statistically dif- populations consist of many distinct groups that population. ferent from their change in public coverage. differ in socioeconomic characteristics, culture, 41 Changes in overall coverage, private cover- 43 The change in overall coverage for the and nativity. For further information, see age, and public coverage for Hispanics were not foreign-born population was not statistically dif-
16 Health Insurance Coverage in the United States: 2018 U.S. Census Bureau opportunity to look at coverage rates for smaller geographies, such as for all 50 states and the District of Health Insurance Coverage in the American Community Survey Columbia. This report presents state-level coverage status. This uninsured estimates of health insurance rate measures a different concept During 2018, the percentage of coverage using data from the than the CPS ASEC measures. people without health insurance at American Community Survey the time of interview ranged from The ACS also allows us to view (ACS). The ACS is an ongoing 2.8 percent (Massachusetts) to 17.7 uninsured rates over a longer survey that collects comprehen- percent (Texas) (Figure 8 and Table time period than the CPS ASEC sive information on social, eco- 6).44 Six states and the District of (see Appendix A). As mea- nomic, and housing topics. Due Columbia had an uninsured rate of sured by the ACS, uninsured to its large sample size, the ACS less than 5.0 percent, and six states rates remained relatively stable provides estimates at many levels had an uninsured rate of 12.0 per- between 2008 and 2013, but of geography and for smaller cent or more.45 The remainder of decreased sharply by 2.8 per- population groups. states had uninsured rates between centage points between 2013 5.0 percent and 11.9 percent in 2018. The ACS asks respondents to and 2014 (Figure 7). Uninsured report their coverage at the time rates then decreased by 2.3 Between 2017 and 2018, the per- of interview, and the Census percentage points between 2014 centage of people without health Bureau conducts the ACS and 2015 and 0.8 percentage insurance coverage decreased in throughout the year. The result- points between 2015 and 2017. three states and increased in eight ing measure of health coverage, Between 2017 and 2018, the states (Figure 9 and Table 6). The therefore, reflects an annual aver- uninsured rate increased by 0.1 magnitude of decreases were 1.8 age of current health insurance percentage points. percentage points (Wyoming), 0.5 percentage points (South Carolina), and 0.3 percentage points (New York).46 All increases were 1.0 Figure percentage-point or less. Thirty-nine Uninsured Rate to states and the District of Columbia Percent did not have a statistically significant change in their uninsured rate.47
44 The percentage of people without health insurance coverage in Massachusetts (2.8 percent) was not statistically different from the percentage without coverage in the District of Columbia (3.2 percent). 45 Consistent with Figure 8, classification into these categories is based on rounded uninsured rates. 46 The percentage-point decreases in Wyoming, South Carolina, and New York were not statistically different from one another. 47 After the release of the 2017 data prod- ucts, the Census Bureau identified issues with data collection in Delaware. As a result, com- parisons between 2017 and 2018 for Delaware are not made in this report. For more informa- Note: Estimates reflect the population as of July of the calendar year. For tion, see
U.S. Census Bureau Health Insurance Coverage in the United States: 2018 17 As part of the Patient Protection and (“expansion states”), the uninsured national average, while many non- Affordable Care Act, 31 states and rate in 2018 was 6.6 percent, com- expansion states had uninsured rates the District of Columbia expanded pared with 12.4 percent in states that above the national average (Figure Medicaid eligibility on or before did not expand Medicaid eligibility 9). In 2018, the uninsured rates by January 1, 2018. (“non-expansion states”). This rate state ranged from 2.8 percent to 12.6 is not statistically different from the percent in expansion states, and from In general, the uninsured rate in 2017 rate for expansion states but is 5.5 percent to 17.7 percent in non- states that expanded Medicaid 0.2 percentage points higher than the expansion states. eligibility prior to January 1, 2018, 2017 rate in non-expansion states. was lower than in states that did not expand eligibility (Figure 8). In states Many Medicaid expansion states that expanded Medicaid eligibility had uninsured rates lower than the
Figure
AK Uninsured Rate by State (Civilian noninstitutionalized population)
Miles
WA
ME MT ND VT
OR MN ID NH SD WI NY MA MI WY RI CT IA PA NE NJ NV OH
! ! DE
! ! UT ! IN ! IL ! ! ! ! ! ! ! ! WV ! ! MD CA CO ! ! ! ! ! ! !
! VA ! KS ! MO !
