What Do the New Census Data Say About the Uninsured in 2023?

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In 2023, the uninsured rate remained at a near historic low of 8.0%, according to new data from the Current Population Survey (CPS). After falling during the past three years, largely due to pandemic-era policies that paused Medicaid disenrollments and enhanced Affordable Care Act Marketplace premium subsidies, the uninsured rate stabilized in 2023. Continued growth in Marketplace coverage partially offset a decline in employer-based coverage, while Medicaid coverage, which had increased during the pandemic to a record high 94 million in April 2023, showed no change from 2022.

While the overall uninsured rate and the rate for adults was unchanged from 2022, the uninsured rate for children increased by nearly half a percentage point from 5.4% in 2022 to 5.8% in 2023 (Figure 1). This increase was driven by a drop in employer coverage that was not offset by increases in Medicaid or Marketplace coverage for children.

Although the survey data show no overall increase in the uninsured rate, the survey may not be capturing the full impact of changes in insurance coverage in 2023. The CPS only counts someone as uninsured if they lack coverage for the entire year. Medicaid continuous enrollment that was in place during the pandemic ended on March 31, 2023, and since April 2023, states have disenrolled over 25 million people from Medicaid. While many people who were disenrolled found their way back onto the program or transitioned to other coverage, KFF survey data indicate that about 8% of those who were disenrolled became uninsured. However, these newly uninsured individuals may not have been counted as uninsured in the 2023 CPS data because they were covered by Medicaid for part of the year. The 2024 CPS data should provide a more complete look at the effects of Medicaid unwinding.

The Census Bureau will be releasing health insurance estimates from the American Community Survey (ACS) on September 12, 2024, which may paint a slightly different picture than the CPS. The ACS, which was fielded throughout 2023, asks individuals about their current insurance status, and as a result, may pick up on those people who became uninsured after losing Medicaid. The ACS will also show variation and changes in health coverage across states.