Metro/Non-Metro Differences in the Uninsured Populations within U.S. States

Lauren A. Bowers, U.S. Census Bureau
Tamara Lee, U.S. Census Bureau

This paper investigates the differences in the uninsured population in metro and non-metro counties within states. The analysis uses the 2010 Small Area Health Insurance Estimates to answer these questions: (1) Within each state, do metro and non-metro counties differ statistically in health insurance coverage? (2) Do these results vary by age and income groups? We examined populations under age 65, children, and working age adults. We analyzed all income groups and populations with an income-to-poverty ratio (IPR) up to 138%, the cutoff used in the Affordable Care Act’s Medicaid expansion provision. In the majority of states, results found that there is a difference between metro and non-metro counties for all age categories and income levels. All significantly higher rates were in non-metro counties. For the 138% IPR group, fewer states had a statistical difference. Of the states with statistical differences, the majority had higher rates in metro counties.