! KY ! DC NC TN OK AZ AR SC NM Percent without health insurance MS AL GA coverage or more TX LA to FL to to Less than
HI Miles
Miles
A state with a circle around its abbreviation expanded Medicaid eligibility on or before January 1, 2018. Note: For information on confidentiality protection, sampling error, nonsampling error, and definitions in the American Community Survey, see
18 Health Insurance Coverage in the United States: 2018 U.S. Census Bureau Table 6. Number and Percentage of People Without Health Insurance Coverage by State: 2017 and 2018 (Numbers in thousands. Civilian noninstitutionalized population. For information on confidentiality protection, sampling error, nonsampling error, and defini- tions, see
U.S. Census Bureau Health Insurance Coverage in the United States: 2018 19 Figure Change in the Uninsured Rate by State and (Civilian noninstitutionalized population States with names in bold experienced a statistically significant change between and ) Massachusetts District of Columbia Vermont Hawaii Rhode Island
Minnesota Iowa Connecticut New York Michigan Wisconsin Pennsylvania Kentucky Delaware New Hampshire
Maryland West Virginia Washington Ohio Illinois Oregon California North Dakota New Jersey Colorado
Louisiana Maine Montana Arkansas Indiana
Nebraska Kansas Virginia
United States Missouri Utah New Mexico
South Dakota Alabama Tennessee Wyoming South Carolina
Arizona North Carolina Idaho Nevada Mississippi
Alaska Florida Georgia Oklahoma Texas Percent Expanded Medicaid eligibility as of January Expanded Medicaid eligibility after January and on or before January Expanded Medicaid eligibility after January and on or before January Expanded Medicaid eligibility after January and on or before January After the release of the data products the Census Bureau identified issues with data collection in Delaware As a result estimates for Delaware are omitted from this figure For more information see wwwcensusgovprograms-surveysacs technical-documentationerrata html Note For information on confidentiality protection sampling error nonsampling error and definitions in the American Community Survey see httpswww censusgovprograms-surveysacstech¡docsaccuracyACS¡Accuracy¡of¡Data¡ pdf Source US Census Bureau and American Community Survey -Year Estimates
20 Health Insurance Coverage in the United States: 2018 U.S. Census Bureau More Information About Health Comments the United States. People in institu- Insurance Coverage tions, such as prisons, long-term care The Census Bureau welcomes the hospitals, and nursing homes are comments and advice of data and Additional Data and Contacts not eligible to be interviewed in the report users. If you have suggestions CPS. Students living in dormitories Detailed tables, historical tables, or comments on the health insurance are included in the estimates only if press releases, and briefings are avail- coverage report, please write to: able on the Census Bureau’s Health information about them is reported in Insurance Web site. The Web site can Sharon Stern an interview at their parents’ home. be accessed at
U.S. Census Bureau Health Insurance Coverage in the United States: 2018 21 estimate based on a sample and the as editing, reviewing, or keying data The remaining data presented in corresponding value that would be from questionnaires. In this report, the this report are based on the ACS obtained if the estimate were based variances of estimates were calcu- sample collected from January 2018 on the entire population (as from a lated using the Fay and Train (1995) through December 2018. For more census). All comparative statements Successive Difference Replication information on sampling and esti- in this report have undergone sta- (SDR) method. mation methods, confidentiality tistical testing, and comparisons are protection, and sampling and non Most of the data from the 2019 CPS significant at the 90 percent confi- sampling errors, please see the 2018 ASEC were collected in March (with dence level unless otherwise noted. ACS Accuracy of the Data document some data collected in February Data are subject to error arising from located at
22 Health Insurance Coverage in the United States: 2018 U.S. Census Bureau * 1, –4 65 less less 122 *425 *463 *792 (2018
*1,867 *1,442 *1,862 Change 2017) of 66 (±) 630 619 222 521 195 214 207 254 error² error² Margin Margin 2018 491 4,281 4,192 5,686 5,112 7,701 27,462 26,971 22,690 Number Uninsured⁵ of 69 (±) 596 575 235 455 183 202 181 273 error² error² Margin Margin 2017 496 3,856 4,070 5,621 4,649 6,908 25,600 25,104 21,248 Number * 1, 42 less less the estimate, forms 90 percent confidence interval. -821 –240 (2018 *–323 *–798 *1,556 Change 2017) *–2,377 *–1,057 *–1,319 of (±) 962 929 529 610 212 239 213 356 280 error² error² Margin Margin 2018 5,366 7,127 6,665 61,683 27,578 34,104 14,945 49,647 Number 111,330 of (±) 928 883 482 590 205 249 227 353 241 error² error² Margin Margin Public health insurance⁴ 2017 5,606 7,450 6,624 64,059 28,636 35,424 15,743 48,092 Number 112,151 * 1, 74 less less 236 ttps://www2.census.gov/library/publications/2019/demo/p60-267sa.pdf>. *773 -430 –666 –740 –380 –228 (2018 *–905 Change 2017) 3 of Total (±) 541 795 300 355 261 450 411 error² error² 1,222 1,173 Margin Margin 2018 47,817 20,492 29,084 30,252 62,462 27,671 Number 217,780 190,109 142,291 of (±) 509 725 304 340 258 422 471 Any health insurance Any error² error² 1,129 1,001 Margin Margin Private health insurance Private 2017 47,743 20,873 28,311 30,480 63,367 27,435 Number 218,209 190,775 143,032 * 1, less less –98 *482 -684 (2018 *–579 *–636 *1,726 Change 2017) *–2,410 *–1,831 *–1,580 of (±) 641 671 284 577 252 273 209 344 261 error² error² Margin Margin 2018 73,052 25,105 35,082 35,915 74,754 52,296 Number 296,206 243,910 170,857 of (±) 622 616 285 511 301 301 182 312 212 error² error² Margin Margin 2017 73,631 25,741 34,600 36,013 76,334 50,570 Number 296,890 246,320 172,689 77,333 29,297 40,768 41,027 82,455 52,788 2018 Number 323,668 270,881 193,548 77,487 29,811 40,222 40,662 83,242 51,066 2017 Number 322,490 271,424 193,937 ...... Characteristic Private health insurance includes coverage provided through