26% Drop in Uninsured Americans: Potential Impact on Behavioral Health Care

The number of uninsured Americans has steadily decreased since 2019, new CDC data shows. This fact could have major implications for behavioral health access. 

A new report using results from the National Health Interview Survey (NHIS) found that the number of uninsured Americans dropped from 10.3% in 2019 to 7.6% in 2023.

People without health insurance are less likely to receive health care treatment or to delay treatment and are less likely to receive preventive care, according to KFF. On top of delaying or preventing care, lack of insurance can also land patients with substantial and unaffordable medical bills. 


During the public health emergency, the federal government allowed states to provide continuous Medicaid enrollment in exchange for additional funding. However, redeterminations have been ongoing for the last year. Several behavioral health providers including Acadia (Nasdaq: ACHC) and UHS (NYSE: UHS) have discussed how their organizations are addressing Medicaid redeterminations. 

Health insurance status strongly influences access to behavioral health care, including treatment for opioid use disorder.

Adults aged 18 to 64 made up the largest group of uninsured people. In 2023, 21.8% of people in this age group were uninsured, down from 29% in 2019. 

A bar graph showing that the number of uninsured people fell from 8.4% in 2022 to 7.6% in 2023. Centers for Disease Control and Prevention

In 2023, 2.8% of children under 18 lacked health insurance and only 0.5% of adults 65 and older were uninsured.

The number of uninsured Americans decreased from 27.6 million Americans, or 8.4%, in 2022 to 25 million people, or 7.6%, in 2023. The report’s authors noted that this was not significantly different year-over-year, but the drop follows a trend of incremental decreases year-over-year since 2019.

Both private and public insurance enrollment increased from 2019 to 2023. Public coverage increased from 20.4% in 2019 to 23% in 2023. Private coverage increased from 66.8% in 2019 to 68% in 2023.

The report also found that adults in Medicaid expansion states were more likely to have public coverage in 2023. However, from 2019 to 2023, public coverage for adults 18-64 grew at similar rates in both expansion and non-expansion states.

Despite overall improvements in health coverage, disparities persist across racial and ethnic groups.

Hispanic and Black adults are more likely to be uninsured than White or Asian non-Hispanic adults, CDC data showed. This aligns with KFF data, which demonstrates that most nonelderly uninsured people are working, low-income adults and people of color. 

Certified Community Behavioral Health Clinics (CCBHCs) are among the providers seeking to bridge the care gap for uninsured people.  According to data from the National Council for Mental Wellbeing, 16% of CCBHCs reported expanding access to care among uninsured people. 

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