Census survey shows no change in child uninsured rate as Medicaid rolls shrink, but researchers say the data may be missing the real story
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The share of American children without health insurance did not change significantly in 2025, according to Census Bureau survey data released last week. Researchers at Georgetown University's Center for Children and Families say they doubt the numbers caught what happened to children's coverage that year.
The figures come from the Current Population Survey's Annual Social and Economic Supplement, which the bureau released alongside its income and poverty reports. It counted 5.8 percent of children under 19 as uninsured for all of 2025, compared with 6.1 percent in 2024, a difference the bureau does not consider statistically significant. The share uninsured for part of the year went from 4.5 percent to 4.8 percent, also not significant. The share uninsured at the time the survey was taken, in the spring, stayed at 6.5 percent.
The only significant changes were regional. The child uninsured rate fell to 2.6 percent in the Northeast and rose 1.1 points to 5.5 percent in the West. The South remained highest at 8.0 percent.
Why the center questions the numbers
The survey's main child uninsured rate counts a child only if they had no coverage for the entire year. A child who lost Medicaid partway through 2025 does not show up in it.
Enrollment records point the other way. The center's tracker of state Medicaid and CHIP data shows almost 2.5 million fewer children enrolled in July 2026 than in January 2025, with the decline speeding up in the first half of 2026. The center has pointed to anecdotal reports of parents in mixed-status families avoiding public coverage for their citizen children, after the administration began sharing Medicaid data with the Department of Homeland Security.
The same fear could keep those families from answering a Census Bureau survey. One in four children in the U.S. lives in a family with a noncitizen or foreign-born member, according to the center. The survey showed the uninsured rate for noncitizen children falling 2.8 points in 2025, a change that was not statistically significant and that the center called unexpected. At 18.3 percent, it is still more than three times the rate for all children.
The survey is also small as the bureau's own poverty report puts its sample at about 88,000 addresses, and response rates have not recovered from the pandemic, leaving a sample the center says skews toward higher-income households.
The state data that is missing
State-by-state figures would normally come from the American Community Survey, released the same week, with a far larger sample. This year it has not appeared. The center says the release has been delayed indefinitely following a Commerce Department order restricting the methods the bureau can use to protect respondents' confidentiality, a change we covered in the Commerce ban on noise infusion.
The most recent state numbers are from the 2024 American Community Survey. They showed 4.65 million children under 19 without coverage, 6.0 percent, the highest rate in the table below and above the 2019 level.
| Year | Uninsured children under 19 | Rate |
|---|---|---|
| 2019 | 4,375,102 | 5.7% |
| 2022 | 3,931,919 | 5.1% |
| 2023 | 4,155,019 | 5.4% |
| 2024 | 4,648,418 | 6.0% |
By state, the gap is wide. Texas had 13.6 percent of children uninsured in 2024, far above any other state, and its 1.1 million uninsured children were almost a quarter of the national total. Arizona was next at 9.3 percent, then Wyoming at 9.0 percent, Alaska at 8.8 percent, and Oklahoma and Florida at 8.5 percent. The lowest rates were in Massachusetts at 2.1 percent, New Hampshire at 2.3 percent, and Vermont and Connecticut at 2.6 percent.
Those 2024 figures predate the Medicaid enrollment decline the center describes, which it measures from January 2025. Until the 2025 American Community Survey is released, there is no survey measure of which states saw more children go uninsured.
County-level estimates are in county uninsured rates, and the broader picture of coverage types is in how Americans get health insurance. The poverty figures from the same release are in the 2025 poverty report.
Sources
The 2025 coverage figures, the Medicaid and CHIP enrollment decline, and the account of the American Community Survey delay are from the Georgetown University Center for Children and Families post Census Bureau Releases Some New Data on Child Uninsured Rate, but Questions Remain (September 18, 2026), based on the Current Population Survey Annual Social and Economic Supplement. The CPS sample size is from the Census Bureau report Poverty in the United States: 2025 (P60-290). The 2019 through 2024 child uninsured figures are from the American Community Survey 1-year estimates, table B27010, calculated by CensusEasy; no standard 1-year estimates were released for 2020. The two surveys measure coverage differently and their rates are not directly comparable.
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What was the child uninsured rate in 2025?
The Census Bureau's Current Population Survey found 5.8 percent of children under 19 were uninsured for all of 2025, down from 6.1 percent in 2024, a change that was not statistically significant. The share uninsured at the time of the spring survey stayed at 6.5 percent.
Why might the survey miss children losing Medicaid?
Its main rate counts only children uninsured for the entire year, so a child who lost Medicaid partway through 2025 is not included. Researchers also worry that families afraid of immigration enforcement may skip the survey, and response rates have not recovered from the pandemic.
Which state has the highest child uninsured rate?
Texas, where 13.6 percent of children under 19 were uninsured in the 2024 American Community Survey, the most recent state data available. Arizona followed at 9.3 percent. Massachusetts had the lowest rate at 2.1 percent.