an employer or union, coverage purchased directly, or TRICARE. or TRICARE. directly, purchased or union, coverage an employer through provided includes coverage health insurance Private * Changes between the estimates are statistically different from zero at the 90 percent confidence level. confidence at the 90 percent zero from different statistically are the estimates * Changes between because of rounding. totals not sum to may ¹ Details ² A margin of error (MOE) is a measure an estimate’s variability. The larger the MOE in relation to size estimate, less reliable estimate. This number, when added and subtracted from 3 and the military. Affairs Veterans of by the Department provided and care Affairs), of Veterans of the Department Health and Medical Program (Civilian CHAMPVA includes Medicaid, Medicare, coverage ⁴ Public health insurance calendar year. the entire for coverage health insurance do not have if they be uninsured to considered ⁵ Individuals are Medicaid/CHIP. eligible for under the age of 19 are ⁶ Children plan. health insurance on a parent’s be a dependent be eligible to may 25 years ⁷ Individuals aged 19 to during the year. of health insurance than one type more by people can be covered not mutually exclusive; are of coverage type by estimates The Note: Supplement.. Annual Social and Economic Bridge File and 2019 Supplement Annual Social and Economic 2018 Survey, Population Current Bureau, Census U.S. Source: Appendix Table 1. Appendix Table and 2018 2017 Age: by Coverage of Health Insurance Type by Number of People and definitions, see U.S. Census Bureau Health Insurance Coverage in the United States: 2018 23 * 4 1, 64 45 49 143 258 213 less less *301 *170 *353 *662 *348 *622 *156 (2018 *1,320 *1,442 *1,347 *1,133 *1,605 *1,450 *1,862 Change 2017) of 81 92 59 (±) 134 235 152 116 331 447 221 125 309 521 248 426 341 232 630 549 114 525 error² error² Margin Margin 2018 757 835 464 2,443 6,622 2,661 1,603 4,412 2,428 8,463 7,286 5,982 1,476 10,500 18,498 22,690 16,602 10,621 27,462 23,889 22,413 Number Uninsured⁵ of 66 76 56 (±) 139 234 139 114 286 404 181 145 271 455 288 365 273 240 596 482 103 474 error² error² Margin Margin 2017 587 790 415 2,143 6,269 2,656 1,461 9,838 4,063 2,364 7,841 7,028 9,487 5,768 1,320 17,178 21,248 15,256 25,600 22,284 20,963 Number * 1, –29 –87 –65 –73 –40 –64 less less –138 –207 –122 –337 –821 *–638 *–264 *–735 *–920 *–322 *–598 (2018 *–1,079 *–1,319 *–1,257 *–1,173 Change 2017) https://www2.census.gov/programs-surveys/cps/techdocs < of 97 94 92 (±) 159 309 202 140 346 541 232 222 359 610 460 371 241 264 962 672 285 581 error² error² Margin Margin 2018 3,330 1,288 4,829 2,799 5,611 4,719 1,249 1,182 8,013 9,197 8,323 10,881 14,142 28,738 12,812 34,104 22,329 17,210 39,539 31,195 111,330 Number of 92 89 (±) 102 171 326 212 139 388 539 220 367 199 590 486 928 629 279 536 362 238 257 error² error² Margin Margin Public health insurance⁴ 2017 1,317 5,467 3,468 2,864 5,733 4,983 1,322 1,222 8,335 9,795 8,387 10,968 14,349 29,817 13,547 35,424 22,666 18,130 40,796 32,368 112,151 Number * 1, 27 –21 –77 –62 497 563 395 less less –360 –175 –570 –638 –740 –299 –939 –611 –430 *–655 *–447 *–877 (2018 *1,028 *–1,091 Change 2017) 3 of Total (±) 429 392 546 224 534 354 554 708 334 133 815 115 795 484 739 428 878 223 879 787 The sum of those with and without a disability does not equal the total because disability status is not defined for individuals is not defined status because disability does not equal the total sum of those with and without a disability The Individuals are considered to be uninsured if they do not have health insurance coverage for the entire calendar year. the entire for coverage health insurance do not have if they be uninsured to considered Individuals are The combined category “married” includes three individual categories: “married, civilian spouse present,” “married, “married, civilian spouse present,” individual categories: “married” includes three category combined The 1,222 error² error² 5 6 7 of health than one type more by people can be covered not mutually exclusive; are of coverage type by estimates The Note: Bridge File and 2019 Supplement Annual Social and Economic 2018 Survey, Population Current Bureau, Census U.S. Source: Margin Margin in the U.S. armed forces. armed forces. in the U.S. and “married, spouse absent.” spouse present,” armed forces U.S. during the year. insurance Supplement. Annual Social and Economic 2018 5,629 2,201 1,882 6,907 20,908 18,423 34,235 28,646 13,958 42,347 12,093 83,769 28,526 95,296 29,645 121,799 142,291 217,780 124,941 153,467 145,638 Number of (±) 433 581 209 352 326 504 683 498 137 120 341 725 770 447 243 767 708 506 779 743 Any health insurance Any 1,129 error² error² Margin Margin Private health insurance Private 2017 5,804 2,279 1,855 7,207 20,411 19,078 33,671 13,979 41,952 29,216 12,540 84,407 29,403 94,267 30,736 122,159 143,032 218,209 125,003 154,406 146,250 Number * 5 1, –91 –94 453 513 185 less less *884 –311 –553 –401 –684 *–623 *–783 (2018 *–1,207 *–1,195 *–1,304 *–1,831 *–1,121 *–1,667 *–1,904 *–1,474 Change 2017) of (±) 557 428 301 430 378 506 607 164 608 144 419 827 577 545 641 609 339 700 693 707 440 error² error² Margin Margin 2018 3,365 2,921 21,756 36,811 10,785 22,316 16,131 54,976 37,952 16,255 93,342 48,286 13,962 37,290 145,752 170,857 296,206 138,618 101,329 186,905 172,021 Number of (±) 582 434 318 402 339 507 587 157 565 387 795 145 511 586 622 525 347 576 694 674 534 error² error² Margin Margin 2017 3,459 2,916 21,303 36,298 11,096 23,523 16,222 54,791 38,505 16,877 94,646 49,407 14,363 38,956 146,948 172,689 296,890 139,401 100,445 188,808 173,496 Number 4,200 3,385 22,514 39,255 15,197 24,977 17,735 65,475 44,573 18,683 55,573 15,438 43,271 2018 164,250 193,548 101,805 323,668 155,221 111,950 210,794 194,434 Number 4,249 3,331 21,890 38,441 15,159 26,179 17,683 64,629 44,774 19,241 56,436 15,683 44,725 2017 164,126 193,937 102,487 322,490 154,657 109,932 211,093 194,458 Number . . . . 6 . . . . . . ...... 