The SAHIE program is the only source of single-year health insurance estimates for every county in the US. Estimates are available for each county by sex, age, and Federal Poverty Level (FPL). Race/ethnicity information is available at the state level.
The following are highlights from the 2017 SAHIE release.
Nationwide, county uninsured rates for the nonelderly population (i.e., under age 65) ranged from 2.3% to 33.7% in 2017, with a median county uninsured rate of 10.6%.
In 1,206 counties, (38.4% of all counties), the 2017 nonelderly uninsured rate was at or below 10%. An estimated 493 counties (15.7%) had uninsured rates greater than or equal to 15.0%, an increase of 2.2% from 420 counties in 2016 (13.5%).
Among the 493 counties with uninsured rates at or above 15.0 percent, 82.6 percent (407 counties) were located in the South. The remaining were located in the Midwest (41 counties) and West (45 counties). No counties in the Northeast fell into this category.
Alaska, Georgia, Idaho, Montana, Nebraska, Oklahoma, and Texas all had counties with 2017 nonelderly uninsurance rates that exceeded 25.0%.
From 2016 to 2017, the nonelderly population (i.e., under age 65) in over 91% of counties (2,879) did not have a statistically significant change in their uninsured rate. Among counties that did experience change in their uninsured rates, more saw an increase (183 counties) than a decrease (79 counties).
SAHIE are created using statistical models that combine American Community Survey (ACS) data with population estimates and administrative records.
SAHIE are consistent with the direct ACS survey estimates, but SAHIE are more precise than the ACS 1-year and 5-year survey estimates alone for most counties because SAHIE are supplemented with other data sources.
SHADAC Brief #26 provides an overview of how the SAHIE are developed as well as a comparison of the SAHIE model-based methodology to that used by ACS (see Table 2).
The State Health Access Data Assistance Center (SHADAC) is a program of the Robert Wood Johnson Foundation and a part of the Health Policy and Management Division of the School of Public Health at the University of Minnesota.