Health Insurance


The percent of uninsured King County adults has dropped by over half since health care reform was implemented.


Expansion of coverage through the Affordable Care Act (ACA) has reduced the rate of uninsured adults under 65 from 16% in 2013 (prior to the ACA individual mandate and Medicaid expansion) to 8% in 2017, while the number of these uninsured adults dropped from 223,000 to 108,000. Among adults, race/ethnicity, place of residence and other disparities  have been reduced, but are still substantial despite widespread and collective outreach efforts. The proportion of uninsured children dropped from 6% in 2008 to 2% in 2017.

By race and place

  • Most communities of color remain disproportionately uninsured. Among adults, Black/African Americans, Hispanic/Latinos and Native Hawaiian/Pacific Islanders are more likely than Whites to be uninsured. Limits of coverage expansion under the ACA, such as length-of-residency requirements and documentation status, may contribute to these differences.

  • Fewer residents of Auburn, Federal Way, Kent, and Renton lacked coverage in 2017 than in 2013. However, in 2017, they remained more likely than residents of King County on average to be uninsured. 

By poverty and age

  • In 2017, low-income adults (household income below 200% of the Federal Poverty Level) were more than 8 times as likely as those with household incomes of at least 400%  of the Federal Poverty Level   to be uninsured.

  • Lack of insurance coverage decreased with age, with those age 55 to 64 less  likely than younger adults to be uninsured.

  • In 2008, an estimated 26,000 children under age 18 were uninsured. By 2017, that fell to 2,000 young children and 7,000 school-age children (9,000 total) without health insurance. Lack of coverage among children had already begun decreasing prior to ACA implementation, as state and local policies and programs were enacted to ensure health insurance access for young people .

By employment and citizenship

  • From 2013 to 2017, lack of coverage fell by about two thirds among those who were unemployed. Over the same time period, it decreased by half among employed adults.

  • Since 2013, lack of insurance has fallen among adult US-born citizens, naturalized citizens, and noncitizens, while US-born citizens continue to be the least likely to be uninsured. At 3%, their rate has fallen by two thirds since 2013. Non-citizens are most likely to be uninsured at 19% .  For more detailed reports on health insurance coverage in King County, go here


Notes & Sources

Source: US Census Bureau, American Community Survey

For 2017, “Adults” includes those ages 19-64, and “Children” includes those ages 0-18. For all prior years, “Adults” includes those ages 18-64, and “Children” includes those ages 0-17.

Children’s access to health insurance: Washington passed the Cover All Kids law in 2007, which provided for comprehensive health insurance options for children in low and moderate income families. Following this, the King County Children’s Health Initiative, a local public/private partnership, worked to improve low-income families’ ability to enroll into health insurance and ensure that their children obtain appropriate health care. Since the Affordable Care Act was implemented in 2014, King County navigators continue to help children enroll into health insurance and access health care. 


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