How to Read the Census Report on Health Insurance Coverage — Uninsured All Year, Overlapping Types and Revised 2024

As of 10 November 2026, 00:40 KST (retrieved by this page at that time); the latest national CPS ASEC report in this series listed at retrieval on the Census health insurance topic page: Health Insurance Coverage in the United States: 2025 (Current Population Reports P60-291), U.S. Census Bureau. The topic page also lists a separate state brief, Health Insurance Coverage by State: 2025, based on the American Community Survey. Report cover: Issued September 2026; publication page dated September 15, 2026, Page Last Revised September 15, 2026. Data: the 2026 Current Population Survey Annual Social and Economic Supplement (CPS ASEC), collected February to April 2026, about coverage during calendar year 2025. Primary source: https://www2.census.gov/library/publications/2026/demo/p60-291.pdf^[1][2][5]

Comparison basis: counts are in thousands and rates are percentages of the civilian noninstitutionalized population, rounded to one decimal; the report states: "To further protect respondent privacy, all estimates in this report have undergone additional rounding." "As a result, details may not sum to totals." The printed changes compare 2025 with 2024 re-estimated under Vintage 2025 population controls (Table 1, footnote 1): "Estimates for 2024 may not match those published last year due to the implementation of Vintage 2025 population controls." The previous column therefore shows 2024 as first published in P60-288, and the change against it is this page's calculation. "All comparative statements have undergone statistical testing and are statistically significant at the 90 percent confidence level unless otherwise noted."^[1][3]

In three lines

1. 26.7 million people (7.9%) had no health insurance at any time in 2025 (Table 1, Figure 1), not statistically different from 2024; the margin of error on the rate is 0.2.
2. Medicare rose to 20.1% (+0.6 points) and Medicaid fell to 17.1% (-0.5 points), both significant, leaving public coverage at 35.8% (Figure 1).
3. Private coverage among adults 65 and older fell 2.8 points to 41.5% (Figure 2).^[1][2]

Uninsured means uninsured all year. Table 1, footnote 5: "In the CPS ASEC, individuals are considered to be uninsured if they did not have health insurance coverage for the entire calendar year." People with any comprehensive coverage at some point in the year count as insured; the report adds: "Additionally, people are considered uninsured if they only had coverage through the Indian Health Service (IHS), as IHS coverage is not considered comprehensive."^[1]

Coverage types overlap. "The estimates by type of coverage are not mutually exclusive; people can be covered by more than one type of health insurance during the year." The coverage-type rows of Table 1 therefore do not add to the 311,200 thousand people with any health plan; endnote 14 says 44.7 percent of people age 65 and older reported holding more than one type of coverage concurrently for some or all of calendar year 2025.^[1]

Who is in the survey. The appendix says: "The CPS ASEC collects data in the 50 states and the District of Columbia; these data do not represent residents of Puerto Rico or the U.S. Island Areas." "Since the CPS is a household survey, people who are homeless and not living in shelters are not included in the sample." People in institutions such as prisons and nursing homes are not eligible to be interviewed. "The 2026 CPS ASEC sample consists of about 88,000 addresses." "The Census Bureau administers the CPS ASEC each year between February and April by telephone and in-person interviews, with most data collected in March." "The weighted response rate for the 2026 CPS ASEC was 61.3 percent, compared to 62.0 percent for the previous year."^[1]

Series breaks. Endnote 22 says: "Figure 7 includes a series break after 2017, when an updated processing system was introduced for the CPS ASEC." "The U.S. Census Bureau recommends using caution when making health insurance coverage comparisons between 2019 and other years." The report's Figure 7 starts in 2013, after the redesigned 2014 CPS ASEC questionnaire, with the uninsured rate at 13.3 percent in 2013 and 7.9 percent in 2025.^[1]

Medicare: +0.6 or +1.0 points. P60-288 gave a Medicare rate of 19.1 percent for 2024, and P60-291 gives 20.1 percent for 2025 with a printed change of +0.6 points. Against the first-published 19.1 percent the difference is 20.1 - 19.1 = +1.0 points; against the revised 2024 base it is +0.6 points, which implies a revised 2024 rate near 19.5 percent that the report text does not print. The two bases differ in population controls (Vintage 2024 and Vintage 2025), so the printed +0.6 is the change the Census Bureau tested.^[1][3]

More people on Medicare, same share of older people on it. Table 1 shows Medicare up by a significant 2,165 thousand people. The report says: "The increase in the Medicare rate was due, in part, to growth in the number of people age 65 and older." Endnote 11 adds: "The estimated proportion of the population age 65 and older with Medicare coverage did not statistically change between 2024 and 2025." The number grew while the rate within the 65-and-older group did not change significantly.^[1]

Printed changes and table subtraction. In Table 1, 26,670 - 26,940 = -270 thousand while the printed uninsured change is -268, and 67,910 - 65,740 = 2,170 while the printed Medicare change is 2,165. The additional rounding the report describes may explain these gaps; the cause is not established.^[1]

No overall change, a change for one age group. The report says: "There were no statistically significant changes in private coverage, public coverage, or the uninsured rate between 2024 and 2025." Within that, the publication page says: "In 2025, 41.5 percent of adults age 65 and older held private coverage, down 2.8 percentage points from 2024." The all-ages and 65-and-older rates are different populations, so both statements hold.^[1][2]

National survey, not state estimates. "The Census Bureau recommends that people use the CPS ASEC for timely and thorough estimates of national health insurance coverage." The report names the American Community Survey and the Small Area Health Insurance Estimates for states and counties, so state figures from those programs are from different surveys and are not this report's numbers.^[1]

Children and working-age adults. 5.8 percent of children under 19 were uninsured in 2025, and 11.0 percent of adults ages 19 to 64, neither statistically different from 2024 (Figures 5 and 6). Among adults 19 to 64, those 19 to 25 had the highest rate (14.5 percent) and those 45 to 64 the lowest (8.6 percent; Figure 4).^[1]

Regions and nativity. The uninsured rate for children in the Northeast fell 1.8 points to 2.6 percent, and in the West rose 1.1 points to 5.5 percent. Among adults 19 to 64, the native-born rate rose 0.6 points to 8.9 percent and the foreign-born rate fell 1.2 points to 19.4 percent; for noncitizens it was 28.9 percent (Figures 5 and 6).^[1]

Expansion states. Figure 3 splits coverage by residence in one of the 40 expansion states and the District of Columbia, or 10 nonexpansion states, using expansion status as of January 1, 2025. The split describes where people live; the report does not attribute coverage gaps to it.^[1]

Dates kept apart. P60-291: cover Issued September 2026; publication page dated September 15, 2026 and last revised September 15, 2026. P60-288 (previous edition): cover Issued September 2025; page dated September 09, 2025 and last revised September 11, 2025. Coverage year 2025; survey fieldwork February to April 2026, mostly March.^[1][2][3][4]

Next release. The report, its publication page and the Census health insurance topic page do not state a date for the 2026 coverage report, so the next release date is not established.^[1][2][5]