Association for Public Policy Analysis & Management

Objectives: To describe trends in the social and demographic composition of the population without insurance from 2008 to 2017, with an emphasis on changes between 2013 and 2017.

Methods: Analyses used 2008 through 2017 1-year American Community Survey (ACS) data on the noninstitutionalized civilian population ages 19-64 to examine trends in the characteristics of the uninsured population in the United States. Analyses also explored the importance of social and demographic change in the overall U.S. population by decomposing the change in the uninsured rate between 2013 and 2017.

Results: In 2017, the profile of the uninsured population differed from the profile of the noninstitutionalized civilian population ages 19-64 with respect to a number of characteristics, including age, sex, and socioeconomic resources. Between 2013 and 2017, the uninsured population became disproportionately more likely to live in the south and have less than a high school education. However, compositional changes did not drive the overall decline in the uninsured rate.

Conclusions: Although a fair amount of research has considered changes in the uninsured rate for key sociodemographic groups, only a limited amount of research has considered how these changes affected the composition of the uninsured population in the United States. The profile of the uninsured population, which has changed over time, can help to inform interventions to target this group.