7 Characteristic Public health insurance coverage includes Medicaid, Medicare, CHAMPVA (Civilian Health and Medical Program of the Health and Medical Program (Civilian CHAMPVA includes Medicaid, Medicare, coverage Public health insurance Private health insurance includes coverage provided through an employer or union, coverage purchased directly, or TRICARE. directly, purchased or union, coverage an employer through provided includes coverage health insurance Private A margin of error (MOE) is a measure of an estimate’s variability. The larger the MOE in relation to the size of the estimate, the of the estimate, the size to the MOE in relation larger The variability. of an estimate’s (MOE) is a measure of error A margin Details may not sum to totals because of rounding. totals not sum to may Details * Changes between the estimates are statistically different from zero at the 90 percent confidence level. confidence at the 90 percent zero from different statistically are the estimates * Changes between 1 2 3 4 otal, 15 to 64 15 to otal, less reliable the estimate. This number, when added to and subtracted from the estimate, forms the 90 percent confidence interval. interval. confidence the 90 percent forms the estimate, from and subtracted when added to number, This the estimate. reliable less see “Standard information, more For weights. using replicate calculated errors based on standard in this table are MOEs shown 24 Health Insurance Coverage in the United States: 2018 U.S. Census Bureau * 1, * 64 4 1, –51 –54 259 less less 64 45 49 *496 *422 *331 *301 *298 *757 –144 –193 143 258 213 less less (2018 *301 *170 *353 *662 *348 *622 *156 *1,088 *1,857 *1,862 (2018 Change *1,320 *1,442 *1,347 *1,133 *1,605 *1,450 *1,862 2017) Change 2017) of (±) of 203 292 239 354 180 628 361 135 278 181 214 335 319 274 630 81 92 59 (±) 134 235 152 116 331 447 221 125 309 521 248 426 341 232 630 549 114 525 error² error² Margin Margin error² error² Margin Margin 2018 2018 757 835 464 3,546 4,669 5,469 7,519 2,063 9,082 1,143 6,212 1,924 3,162 5,939 7,255 5,976 27,415 27,462 2,443 6,622 2,661 1,603 4,412 2,428 8,463 7,286 5,982 1,476 10,500 18,498 22,690 16,602 10,621 27,462 23,889 22,413 Number Number Uninsured⁵ Uninsured⁵ of (±) of 201 217 249 331 155 399 104 595 316 155 202 329 299 294 596 66 76 56 (±) 139 234 139 114 286 404 181 145 271 455 288 365 273 240 596 482 103 474 error² error² Margin Margin error² error² Margin Margin 2017 812 2017 587 790 415 3,050 5,406 3,581 7,260 1,641 9,225 6,263 1,624 2,864 5,182 7,448 6,029 25,558 25,600 2,143 6,269 2,656 1,461 9,838 4,063 2,364 7,841 7,028 9,487 5,768 1,320 17,178 21,248 15,256 25,600 22,284 20,963 Number Number * 1, * 1, –25 464 107 182 216 less less *947 –558 –658 –720 –821 –29 –87 –65 –73 –40 –64 less less *–915 (2018 –138 –207 –122 –337 –821 *1,264 *–638 *–264 *–735 *–920 *–322 *–598 (2018 *–1,601 *–1,254 *–1,310 Change 2017) *–1,079 *–1,319 *–1,257 *–1,173 Change 2017) https://www2.census.gov/programs-surveys/cps/techdocs of (±) < of 356 458 468 692 338 961 748 229 650 426 322 572 712 663 962 97 94 92 (±) 159 309 202 140 346 541 232 222 359 610 460 371 241 264 962 672 285 581 error² error² Margin Margin error² error² Margin Margin 2018 2018 7,937 3,718 6,471 12,071 25,102 18,318 30,069 38,279 25,433 10,929 19,848 31,587 30,840 3,330 1,288 4,829 2,799 5,611 4,719 1,249 1,182 8,013 9,197 8,323 110,993 111,330 10,881 14,142 28,738 12,812 34,104 22,329 17,210 39,539 31,195 Number 111,330 Number of (±) of 406 561 491 756 340 923 809 665 237 443 321 533 759 695 928 92 89 (±) 102 171 326 212 139 388 539 220 367 199 590 486 928 629 279 536 362 238 257 error² error² Margin Margin Public health insurance⁴ error² error² Margin Margin Public health insurance⁴ 2017 2017 7,830 3,537 6,255 11,607 18,876 24,155 30,727 39,880 26,349 10,954 18,584 32,842 32,149 1,317 5,467 3,468 2,864 5,733 4,983 1,322 1,222 8,335 9,795 8,387 111,713 112,151 10,968 14,349 29,817 13,547 35,424 22,666 18,130 40,796 32,368 Number 112,151 Number * 1, * –9 97 1, 141 301 411 718 416 465 less less 27 –655 –424 –430 –21 –77 –62 497 563 395 less less *–622 *–935 (2018 –360 –175 –570 –638 –740 –299 –939 –611 –430 *–655 *–447 *–877 (2018 *–1,222 *–1,182 Change *1,028 2017) *–1,091 Change 2017) 3 of Total 3 (±) of Total 640 701 660 419 601 319 753 679 739 690 351 (±) 429 392 546 224 534 354 554 708 334 133 815 115 795 484 739 428 878 223 879 787 1,212 1,116 1,222 1,222 error² error² The sum of those with and without a disability does not equal the total because disability status is not defined for individuals is not defined status because disability does not equal the total sum of those with and without a disability The Individuals are considered to be uninsured if they do not have health insurance coverage for the entire calendar year. the entire for coverage health insurance do not have if they be uninsured to considered Individuals are The combined category “married” includes three individual categories: “married, civilian spouse present,” “married, “married, civilian spouse present,” individual categories: “married” includes three category combined The Margin Margin 1,222 error² error² 5 6 7 of health than one type more by people can be covered not mutually exclusive; are of coverage type by estimates The Note: Bridge File and 2019 Supplement Annual Social and Economic 2018 Survey, Population Current Bureau, Census U.S. Source: Margin Margin 2018 in the U.S. armed forces. armed forces. in the U.S. and “married, spouse absent.” spouse present,” armed forces U.S. during the year. insurance Supplement. Annual Social and Economic 2018 8,357 32,768 32,596 22,986 58,324 14,352 20,250 28,748 36,468 34,967 28,319 10,704 5,629 2,201 1,882 6,907 120,913 217,620 217,780 20,908 18,423 34,235 28,646 13,958 42,347 12,093 83,769 28,526 95,296 29,645 Number 121,799 142,291 217,780 124,941 153,467 145,638 Number of (±) of 710 664 603 388 485 612 759 688 653 689 406 (±) 433 581 209 352 326 504 683 498 137 120 341 725 770 447 243 767 708 506 779 743 Any health insurance Any 1,325 1,135 1,076 1,129 error² error² Any health insurance Any Margin Margin 1,129 error² error² Private health insurance Private Margin Margin Private health insurance Private 2017 2017 8,979 32,627 32,185 23,641 58,333 15,575 20,153 28,030 36,052 34,501 29,254 11,886 5,804 