Healthcare Coverage StatisticsData for Every Location in America
Health insurance is any program that helps pay for medical expenses. There are two main types of health insurance in the United States: private and public. Private insurance is purchased from companies, either directly by individuals or by employers for their employees. Public insurance, which includes Medicare (for seniors) and Medicaid (for low-income Americans), is supplied by the government. People may have more than one type of health insurance. In 2018, about 8.5% of Americans—27.5 million people—lacked health insurance.
This site explores the data behind the healthcare coverage in America. Choose a topic below. Then search for any state, county, or city in the United States to see the data for that location.
The Uninsured Rate: A Closer Look
Vital health care can be prohibitively expensive without health insurance. While the uninsured rate has fallen in recent years, it remains unevenly distributed across the United States. These topics compare the uninsured rate across various demographic, social, and economic factors.
Healthcare Coverage in America: A Short History
The founding fathers recognized the importance of health to American citizens. However, the concept of health insurance is a relatively modern innovation. It evolved from several earlier movements, such as accident insurance that replaced lost wages suffered by injured factory workers.
The model of the modern private insurance industry emerged in Texas during the 1920's—a local teacher's union was offered a subscription service that would cover the cost of a 21-day hospital stay, plus a deductible. The concept spread widely, and in 1939 it had become known as "Blue Cross Plans"—which were originally not-for-profit.
“...You may promise yourself every thing—but health, without which there is no happiness. An attention to health then should take place of every other object.”
—Thomas Jefferson to Thomas Mann Randolph Jr., July 6 1787
The Birth of Public Health Coverage
Various presidents have voiced support for publicly-funded health insurance coverage. In 1945, President Harry S. Truman proposed a universal health program. However, the bill was attacked as "socialized medicine" and likened to a Communist threat.
The first foray into public health coverage came in 1965, when President Lyndon Johnson signed an amendment to the Social Security Act. The amendment established the Medicare and Medicaid programs. Medicare covered the elderly, and Medicaid covered the poor. Originally, Medicare came in Part A (for hospital insurance) and Part B (for medical insurance).
Over time, Medicare became more complex, and covered more people. In 1972, Medicare expanded beyond seniors to cover people with long-term disabilities and end-stage renal (kidney) disease. Today, Medicare also includes prescription drug coverage (Part D). A private insurance alternative to Medicare, called Medicare Advantage or Part C, is also available.
In 1997, the Balanced Budget Act created the Children's Health Insurance Program (CHIP), which provided coverage to millions of low-income children whose families are not poor enough to qualify for Medicaid.
The Patient Protection and Affordable Care Act
The Patient Protection and Affordable Act, often called the Affordable Care Act (ACA) or Obamacare, was signed into law by President Barack Obama on March 23, 2010. The Affordable Care Act served to overhaul existing insurance rules and expand health coverage to more people. It built upon the existing framework of Medicare and Medicaid, and also created "exchanges" that enabled people and businesses to purchase private insurance plans. Under the ACA, the uninsured rate fell to the lowest rate in recent history.
The ACA served to increase coverage in several ways. It outlawed insurance companies' practice of denying coverage to people with pre-existing conditions, such as cancer and other chronic diseases. The ACA also required businesses with over 50 employees to offer health insurance, and allowed children to stay on their parents' insurance plans until the age of 26. In addition, the ACA provided funding to states that expanded their eligibility requirements for Medicaid coverage, which more than half of states have done.
In short, the ACA made it much easier for people who need expensive medical care to get health insurance—which could have caused insurance costs to spiral out of control. To guard against this risk, the act also includes incentives for healthy people to acquire insurance. It introduced a tax penalty for people who elect not to get insurance, a provision popularly known as the "mandate." The act also provided subsidies—paid via tax increases—to help lower-income Americans afford private insurance. The ACA is forecasted to lower the budget deficit by $143 billion according to the Congressional Budget Office.
As of October 2019, a slim majority of Americans support the act, with views divided across partisan lines. In December 2017, President Donald Trump passed the Tax Cuts and Jobs Act, which repealed the "mandate" or tax penalty for those who do not buy insurance. Many healthy individuals are likely to opt out of health insurance.
Health System Tracker | The Peterson-Kaiser Health System Tracker provides clear, up-to-date information on trends, drivers, and issues that impact the performance of the system. It also illustrates how the U.S. is performing relative to other countries, and how different parts of the system are performing relative to one another.
Healthcare.gov | The central site for the Patient Protection and Affordable Care Act (ACA), operated by the federal government.