The Uninsured by State and Congressional District, 2010

Annie L. Mach
Analyst in Health Care Financing

The total U.S. civilian non-institutionalized population in 2010 was estimated to be slightly more  than 304 million, of whom 15.5%, or 47.2 million, were estimated by the American Community  Survey to be without health insurance or uninsured. The uninsured are far more likely than those  with health insurance to report problems getting needed medical care, less likely to follow  recommended treatments because of costs, have less access to care, receive less preventive care,  and are more likely to be hospitalized for avoidable health problems. Moreover, it is widely  believed that the uninsured, when they need care, are less able to pay for their care since they do  not have health insurance and therefore it is further assumed that other payers take on the  financial burden of their care through higher prices.

Many Americans obtain their health insurance through employers. Local factors such as labor  market conditions, the mix of firms and firm sizes, and demographic factors such as age, play a  role in the proportion of uninsured among those of working age. The Medicare program has  effectively provided health insurance to almost all elderly Americans, while the Medicaid  program and the State Children’s Health Insurance Program have expanded health insurance  coverage to both the poor and to children. State policies to expand coverage, including  implementing Medicaid waivers to expand coverage, account for some of the differences across  states in the proportion of uninsureds. Similarly, state policies to expand coverage, such as  employer or personal mandates to purchase insurance in Hawaii and Massachusetts, further  explain some of the differences in the number of uninsureds across states.

The Patient Protection and Affordable Care Act (ACA, P.L. 111-148, as amended), through an  expansion of Medicaid and the creation of state health insurance exchanges, is projected by the  Congressional Budget Office to reduce the share of legal non-elderly residents without health  insurance to 6% of the population by 2019.

This report, using the U.S. Census Bureau’s 2010 American Community Survey, details  differences in the number and proportion of uninsured across states, within states, and across  demographic groups.


Date of Report: November 17, 2011
Number of Pages: 142
Order Number: R42102
Price: $29.95

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