2,279 1,855 7,207 120,613 218,045 218,209 20,411 19,078 33,671 13,979 41,952 29,216 12,540 84,407 29,403 94,267 30,736 Number 122,159 143,032 218,209 125,003 154,406 146,250 Number * 1, * 5 1, –98 407 367 287 946 596 881 less less –807 –591 –684 –91 –94 453 513 185 less less 1,231 (2018 *884 –311 –553 –401 –684 *–623 *–783 (2018 *–1,324 *–2,347 *–1,746 *–2,014 Change 2017) *–1,207 *–1,195 *–1,304 *–1,831 *–1,121 *–1,667 *–1,904 *–1,474 Change 2017) of (±) of 719 778 643 936 696 783 644 844 840 959 876 641 711 (±) 557 428 301 430 378 506 607 164 608 144 419 827 577 545 641 609 339 700 693 707 440 1,237 1,161 error² error² Margin Margin error² error² Margin Margin 2018 2018 40,078 45,162 47,783 61,876 31,844 49,122 22,148 32,217 41,377 51,878 49,365 37,345 3,365 2,921 130,890 295,757 296,206 21,756 36,811 10,785 22,316 16,131 54,976 37,952 16,255 93,342 48,286 13,962 37,290 Number 145,752 170,857 296,206 138,618 101,329 186,905 172,021 Number of (±) of 841 632 813 768 966 921 655 833 853 815 622 793 (±) 582 434 318 402 339 507 587 157 565 387 795 145 511 586 622 525 347 576 694 674 534 1,400 1,114 1,013 error² error² Margin Margin error² error² Margin Margin 2017 2017 39,671 45,260 48,591 33,168 61,509 51,469 21,862 31,271 40,781 48,483 53,624 39,359 3,459 2,916 129,659 296,348 296,890 21,303 36,298 11,096 23,523 16,222 54,791 38,505 16,877 94,646 49,407 14,363 38,956 Number 146,948 172,689 296,890 139,401 100,445 188,808 173,496 Number 43,624 50,632 55,302 38,056 63,939 58,204 23,291 34,142 44,539 55,304 59,133 43,320 4,200 3,385 2018 135,559 323,172 323,668 22,514 39,255 15,197 24,977 17,735 65,475 44,573 18,683 55,573 15,438 43,271 Number 2018 164,250 193,548 101,805 323,668 155,221 111,950 210,794 194,434 Number 4,249 3,331 42,721 50,666 55,850 39,431 63,151 60,694 22,674 32,895 43,645 53,665 61,072 45,388 2017 21,890 38,441 15,159 26,179 17,683 64,629 44,774 19,241 56,436 15,683 44,725 133,239 321,907 322,490 Number 2017 164,126 193,937 102,487 322,490 154,657 109,932 211,093 194,458 Number . . . . . . . . . . . . . . . . 6 . ...... ...... 7 Characteristic Characteristic Private health insurance includes coverage provided through an employer or union, coverage purchased directly, or TRICARE. or TRICARE. directly, purchased or union, coverage an employer through provided includes coverage health insurance Private Public health insurance coverage includes Medicaid, Medicare, CHAMPVA (Civilian Health and Medical Program of the Health and Medical Program (Civilian CHAMPVA includes Medicaid, Medicare, coverage Public health insurance Private health insurance includes coverage provided through an employer or union, coverage purchased directly, or TRICARE. directly, purchased or union, coverage an employer through provided includes coverage health insurance Private A margin of error (MOE) is a measure of an estimate’s variability. The larger the MOE in relation to the size of the estimate, the of the estimate, the size to the MOE in relation larger The variability. of an estimate’s (MOE) is a measure of error A margin Details may not sum to totals because of rounding. totals not sum to may Details * Changes between the estimates are statistically different from zero at the 90 percent confidence level. confidence at the 90 percent zero from different statistically are the estimates * Changes between because of rounding. totals not sum to may ¹ Details MOEs interval. confidence the 90 percent forms the estimate, from and subtracted when added to number, This the estimate. reliable the less of the estimate, the size to the MOE in relation larger The variability. of an estimate’s (MOE) is a measure of error ² A margin 3 and the military. Affairs Veterans of by the Department provided and care Affairs), of Veterans of the Department Health and Medical Program (Civilian CHAMPVA includes Medicaid, Medicare, coverage ⁴ Public health insurance calendar year. the entire for coverage health insurance do not have if they be uninsured to considered ⁵ Individuals are during the year. of health insurance than one type more by people can be covered not mutually exclusive; are of coverage type by estimates The Note: Supplement.. Annual Social and Economic Bridge File and 2019 Supplement Annual Social and Economic 2018 Survey, Population Current Bureau, Census U.S. Source: * Changes between the estimates are statistically different from zero at the 90 percent confidence level. confidence at the 90 percent zero from different statistically are the estimates * Changes between 1 2 3 4 otal, 15 to 64 15 to otal, shown in this table are based on standard errors calculated using replicate weights. For more information, see “Standard Errors and Their Use” at U.S. Census Bureau Health Insurance Coverage in the United States: 2018 25 * 1, 10 107 123 205 449 less less *239 *545 *783 *367 *485 *265 *312 *157 (2018 *1,124 *1,079 *1,495 *1,372 *1,423 *1,368 *1,862 Change 2017) of 38 (±) 136 295 325 354 521 125 206 463 446 397 263 592 548 406 209 107 217 630 551 error² error² Margin Margin Black or African Black or African and 2018 141 1,956 6,719 8,675 1,348 4,141 6,782 3,857 3,774 1,183 6,376 10,688 18,787 23,605 10,078 13,527 20,345 10,571 27,462 20,540 Number Uninsured⁵ of 92 31 (±) 127 279 325 356 482 130 432 467 314 208 247 644 470 346 190 220 596 557 error² error² Margin Margin 2017 131 1,717 6,174 7,892 9,565 1,241 3,936 6,297 9,955 3,490 3,462 1,027 6,112 17,708 12,155 22,110 18,921 10,122 25,600 19,172 Number * 1, –9 –41 –32 270 229 150 less less –242 –159 –255 –406 –182 –414 –582 –324 –143 –961 –821 *–967 *–569 (2018 –1,050 Change 2017) of American Indian and Alaska Native or Asian Native American Indian and Alaska 74 (±) 282 272 404 469 944 401 221 475 905 821 676 509 240 368 962 and 1,507 1,263 1,249 1,009 error² error² Margin Margin 2018 453 6,156 8,118 5,155 8,634 14,274 21,871 97,056 17,598 24,882 93,410 36,919 56,491 17,920 83,728 64,676 25,553 28,723 85,995 111,330 Number of 84 (±) 275 280 401 398 905 397 247 948 465 744 678 411 459 225 928 933 1,411 1,145 1,342 error² error² Margin Margin Public health insurance⁴ 2017 462 6,197 7,848 5,187 9,204 14,045 22,113 98,106 17,779 37,078 56,746 18,327 24,732 