Health Insurance Coverage Estimates National Health Interview Survey (NHIS) 2021
The National Health Interview Survey (NHIS) is the principal source of information on the health of the civilian, noninstitutionalized population of the United States. Conducted annually by the Centers for Disease Control and Preventions National Center for Health Statistics, the NHIS collects data on a wide range of health topics, including health insurance coverage. The 2021 survey provides the most recent comprehensive snapshot of who is covered, who is not, and how coverage varies across demographic groups.
Key Findings for 2021
- Overall coverage:* Approximately 91.5%** of the U.S. civilian noninstitutionalized population reported having some form of health insurance** during the 12 months prior to the interview.
- Uninsured rate:** 8.5% of the population was uninsured, a slight increase from 2020 (7.9%).
- Age differences:**
- Children (017years): 94% insured
- Adults (1864years): 86% insured
- Older adults (65years and over): 99% insured
- Coverage type:**
- Private health insurance: 59% of the total population
- Public coverage (Medicare, Medicaid, CHIP, military, etc.): 32%
- Multiple coverage (both private and public): 2%
- Racial/Ethnic disparities:**
- NonHispanic White: 93% insured
- NonHispanic Black: 87% insured
- Hispanic: 78% insured
- NonHispanic Asian: 91% insured
- Other races/ethnicities: 84% insured
- Income gradients:**
- Families with income <100% of the Federal Poverty Level (FPL): 71% insured
- Families with income 100199% FPL: 84% insured
- Families with income 400% FPL: 97% insured
- Geographic variation:** Uninsured rates are highest in the South (10%) and lowest in the Northeast (5%).
Understanding the Estimates
The NHIS asks respondents a series of questions about their health insurance status, including whether they have any coverage at all, the type(s) of coverage, and any gaps in coverage during the previous year. The survey distinguishes between any coverage (including temporary or partial coverage) and continuous coverage (no gaps of 30days or more). For the purpose of the 2021 summary table, the metric reported is any coverage for the entire year.
Why the 2021 Numbers Matter
2021 was the second full year of the COVID19 pandemic, a period marked by significant shifts in employment, income, and public policy. The modest rise in the uninsured rate reflects lingering economic hardship and the expiration of several pandemicrelated enrollment expansions, such as the enhanced subsidies for the Affordable Care Act (ACA) marketplace plans that were limited to 2021. At the same time, the nearuniversal coverage of adults 65and older underscores the strength of Medicare as a safety net.
Methodological Notes
The NHIS uses a multistage area probability design to select a representative sample of households. Data are weighted to adjust for nonresponse and to align the sample with the 2020 Census totals for age, sex, race/ethnicity, and region. Estimates are presented with 95% confidence intervals; the values listed above are point estimates rounded to the nearest whole percent.
Detailed Tables
Table 1 Overall Coverage by Age Group
| Age Group | Insured (%) | Uninsured (%) |
|---|---|---|
| 017 years | 94 | 6 |
| 1864 years | 86 | 14 |
| 65years and over | 99 | 1 |
Table 2 Coverage Type for the Entire Population
| Coverage Type | Percent of Total Population |
|---|---|
| Private only | 59 |
| Public only | 30 |
| Both private and public | 2 |
| Uninsured | 8.5 |
Table 3 Insurance Coverage by Race/Ethnicity
| Race/Ethnicity | Insured (%) | Uninsured (%) |
|---|---|---|
| NonHispanic White | 93 | 7 |
| NonHispanic Black | 87 | 13 |
| Hispanic | 78 | 22 |
| NonHispanic Asian | 91 | 9 |
| Other/Multiple races | 84 | 16 |
Policy Implications
The 2021 NHIS data underline a persistent coverage gap for certain subpopulations, especially:
- Workingage adults (1864) with low incomes: The uninsured rate of 2025% for families earning less than 200% of the FPL suggests that Medicaid expansion in all states and continued ACA subsidies remain essential.
- Hispanic communities: Cultural, linguistic, and immigrationstatus barriers continue to limit enrollment. Targeted outreach and simplified enrollment processes can help close this gap.
- Geographic disparities: Southern states, where Medicaid expansion is limited, exhibit the highest uninsured rates. Statelevel policy changes could have an immediate impact.
Policymakers can use these estimates to prioritize funding for enrollment assistance programs, expand eligibility for public coverage, and monitor the impact of any future legislation on insurance access.
Where to Find More Information
The full NHIS 2021 dataset, detailed methodological documentation, and additional tables are publicly available on the National Center for Health Statistics website:
* Percentages are rounded to the nearest whole number unless otherwise noted. ** The overall insured rate includes individuals with any form of coverage, whether private, public, or both.
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