The Census Bureau reported Tuesday that 26.7 million people, or 7.9% of the U.S. population, had no health insurance at any time in 2025. Most people had coverage for some or all of the year. The bureau said the figure was not a significant change from 2024 and that the uninsured rate remained near historic lows, according to Reuters.
The number works best as a baseline. It describes coverage before most of the major scheduled changes to Medicaid and marketplace coverage took effect, so it will serve as the starting point for measuring how those changes affect households.
For families, the timing matters. The figure covers 2025, not this year. Households whose marketplace premiums rose in January will not see that reflected in these numbers.
Why This Number Differs from the CDC's May Estimate
In May, the CDC's National Center for Health Statistics reported that 8.3% of Americans, about 28.0 million people, did not have health insurance in 2025. That estimate comes from the National Health Interview Survey, which asks whether people are covered at the time they are interviewed.
The Census figure uses a narrower definition. It counts people as uninsured only if they had no coverage at any point during the year. A person who was uninsured from March to May but covered for the rest of the year would not be counted as uninsured in the Census measure. That same person could be counted as uninsured in the CDC survey if interviewed during the gap.
Neither number is wrong. The two surveys answer different questions, so comparing one survey's figure for one year with the other survey's figure for another year can create a false trend.
The CDC data also show where coverage gaps are largest. In 2025, 11.6% of adults ages 18 to 64 were uninsured, unchanged from 2024 but down from 13.5% in 2021. The uninsured rate for children was 5.6%, or 4.0 million, up from 5.1% in 2024, a change the agency said was not statistically significant. Working-age adults in states that had not expanded Medicaid were almost twice as likely to be uninsured as those in expansion states, at 18.1% compared with 9.0%.
State and City Numbers Are Still on Hold
The Census Bureau released Tuesday's national estimates from the Current Population Survey Annual Social and Economic Supplement. The American Community Survey (ACS), which most local health departments and reporters use for state and city analysis, has not been released yet.
In August, the bureau said the release date for the latest ACS estimates, which cover 2025, was still being determined. The bureau said it was assessing a new Commerce Department order on disclosure avoidance and looking for compliant ways to release the one-year tables later this year. The ACS is the only source of local estimates for most of the topics it covers, including health insurance coverage.
Until those tables are published, there is no way to know from Census data how uninsured rates changed in 2025 in any particular state or metro area.
What the Baseline Will Be Measured Against
Several coverage changes are expected to push these numbers in a direction the 2025 data cannot yet show.
The enhanced premium tax credits that lowered marketplace premiums starting in 2021 expired at the end of 2025. In a preview of the Census release, the Center on Budget and Policy Priorities, a left-leaning policy group, said nearly 2.2 million fewer people were enrolled in marketplace coverage in February 2026 than in December 2025. The group also cited Congressional Budget Office projections that the 2025 reconciliation law, the expiration of the enhanced credits, and administration rule changes will together leave about 15 million more people uninsured by 2034.
Those figures are projections, not measurements, and long-range estimates carry uncertainty. The reconciliation law's largest Medicaid changes, including work requirements, are set to start in early 2027. That means Census releases covering 2026 and 2027 are likely to show the effects more clearly.
Survey methods matter too. The Census Bureau has found that response to the survey has fallen since 2020, especially among people with low incomes. In its nonresponse bias analysis, the bureau concluded that nonresponse raised 2024 median income estimates by 2% or 3% and lowered the official 2024 poverty rate by 0.4 percentage points. The health coverage estimates come from the same survey.
Checking Your Own Household Before Open Enrollment
National averages cannot tell a family whether it is covered. A few checks before the next open enrollment period can.
People with marketplace plans should confirm their actual 2026 premium and tax credit rather than assume last year's amounts carried over. The end of the enhanced credits changed costs for many enrollees. Households facing a large increase can compare plans across metal tiers, since the net cost after the credit can vary more than expected.
People covered by Medicaid should make sure their state agency has their current mailing address and phone number, because renewal notices and other paperwork go to the address on file. Missed paperwork, rather than a change in eligibility, has been a common reason people lose Medicaid coverage.
People who lose coverage have options. Losing job-based or other health coverage generally qualifies a person for a special enrollment period, so there is no need to wait for open enrollment. Federally qualified health centers offer care on a sliding fee scale based on income, and nonprofit hospitals are required to have written financial assistance policies that patients can request.
The next major data release will come when the Census Bureau publishes the 2025 ACS one-year estimates, which will include state and metro detail. MedicalDaily will report those figures when they are available.
Key Questions Answered
What did the Census Bureau report? It reported that 26.7 million people, or 7.9% of the population, had no health insurance at any time in 2025. The bureau said this was not a significant change from 2024.
Why is this different from the 28 million figure reported in May? The CDC survey counts people who were uninsured when they were interviewed. The Census measure counts only people who had no coverage at any point during the year.
Does this reflect higher 2026 premiums? No. The data cover 2025, and the enhanced premium tax credits expired at the end of that year.
Where are the state and city numbers? They will come from the 2025 American Community Survey one-year estimates. The Census Bureau has not set a release date but says it is working to publish them later this year.
Who is most likely to be uninsured? According to CDC data, working-age adults in states that have not expanded Medicaid were almost twice as likely to be uninsured as those in expansion states.
What can someone do after losing coverage? Losing health coverage generally opens a special enrollment period. Federally qualified health centers offer sliding-scale fees, and nonprofit hospitals must have financial assistance policies.
What should Medicaid enrollees check now? They should make sure their state agency has their current address and phone number, since renewal notices go to the address on file.