93,824 84,311 65,000 26,520 28,865 86,957 112,151 Number * 1, 97 27 34 35 –25 –57 332 130 386 less less –527 –179 –653 –962 –222 –399 –430 1,040 *–502 *–816 (2018 –1,154 Change 2017) 3 Total of 81 (±) 355 372 512 571 309 466 623 993 225 812 462 522 1,232 1,484 1,713 1,934 2,141 1,222 1,235 error² error² ⁷ Federal surveys now give respondents the option of reporting more than one race. Therefore, two basic ways of defining a basic ways two Therefore, than one race. more the option of reporting respondents give now surveys ⁷ Federal of health than one type more by people can be covered not mutually exclusive; are of coverage type by estimates The Note: Bridge File and 2019 Supplement Annual Social and Economic 2018 Survey, Population Current Bureau, Census U.S. Source: Margin Margin race group are possible. A group, such as Asian, may be defined as those who reported Asian and no other race (the race-alone or race-alone (the race Asian and no other reported be defined as those who such as Asian, may A group, possible. are group race (the race-alone-or-in- another race also reported they of whether Asian regardless or as those who reported concept) single-race does not population The use of the single-race alone). (race approach using the first data table shows This concept). combination Information of approaches. uses a variety Bureau Census The data. or analyzing of presenting method it is the preferred imply that such as White than one race, more on people who reported than one race more of people reported percent About 2.9 American FactFinder. through Census the 2010 from American, is available reporting and those Islanders, and Other Pacific Hawaiians Native Natives, American Indians and Alaska for Data Census. in the 2010 separately. not shown are races or more two during the year. insurance Supplement. Annual Social and Economic 2018 534 11,393 14,275 25,668 29,749 14,456 66,355 26,240 23,705 37,700 13,555 60,097 44,514 192,111 191,539 125,185 171,563 145,560 217,780 179,546 Number of 90 (±) 359 409 556 520 300 435 674 916 842 233 486 453 Any health insurance Any 1,098 2,205 1,540 2,039 1,742 1,129 1,172 error² error² Margin Margin Private health insurance Private 2017 591 11,895 14,300 26,195 29,928 14,124 65,315 27,057 23,575 37,673 13,521 44,479 60,319 192,014 125,838 191,153 172,717 146,522 218,209 179,945 Number * 1, 93 –54 178 165 416 770 360 less less –288 –396 –232 –354 –990 –295 –684 *–574 *–954 *–359 *–533 (2018 *–1,100 *–1,145 Change 2017) of (±) 454 436 802 603 352 235 527 212 789 413 145 114 641 297 475 2,373 2,584 1,825 2,404 1,017 error² error² Margin Margin 2018 929 16,805 20,340 37,145 49,236 18,422 94,638 38,442 38,618 54,482 21,536 67,976 77,131 259,061 163,126 257,764 227,127 184,107 296,206 240,796 Number of (±) 447 819 466 641 363 237 500 395 212 145 122 782 622 283 998 465 2,458 2,610 1,877 2,558 error² error² Margin Margin 2017 983 17,379 20,162 37,541 49,469 18,257 93,869 39,542 38,525 21,896 54,121 68,509 77,427 259,349 163,480 257,348 228,272 185,061 296,890 241,786 Number 1,069 23,524 22,296 45,820 59,925 19,770 42,300 42,758 22,720 61,264 71,750 83,508 2018 277,848 176,653 281,369 104,716 247,472 194,679 323,668 261,336 Number 1,113 23,553 21,880 45,433 59,033 19,498 43,032 42,461 22,922 60,419 71,971 83,539 2017 277,057 175,635 279,458 103,823 247,193 195,183 322,490 260,958 Number . . . . . . . . . . . 6 ...... Characteristic . . Public health insurance coverage includes Medicaid, Medicare, CHAMPVA (Civilian Health and Medical Program of the Health and Medical Program (Civilian CHAMPVA includes Medicaid, Medicare, coverage Public health insurance The “Outside metropolitan statistical areas” category includes both micropolitan statistical areas and territory outside of and territory areas statistical includes both micropolitan category areas” statistical metropolitan “Outside The Individuals are considered to be uninsured if they do not have health insurance coverage for the entire calendar year. the entire for coverage health insurance do not have if they be uninsured to considered Individuals are Private health insurance includes coverage provided through an employer or union, coverage purchased directly, or TRICARE. or TRICARE. directly, purchased or union, coverage an employer through provided includes coverage health insurance Private * Changes between the estimates are statistically different from zero at the 90 percent confidence level. confidence at the 90 percent zero from different statistically are the estimates * Changes between because of rounding. totals not sum to may ¹ Details the of the estimate, the size to the MOE in relation larger The variability. of an estimate’s (MOE) is a measure of error ² A margin 3 4 5 6 statistical areas statistical statistical areas statistical Not a citizen interval. confidence the 90 percent forms the estimate, from and subtracted when added to number, This the estimate. reliable less see “Standard information, more For weights. using replicate calculated errors based on standard in this table are MOEs shown 26 Health Insurance Coverage in the United States: 2018 U.S. Census Bureau APPENDIX A. ESTIMATES OF HEALTH INSURANCE COVERAGE Quality of Health Insurance a redesign for the health insurance calendar-year reference period, (2) Coverage Estimates portion of the survey.4 an improvement to the imputation process for households with incom- The Current Population Survey Concurrent to the evaluation of plete and missing data, (3) the ability (CPS) Annual Social and Economic health insurance, other subject- to construct and release new mea- Supplement (ASEC) is used to pro- matter areas were similarly consid- sures, including about marketplace duce official estimates of income and ering changes to the CPS ASEC to coverage, and (4) the use of suban- poverty, and it serves as the most enhance data quality. A split-panel nual measures to capture when in the widely-cited source of estimates on design in the 2014 CPS ASEC tested calendar year a person had health health insurance and the uninsured. redesigned income questions, which insurance coverage. These changes were used for the full CPS ASEC sam- For