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Small Area Health Insurance Estimates (SAHIE) Allow First Look at Post-ACA Uninsurance Rates in All U.S. Counties

UPDATE: WEBINAR DETAILS

SHADAC will host a coffee-break webinar on June 9, 2016, featuring experts from the U.S. Census Bureau, who will discuss findings from the 2014 SAHIE data along with the recent Medicaid data changes used in SAHIE production.

The webinar will take place from 12:00 - 12:30 a.m. ET / 11:00 - 11:30 CT. 

REGISTER HERE.

May 16, 2016:

Although All States Saw Declines in Overall Uninsurance, Changes in Uninsurance Vary at the Sub-State Level 

The U.S. Census Bureau released the 2014 Small Area Health Insurance Estimates (SAHIE) on May 12, 2016. The Census Bureau updated the SAHIE models for 2014, incorporating more current Medicaid data sources in order to better capture Medicaid expansion under the Affordable Care Act (ACA). The Census Bureau also re-released 2013 estimates using this updated methodology to facilitate comparisons between 2013 and 2014.

The current SAHIE release provides researchers and policy analysts with the first opportunity to compare uninsurance rates for all U.S counties before and after full implementation of the coverage provisions of the ACA. 

Highlights from the 2014 Data

State-level estimates from the 2014 ACS show decreases in the uninsured rates for all 50 states and the District of Columbia, but the new SAHIE results indicate that coverage changes vary  at the sub-state level:

• • According to the new SAHIE analysis, 2,325 counties, or 74.1 percent of all counties, saw a decrease in the uninsurance rate.
• • In Medicaid expansion states, 96.1 percent of counties saw a decrease in their estimated uninsured; in non-expansion states, on the other hand, only 36.8 percent of counties saw a decrease in uninsurance.

Table 1 displays the 10 counties with the highest number of nonelderly (0-64) uninsured for 2013 and 2014.

• • Approximately 17% percent of the nation’s 2014 uninsured lived in these 10 counties.
• • All the 2014 top counties saw year-over-year decreases in the estimated number of uninsured.
• • Nine of the top ten 2014 counties were also among the top ten counties in 2013.
• • The top 4 counties with the highest number of uninsured remained the same from 2013 to 2014. 

SHADAC's full analysis of the geographic concentration of the uninsured in 2013 and 2014 (updating past work) will be available soon.

Learn More about the New SAHIE Data

2014 SAHIE Data Release Highlights can be viewed here, and Interactive estimates can be viewed here.