Census Bureau: Uninsurance Rate Remained Stable in 2023

The proportion of Americans without health insurance remained stable in 2023, the Census Bureau reported on Sep. 10, close to the record low that the Biden administration had achieved in 2022 through expansions of public programs, including the Affordable Care Act.

As KFF Health News’s Phil Galewitz reported on that same date, “About 8 percent of Americans were uninsured, a statistically insignificant increase of just 0.1 percentage point from a year earlier. But because of the Census survey’s methodology, the findings likely don’t capture the experience of tens of millions of Americans purged from Medicaid rolls after pandemic-era protections expired in spring 2023. Enrollment in Medicaid, the government health program for people with low incomes and disabilities, reached its highest level in April 2023. That was just before what’s called the “unwinding,” the process states have used to disenroll people from the program after the federal government lifted a prohibition on culling enrollment,” he wrote.

Galewitz noted in his report that the unwinding process has been completed in most states, with 25 million people having been disenrolled, according to the Kaiser Family Foundation. What’s not known is the extent to which the unwinding statistics reveal true, lasting uninsurance. As he noted, “The Census report, based on surveys conducted early this year, counts people as uninsured only if they lacked insurance for all of 2023. So, for example, a person who was on Medicaid in April 2023 before the unwinding began then lost coverage and never regained it would nonetheless be counted as insured for the entire year.” In many cases, the report noted, officials believe that those who have been disenrolled from Medicaid have successfully reenrolled in or obtained other insurance, including from the Affordable Care Act marketplace, or through job-based coverage.

The report noted that, “Before Congress passed the ACA in 2010, the uninsured rate had been in double digits for decades. The rate fell steadily under President Barack Obama but reversed under President Donald Trump, only to come down again under President Joe Biden.”