the past several years, the mean that files based on these ple in 2015 and subsequent years.5 U.S. Census Bureau has been engaged processing updates reflect different Additionally, changes were intro- in implementing improvements to the types of coverage in their definitions duced beginning in 2015 to better CPS ASEC. These changes have been of public, private, and military health identify opposite-sex spouses, same- implemented in a two-step process, insurance coverage. As such, they are sex spouses, and unmarried partners. beginning first with questionnaire not directly comparable to previously design changes incorporated over To ensure that data from the updated released files. the period of 2014 to 2016, followed collection methods were released In April 2019, the Census Bureau by more recent changes to the data on schedule, the data were initially released a rerun of 2018 CPS ASEC processing system. extracted and processed using public-use data using the updated legacy procedures. That is, estimates In 2014, the Census Bureau intro- processing system. These data released from the CPS ASEC for duced redesigned income and health had previously been released in calendar years 2013 through 2017 insurance questions in the CPS ASEC September 2018 using the legacy reflected questionnaire changes, but in an effort to improve data quality. edit procedures. The April 2019 did not take full advantage of the Prior to the questionnaire redesign release was accompanied by several new questionnaire content in data in 2014, researchers questioned the working papers, notes, and tables processing. While data collection validity of the health insurance esti- summarizing differences in estimates 1 methods reflected these changes mates. In particular, the CPS ASEC from the two processing systems. immediately, data processing did not capture as much health insur- Public-use metadata files, a data changes to take full advantage of this ance coverage compared with other dictionary, and supplemental techni- new content have only recently been federal surveys or administrative cal documentation is available on 2 finalized. records. Additionally, these con- the Census Bureau Web site. Similar cerns extended to underestimating The second phase of implementation, resources were released for the 2017 the prevalence of Medicaid coverage which occurred in 2019, updated the CPS ASEC.6 and misreporting of the source and processing system that imputes miss- 3 Evaluation of the updated processing timing of health insurance coverage. ing data, determines family relation- system documented improvements After over a decade of research and ships (including among same-sex in data quality.7 In particular, the evaluation into these data quality couples), and constructs key health estimate of the uninsured popula- issues, the Census Bureau developed insurance measures. Specifically, tion with the updated processing for health insurance coverage esti- 1 The issues with the traditional CPS ASEC system is lower than in the preceding health insurance estimates have been well mates, the updates to data process- CPS ASEC, as the updated process- established, as discussed in the Census Bureau’s ing include: (1) a refinement of the annual publication on health insurance. For an ing system is designed to take full example, see page 22 in the report, P60-245, population that the health insurance advantage of additional information Income, Poverty, and Health Insurance Coverage estimates describe to exclude infants in the United States: 2012 at U.S. Census Bureau Health Insurance Coverage in the United States: 2018 27 Comparisons between 2017 and 2018 of a longer history of improvement from the 2017 CPS ASEC Research estimates in this report are based on spanning decades. File. It is not appropriate to compare estimates derived from the updated 2018 estimates with earlier years pro- processing system. In some cases, Historical Comparisons cessed with the legacy system.8 the 2017 estimates in this report Researchers should use caution Two data files can be used to pro- diverge from the estimates published when comparing results over time. vide estimates of health insurance in the Health Insurance Coverage Due to the differences in measure- coverage in 2017, namely the 2018 in the United States: 2017 report ment, health insurance estimates for CPS ASEC and the 2018 CPS ASEC released September 2018, which calendar year 2013 through 2017 are Bridge File. The 2018 CPS ASEC is were produced using the legacy pro- not directly comparable to previous cessing system. years. Estimates for calendar year 8 Data users may also compare 2019 CPS ASEC and 2018 CPS ASEC Bridge File esti- As seen in the timeline below, this 2018 should only be compared with mates with 2017 CPS ASEC Research File two-stage redesign of CPS ASEC 2017 estimates from the 2018 CPS estimates. However, due to a number of differ- ASEC Bridge File or 2016 estimates ences described on the Census Bureau Web health insurance information is part site, users should use caution in making these comparisons. Figure A Measuring Health Insurance Coverage With the Current Population Survey Annual Social and Economic Supplement (CPS ASEC) A History of Improvement Percent without insurance ¢ ¡ ¢ ¡ ¥¥£ ¥¥¥ ¤ £ ¥ ¤ £ Changes in processing steps People with no coverage other than access to Indian Health Service now considered uninsured Overall estimates of health insurance coverage change only negligibly however the increase in the number of people covered by Medicaid may be partially due to this change These estimates from the CPS ASEC were revised based on improvements to the algorithm that assigned coverage to dependents and there was an adjustment to the weights Updated processing system implemented to take full advantage of the CPS ASEC instrument redesign Change to survey instrument Follow-up verification question added Health insurance questions were redesigned to address underreport of coverage Estimates of overall coverage and coverage types are not comparable with later years Note: CPS measures prior-year coverage, e.g., 1997 statistics come from the 1998 CPS. For more information