2012 State and County Insurance Coverage Estimates from the American Community Survey (ACS)

The tables below contain state and county health insurance coverage estimates for 2012.  These estimates come from the 2012 American Community Survey (ACS) via the U.S. Census Bureau’s American FactFinder (AFF) tool and were released on September 19, 2013.

50-State Estimates

• Private Coverage Rates by State, for All People from 2011 to 2012
• Public Coverage Rates by State, for All People from 2011 to 2012
• Uninsurance Rates by State, for All People from 2011 to 2012
• Uninsurance Rates by State, for All People, 2009-2012
• Uninsurance Rates by State, for Age 0-17 from 2011 to 2012
• Uninsurance Rates by State, for Age 0-17, 2009-2012
• Uninsurance Rates for the United States in 2011 and 2012​ 

About the 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.

Why Aren’t Estimates Provided for All Counties?

Due to sample size constraints, single-year ACS estimates are available at the county level only for counties with a population greater than 65,000.  County estimates will be available for all counties below this population threshold when the five-year (i.e., 2008-2012) ACS estimates are released on December 5, 2013.

How Are these Estimates Different from the Estimates that SHADAC Publishes Using Census Bureau Micro-Data Files?

Two definitions used by the Census Bureau to generate the tabulations below differ from those that SHADAC uses to generate tabulations for the SHADAC Data Center and the RWJF Data Hub.  The definitional differences are as follows:

   Family

• The Census Bureau defines a family as all related people in a household.
• SHADAC defines a family using a measure called the “Health Insurance Unit” (HIU), which includes all individuals who would likely be considered a family unit in determining eligibility for either private or public coverage.
• To learn more about the HIU, see SHADAC Brief #27, “Defining Family for Studies of Health Insurance Coverage.”

   Family Income

• The Census Bureau determines family income as a percentage of the Federal Poverty Level (FPL), which is a definition of poverty used primarily for statistical purposes.  For example, FPL is used to estimate the number of Americans living in poverty each year.
• SHADAC determines family income as a percentage of the U.S. Department of Health and Human Services’ Federal Poverty Guidelines (FPG), which is a measure used for administrative purposes.  For example, FPG is used to determine eligibility for federal programs such as Medicaid and the Supplemental Nutrition Assistance Program (SNAP).
• To learn more about the difference between FPL and FPG, click here.
   

This webinar provides an overview of the 2012 state health insurance coverage estimates from the American Community Survey (ACS), Current Population Survey (CPS), and the 2011 county estimates from the Small Area Health Insurance Estimates (SAHIE) program. 

SHADAC staff present results from the ACS, CPS, and SAHIE, and guide users in accessing the estimates, and experts from the U.S. Census Bureau respond to questions.

Resources

• "2012 State and County Insurance Coverage Estimates from the American Community Survey (ACS)." 
  Comparison Tables. September 2013. SHADAC: Minneapolis, MN.
   
• "American FactFinder."
  Query tool for accessing federal survey data from the U.S. Census Bureau. 2013. U.S. Census Bureau: Washington, D.C.
   
• "Comparing Federal Government Surveys that Count the Uninsured." 
  Issue Brief. September 2013. SHADAC: Minneapolis, MN.   
   
• "Health Insurance Main."
  Web Page. 2013. U.S. Census Bureau: Washingon, D.C.
   
• "Public Use Microdata Areas (PUMAs)." 
  Web Page. 2013. U.S. Census Bureau: Washington, D.C.
   
• "Small Area Health Insurance Estimates (SAHIE)."
  Web Page. 2013. U.S. Census Bureau: Washington, D.C.
   
• "State Estimates of the Low-Income Uninsured Not Eligible for the ACA Medicaid Expansion."
  Issue Brief. March 2013. SHADAC: Minneapolis, MN.
   
• "State Reform Survey Item Matrix (SRSIM)."  
  Excel matrix that allows comparison of survey metrics between state and national surveys and provides a resource to inform decisions around metrics to include in future surveys. 2013. SHADAC: Minneapolis, MN.

SHADAC Senior Research Fellow Brett Fried presented, "Measuring Transitions, Spells of Uninsurance, and Churning in the Redesigned CPS," at the 2013 Joint Statistical Meetings (JSM) in Montreal, Quebec, on August 4, 2013.

SHADAC Senior Research Fellow Joanna Turner presented, "Medicaid Undercount in the American Community Survey: Preliminary Results," at the 2013 Joint Statistical Meetings (JSM) in Montreal, Quebec, on August 7, 2013.

Abraham, J.M., Karaca-Mandic, P., & Boudreaux, M. 2013. "Sizing Up the Individual Market for Health Insurance: A Comparison of Survey and Administrative Data Sources." Medical Care Research and Review 70(4): 418-433. doi: 10.1177/1077558713477206