Check out your state’s numbers on our state data hub.

Every year we look closely at the U.S. Census Bureau’s American Community Survey health insurance coverage data to see what is happening to coverage rates overall and especially for children. The data, which are released in early September, reflect survey responses collected in the prior year – so in this most recent tranche of data we’re talking about 2023.

This year, as others have highlighted, the uninsured rate overall fell to its lowest level in recent history across multiple surveys. However, the uninsured rate for children went up significantly, from 5.1 percent in 2022 to 5.4 percent in 2023. This was equal to about 223,000 additional children without coverage. The number of uninsured children had moved downwards to one of its lowest levels during the pandemic because of the continuous coverage protections put in place during the public health emergency for Medicaid and most enrolled in the Children’s Health Insurance Program (CHIP).

We blogged in August about why we were not expecting much news from this year’s data.

We plan to publish a short issue brief describing the data in more detail, but at the moment we are still busy tracking net Medicaid enrollment change for children related to the unwinding. However, we are updating our State Data Hub today with all of the state-specific data—including breakdowns by age, race, ethnicity, and income—so you can check out how your state fared. (Note: additional updates on sources of coverage and quality data will be coming later this fall!)

In short, three states saw an improvement in their child uninsured rate in 2023: Colorado, Kentucky and North Dakota. Most states started moving in the wrong direction but this change was only statistically significant in six states: New Mexico, South Carolina, Alabama, Louisiana, Washington, and Texas — a preliminary look suggests that children of color and children in lower-income families are worse off, which is very troubling. Medicaid unwinding was kicking off in some states as early as April 2023 and all states had begun by the end of 2023; some were fairly far along. The full effects of unwinding will not be known until we see next year’s ACS data.