on the history of improvement to CPS ASEC health insurance content, see 28 Health Insurance Coverage in the United States: 2018 U.S. Census Bureau allows the report of TRICARE sepa- List of Coverage Years Available and Source File rate from VA and CHAMPVA cover- Coverage Files age. In the 2018 CPS ASEC, private years health insurance includes coverage 1987–2012 1988 CPS ASEC–2013 CPS ASEC provided through an employer or 2013–2017 2014 CPS ASEC–2018 CPS ASEC union, coverage purchased directly 2017–current 2018 CPS ASEC Bridge File; 2019+ CPS ASEC by an individual from an insurance company, or coverage through used to compare coverage estimates Comparison of Estimates of Health someone outside the household. in 2013 through 2017 (using the Insurance Coverage in 2017, In the 2018 CPS ASEC Bridge File, 2014 through 2018 CPS ASEC). The Traditional Processing System and private health insurance also includes 2018 CPS ASEC Bridge File is used Updated Processing System TRICARE. In the 2018 CPS ASEC, this to compare estimates from 2017 and Data files produced with the two pro- type of coverage cannot be sepa- later years (using the 2019 CPS ASEC cessing systems differ with respect to rated from other types of military forward). the population that the health insur- coverage and is included with gov- ance estimates describe; the impu- ernment coverage. Estimates for health coverage in 2017 tation process for households with in this report come from the 2018 Because of these improvements, incomplete and missing data; and the CPS ASEC Bridge File, while esti- coverage estimates are higher in the availability of additional measures to mates in the previous report, Health 2018 CPS ASEC Bridge File than in capture more detailed information Insurance Coverage in the United the 2018 CPS ASEC.9 Coverage rates about coverage. States: 2017, come from the 2018 significantly differ between the two CPS ASEC. Microdata files also include different files for all types of coverage. types of coverage in their definitions 9 For a comparison of estimates, see of public, private, and military cover- U.S. Census Bureau Health Insurance Coverage in the United States: 2018 29 APPENDIX B. REPLICATE WEIGHTS Beginning in the 2011 Current source and accuracy statement to Following the 2009 release of CPS Population Survey (CPS) Annual estimate standard errors. ASEC replicate weights, another study Social and Economic Supplement compared replicate weight standard One study found that the CPS ASEC (ASEC) report, the variance of CPS error estimates with SDB estimates.3 GVF standard errors performed ASEC estimates used to calculate Replicate weight estimates performed poorly against more precise Survey the standard errors and confidence markedly better against SDB standard Design-Based (SDB) estimates.2 In intervals displayed in the text tables errors than those calculated using the most cases, results indicated that the were calculated using the Successive published GVF parameters. published GVF parameters signifi- Difference Replication (SDR) meth- cantly underestimated standard errors Since the published GVF parameters od.1 This method involves the com- in the CPS ASEC. This and other generally underestimated standard putation of a set of replicate weights critiques prompted the U.S. Census errors, standard errors produced that account for the complex survey Bureau to transition from using the using SDR may be higher than in design of the CPS. The SDR method GVF method of estimating standard previous reports. For most CPS ASEC has been used to estimate variances errors to using the SDR method of estimates, the increase in standard in the American Community Survey estimating standard errors for the CPS errors from GVF to SDR will not alter since its inception. ASEC. In 2009, the Census Bureau the findings. However, marginally Before 2011, the standard errors of released replicate weights for the significant differences using the GVF CPS ASEC estimates were calculated 2005 through 2009 CPS ASEC collec- may not be significant using replicate using a Generalized Variance Function tion years and has released replicate weights. (GVF) approach. Under this approach, weights for 2010 to 2019 with the The Census Bureau will continue to generalized variance parameters release of the CPS ASEC public-use provide the GVF parameters in the were used in formulas provided in the data, including for the 2017 Research source and accuracy statement. File and 2018 Bridge File. 1 R. E. Fay and G. F. Train, “Aspects of Survey 2 M. Davern, A. Jones, J. Lepkowski, 3 M. Boudreaux, M. Davern, and P. Graven, and Model-Based Postcensal Estimation of G. Davidson, and L. A. Blewett, “Unstable “Alternative Variance Estimates in the Current Income and Poverty Characteristics for States Inferences? An Examination of Complex Survey Population Survey and the American Community and Counties,” Proceedings of the Section on Sample Design Adjustments Using the Current Survey,” presented at the 2011 Annual Meeting of Government Statistics, American Statistical Population Survey for Health Services Research,” the Population Association of America. Available Association, Alexandria, VA, 1995, pp. 154–159. Inquiry, Vol. 43, No. 3, 2006, pp. 283–297. at U.S. Census Bureau Health Insurance Coverage in the United States: 2018 31 APPENDIX C. ADDITIONAL DATA AND CONTACTS Press releases, briefings, and data access are available on the U.S. Census Bureau’s Health Insurance Web site. The Web site may be accessed through the Census Bureau’s home page at For assistance with health insurance data, contact the Census Bureau Customer Services Center at 1-800-923-8282 (toll- free), or search your topic of interest using the Census Bureau’s “Question and Answer Center” found at Additional Tables notes and FAQs at U.S. Census Bureau Health Insurance Coverage in the United States: 2018 33 P60-267(RV) Health Insurance Coverage in the United States: 2018 Current Population Reports U.S. Census Bureau S S E N I S U B L A I C I F F Penalty for Private Use $300 Penalty for Private U.S. Department of Commerce Commerce of Department U.S. BUREAU U.S. CENSUS DC 20233 Washington, O