2012 ACS Shows National Decline in Uninsured Mirrored in 20 States and DC

September 19, 2013: The 2012 American Community Survey (ACS) estimates of insurance coverage are now available in the US Census Bureau’s American FactFinder.

The National Story

Nationally, the percentage of the US population estimated to be uninsured fell significantly, from 15.1 percent in 2011 to 14.8 percent in 2012, with the estimated number of uninsured falling from 46.4 million to 45.6 million.[1]

The State Story

This nationwide drop in uninsurance from 2011 to 2012 was mirrored by significant decreases in 20 states and the District of Columbia during this time (Figure 1). The largest decrease occurred in New Mexico, which saw a 1.4 percentage point decline in its uninsured rate, followed by Georgia, with a 1.2 percentage point decline, and Alabama and the District of Columbia, each of which saw a 1.0 percentage point drop.  Uninsured rates in the remaining 30 states and Puerto Rico were statistically stable.  (No state showed a significant increase in uninsurance.)

Behind the National and State Numbers: Public and Private Coverage

Nationally, the drop in uninsurance appears to be due to an increase in public coverage, from 30.5 in 2011 to 31.1 in 2012.  This continues the increase seen from 2010 to 2011, when public coverage grew 0.8 percentage points (from 29.7 percent to 30.5 percent).  However, private coverage stabilized from 2011 to 2012, remaining statistically unchanged at 65.1 percent (vs. 65.2 percent in 2011).  This is different from 2011, when private coverage fell a significant 0.6 percentage points from its 2010 level of 65.8 percent.[2]

At the state level, decreases in uninsurance also seem to be largely driven by increases in public coverage: Twenty-eight states saw significant increases in their rates of public coverage from 2011 to 2012, and only two (Arizona and North Dakota) saw significant decreases in public coverage (Figure 2).  Private coverage changes were more variable, with seven states showing significant declines from 2011 to 2012, and five states showing significant increases (Figure 3). 

Among the 20 states and District of Columbia that showed overall decreases in coverage from 2011 to 2012, the significant public and private changes are shown (as percentage-point change) in Table 1.  Eleven of the states with overall decreases in uninsurance saw significant growth in public coverage only; four saw growth in private coverage only; and one (Florida) saw an increase in public coverage accompanied by a decrease in private coverage.

Background: ACS

The ACS is a household survey that began in 2005 and produces annually updated data on a variety of population characteristics, including health insurance coverage.  In total, the ACS surveys approximately three million US households each year. An important feature of the ACS is that it includes a large enough sample for state‐level and sub‐state estimates.

The ACS began asking survey respondents about health insurance coverage during the 2008 calendar year.  Specifically, the survey asks respondents about current coverage for each person in the respondent’s household.  A person is categorized as “insured” if he or she has coverage at the point in time at which the survey is administered.

New This Year

For the first time, 2012 ACS estimates are available based on the 2010 Census definitions for Public Use Microdata Areas (PUMAs), Urban Areas, and Urban/Rural. Also available are data products for the 113^th Congressional Districts. 

Two new Detailed Tables for health insurance have been added this year:

(1)  Health Insurance Coverage Status by Sex by [School] Enrollment Status for Young Adults Aged 19 to 25.

(2)  Private Health Insurance by Sex by [School] Enrollment Status for Young Adults Aged 19 to 25

[1]Civilian noninstitutionalized population.

[2] The ACS defines public coverage as coverage through Medicare, Medicaid, or Veterans Affairs.  Private coverage is defined as coverage through an employer, through direct purchase, or through TRICARE or other military insurance.