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Informing Policy. Advancing Health.

Health Insurance Estimates for All Counties

The U.S. Census Bureau has released 2008 and 2009 estimates of health insurance coverage for each of the roughly 3,140 counties in the United States. These Small Area Health Insurance Estimates (SAHIE) are of such interest because they currently are the only source for estimates of health insurance coverage status at the county level nationwide.

These estimates are available by sex, age groups between 0 and 64, race/ethnicity (for states only), and the federal poverty levels that are used to determine eligibility under the new health care reform legislation and other health insurance programs. These estimates allow local planners to determine the counties in which low-income children are most likely to lack health insurance coverage.

Along with the new data, the Census Bureau released a mapping tool that allows users to examine health insurance coverage by county, based on age, sex and income as a percentage of the federal poverty level. Health insurance coverage can be viewed by race/ethnicity at the state level.  The following maps illustrates the 2009 uninsured rate for all races, all income and both sexes under age 65 by county for the state of Colorado.

The mapping tool can be found here.

These SAHIE estimates are based on statistical models combining data from a variety of sources including the American Community Survey (ACS), U.S. Census Bureau population estimates, administrative records, such as aggregated federal tax returns and Medicaid participation records, and 2000 Census statistics.

"This is the first SAHIE release to make use of the American Community Survey," said U.S. Census Bureau Director Robert Groves. "In the past, our statistical models were based on the Current Population Survey (CPS), which has a smaller sample. The larger ACS sample allows us to provide estimates for additional income groups. By combining data from many sources through statistical modeling, we can considerably enhance the precision of state and county health insurance coverage estimates." Due to the changes in methods, the Census Bureau does not advise comparing SAHIE estimates from 2006 and 2007 to the newest estimates (2008 and 2009).

There are even more uninsured estimates on the horizon. In late October, the Census Bureau for the first time will release health insurance coverage estimates for counties with a population between 20,000 and 65,000 from the 2008-2010 American Community Survey.

The SAHIE represents one of a number of sources of available estimates on the uninsured. Another important source of  regional health insurance coverage in Colorado is the 2011 Colorado Health Access Survey funded by The Colorado Trust, available here.