On February 6, 2025, The National Center for Health Statistics (NCHS) released quarterly estimates of health insurance coverage from the National Health Interview Survey (NHIS) covering the third quarter (July – September) of 2024. This blog post covers this newly released Q3 NHIS data, including relevant changes in health insurance coverage compared to the same period the year prior, July – September 2023. We also delve into coverage changes by various breakdowns, including by age, race and ethnicity, and poverty level.
NHIS Data Continue to Show Medicaid Unwinding Impact on Coverage
These newest data from the NHIS are second from this survey to show significant changes in coverage coincident with the Medicaid unwinding (the state-level resumption of normal Medicaid eligibility redetermination procedures in April 2022 that had been put on hold during the COVID-19 public health emergency).
These data are among the first to describe the landscape of health insurance coverage at the tail end of the Medicaid unwinding—more than 90 percent of Medicaid enrollees had been through the redetermination process by the end of August 2024. We will continue to monitor NHIS early release data to track changes in coverage at the conclusion of the unwinding.
Changes by Age
These new NHIS estimates show that among children (age 0–17), uninsurance rose 1.9 percentage points (PP), increasing from 3.4% in Q3 2023 to 5.3% in Q3 2024. Though not statistically significant changes, the data suggest that this increase in uninsurance among children potentially could have been driven by a decrease in public coverage that was less-than-fully offset by an increase in private coverage. Full-year 2024 coverage estimates may clarify this picture further.
Rates of uninsurance were stable among the other measured age groups, measured at:
- 8.5% among people of all ages,
- 10.3% among people younger than 65, and
- 12.2% among adults (age 18+) younger than 65.
Rates of private coverage and public coverage were statistically unchanged among all measured age groups, including people of all ages, all people younger than 65, and adults younger than 65.
Changes by Income (ages 0–64)
The rate of uninsurance rose 3.8PP among people younger than 65 with incomes between 200% and 400% of the federal poverty level (FPL), increasing from 9.1% in Q3 2023 to 12.9% in Q3 2024. This income group includes people whose incomes are above typical Medicaid eligibility thresholds but still low enough that other forms of coverage may be difficult to afford or who may not work in jobs that come with health insurance coverage as an available benefit.
The 2024 Q3 NHIS estimates did not show statistically significant changes in uninsurance among other measured groups of people younger than 65 by income, remaining stable at:
- 17.4% among those with incomes less than 100% FPL,
- 18.0% among those with incomes 100%–199% FPL, and
- 3.2% among those with incomes greater than 400% FPL.
The new estimates did not show any significant changes in rates of public coverage or private coverage by income.
Changes by Race and Ethnicity (age 18–64)
The Q3 2024 NHIS estimates show that the rate of uninsurance increased 3.2PP among non-Hispanic Asian adults younger than age 65, rising from 3.8% in Q3 2023 to 7.0% in Q3 2024.
Rates of uninsurance among all other measured groups of adults younger than age 65 by race and ethnicity remained stable at:1
- 12.3% among non-Hispanic Black adults younger than age 65,
- 8.1% among non-Hispanic White adults younger than age 65, and
- 25.9% among Hispanic/Latino adults younger than age 65.
Rates of public coverage and private coverage were statistically unchanged among all groups of adults younger than age 65 by race and ethnicity.
Notes
[1] Note that estimates of uninsurance rates for Q3 2024 were not available for non-Hispanic adults younger than 65 of some other race or multiple races.
All changes and differences described were statistically significant based on two-sided t-tests at the 95% level of confidence, indicating that these changes were likely to reflect true changes in the population given the available data. Lack of statistically significant changes does not indicate certainty that there was no true population change, but rather that any true population change was not detectable with the available data.