A Profile of Alabama’s Low-Wage Uninsured Workers

The recently enacted American Rescue Plan Act of 2021 (ARP) includes new large financial incentives for states to extend health insurance coverage to low-wage workers and other adults earning less than $17,775 a year.¹ These incentives apply to regular spending in a state’s Medicaid program and offer a five-percentage point across the board increase in the federal share for a 24-month period after the state extends coverage. The Kaiser Family Foundation estimates that Alabama’s budget would see a net gain of $540 million over a two-year period if the state expanded Medicaid.² Approximately 204,100 uninsured non-elderly adults, or 49 percent of the state’s uninsured adult population, would gain health insurance.³

This fact sheet examines which workers and industries would benefit from expansion of Medicaid coverage.4 The top three industry sectors employing low-wage uninsured workers are hospitality, retail, and health care and social assistance, accounting for approximately 47 percent of those working without insurance; these industry sectors include businesses such as restaurants, general merchandise stores (such as warehouse clubs and supercenters), and nursing care facilities (see Table 1). The most common jobs for low-wage, uninsured workers are cashiers, cooks, freight and stock laborers, and maids and housekeeping staff (see Table 2).


The map below shows the range of uninsured rates for all non-elderly adult workers across the state of Alabama, ranging from 7.4 percent in Shelby County to 19.2 percent in DeKalb County. Hover over the map to see the uninsured rate in each county.


¹ For more information on the provisions of the law, see E. Park and S. Corlette, “American Rescue Plan Act: Health Coverage Provisions Explained” (Washington DC: Georgetown University Center for Children and Families and Center on Health Insurance Reform, March 2021), available at https://ccf.georgetown.edu/2021/03/11/american-rescueplan-act-health-coverage-provisions-explained/.
² R. Rudowitz, B. Corallo, and R. Garfield, “New Incentive for States to Adopt the ACA Medicaid Expansion: Implications for State Spending” (Washington DC: Kaiser Family Foundation, March 2021), available at https://www.kff.org/medicaid/issue-brief/new-incentive-for-states-toadopt-the-aca-medicaid-expansion-implications-for-state-spending/.
³ Kaiser Family Foundation, “Who Could Medicaid Reach with Expansion in Alabama?” (Washington DC: Kaiser Family Foundation, February 2021), available at https://files.kff.org/attachment/fact-sheetmedicaid-expansion-AL.
4. Contact authors for more information on sources of data and methods. All data are derived from the American Community Survey (2019) most from the Public Use Microdata Sample; county data calculated from American Community Survey five-year (2015-2019) prepared tables.<‘p>

[See our full list of Low-Wage Uninsured Worker State Profiles here.]