WASHINGTON (TIP): Between 2008 and 2012, the number of children under age 19 without health insurance declined in 1,171 counties and rose in 17, with 1,950 not having a statistically significant change, according to estimates released by the U.S. Census Bureau.

The number of workingage adults without health insurance rose in 494 counties, declined in 269 counties and did not have a statistically significant change in 2,375 counties. These statistics come from the 2012 Small Area Health Insurance Estimates, the only source for single-year estimates of the number of people with health insurance for each of the nation’s roughly 3,140 counties.

The statistics are provided by broad age and sex groups, and at income levels that reflect thresholds for state and federal assistance programs. Statewide estimates also break out the data by race and Hispanic origin. Nationally, according to the American Community Survey, an essential input to the health insurance estimates, the percentage of children under 19 without health insurance declined from 9.7 percent (7.5 million) in 2008 to 7.5 percent (5.8 million) in 2012, while the percentage for working-age adults rose from 19.4 percent (36.1 million) to 20.8 percent (39.8 million).

The health insurance statistics are provided for two income categories that are relevant to recent changes in federal law. One category is families with incomes less than or equal to 138 percent of the poverty threshold. Eligibility for Medicaid was expanded earlier this year up to this threshold in participating states, i.e., those that allow Medicaid expansion. The second income category is new to the health insurance estimates this year: families with incomes between 138 percent and 400 percent of the poverty threshold. Under the law, these families can receive tax credits that will help them pay for health coverage contracted through the new health insurance exchanges. “These new statistics on health coverage by income can be used as a baseline for policymakers and researchers studying the impacts of health care policy changes at state and local levels in the future,” said Lucinda Dalzell, chief of the Census Bureau’s Small Area Estimates Branch.

Other highlights:
o 68.2 percent of counties in the Northeast and 36.1 percent of counties in the Midwest have uninsured rates below 12.5 percent. Compare this to the South and the West, where only 2.6 percent and 2.5 percent of counties, respectively, have an uninsured rate below 12.5 percent.
o In every county, the uninsured rate for children under age 19 was lower than working-age adults, ages 18 to 64, except for four counties in Nevada, which saw no statistical difference.
o For the population younger than 65 living at or below 138 percent of poverty, non-Hispanic blacks had a lower uninsured rate than non- Hispanic whites in 34 states. Hispanics had a higher uninsured rate than non-Hispanic whites for every state but Hawaii, which was not statistically different.

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The release includes a 2012 highlights document that describes demographic and economic differences in health insurance status across states and counties, as well as time trends in health insurance status. Also available is an interactive data and mapping tool. This tool allows users to create and download state and county custom tables and thematic maps for all concepts available annually for 2006 through 2012 and state health insurance coverage time trend charts. The tool is an easy way for states to evaluate their potential program participants.

Background on the program
The Small Area Health Insurance Estimates program models coverage by combining survey data with population estimates and administrative records. Specifically, it uses the American Community Survey, demographic population estimates, aggregated federal tax returns, participation records for the Supplemental Nutrition Assistance Program, County Business Patterns, Medicaid and the Children’s Health Insurance Program participation records, and the 2010 Census.

American Community Survey data are essential to the production of Small Area Health Insurance Estimates. Later this year, the Census Bureau will release American Community Survey health insurance coverage estimates in three stages: first, 2013 data for counties and other areas with a population of 65,000 or more; next, similar estimates for areas with a population of 20,000 or more using data collected from 2011 to 2013; finally, statistics for all areas, regardless of size, based on American Community Survey data collected from 2009 to 2013.