The Share of Americans Without Health Insurance in 2023 Remained Low

The share of Americans without health insurance remained relatively low throughout the COVID-19 pandemic as well. In fact, Census data show more people were insured in 2023 than before the pandemic — the number of insured Americans rose by 9 million from 2018, the last year of the report before the COVID-19 pandemic impacted data collection, to 2023. That increase was partially due to policies implemented during the pandemic to mitigate its impact, which increased enrollment in public health insurance programs, as well as changes in the labor force. The increased reliance on public health insurance stemmed from the fact many people became eligible for Medicaid and CHIP due to lay-offs and provisions in the Families First Coronavirus Response Act that required states to ensure continuous enrollment. In fact, enrollment in Medicaid and CHIP grew by 30 percent from February 2020 to December 2022, reflecting its counter-cyclical design.

Looking at 2023, Census data show that the uninsured rate of 8.0 percent was not statistically different than the uninsured rate of 7.9 percent in 2022. However, the continuous enrollment provision expired on March 31, 2023 and many states were disenrolling beneficiaries from Medicaid through July 2023. Because the Census report is based on data collected February through April each year, this year’s report does not capture the full extent of the unwinding of Medicaid’s continuous enrollment provision.

Public and Private Health Insurance

Health insurance is provided through various sources in both the private and public sectors. The Census Bureau defines the programs in each sector:

• Private Insurance includes employment-based insurance plans and plans purchased directly from a marketplace. It also includes TRICARE, which serves members of the military.
• Public Insurance includes Medicare, Medicaid, the Children’s Health Insurance Program (CHIP), and veterans’ health programs.

In 2023, private insurance programs covered nearly twice as many Americans as public programs. Of those with health insurance in 2023, nearly two-thirds were enrolled in a private program and around one-third in a public program. Coverage estimates are not mutually exclusive because people can be covered by more than one type of health insurance during the year.