Among the states with the highest private coverage rates in 2021: Minnesota (75.9%), New Hampshire (76.6%), North Dakota (77.3%) and Utah (77.8%) (Figure 2). The rate in New Hampshire was not statistically different from the rates in Minnesota and North Dakota.
These states also had higher rates of employer-sponsored coverage than the national average of 54.7%. High rates of employer-sponsored coverage reflect strong economic conditions. According to the Bureau of Labor Statistics, these states also had lower unemployment rates in 2021 than the national average of 5.3%: Minnesota (3.4%); New Hampshire (3.5%); North Dakota (3.7%); and Utah (2.7%).
Between 2019 and 2021, private coverage rates decreased by 0.4 percentage points nationally.
States that experienced high unemployment also experienced sizable drops in private coverage, although these declines were not statistically different: Nevada (down 2.3 percentage points) and Rhode Island (down 4.2 percentage points) (Figure 2). Both states experienced increases in unemployment rates between 2019 and 2021 that may have contributed to the decline in private coverage.
Private coverage rates decreased in 18 states and only one state — Florida — saw an increase in private coverage driven by a 1.5 percentage point increase in direct-purchase coverage. According to the Centers for Medicaid and Medicare Services (CMS), ACA Marketplace enrollment increased in Florida during this period. Marketplace coverage is a type of direct purchase coverage.
