Profile of Virginia’s Uninsured

The Virginia Health Care Foundation’s Profile of Virginia’s Uninsured provides a detailed picture of the Commonwealth’s uninsured, using the American Community Survey (ACS) of the US Census and the Behavioral Risk Factor Surveillance Survey – both conducted in 2021.

The 2023 Profile includes slides, maps and detailed tables describing the uninsured who are income-eligible for Virginia’s Cardinal Care (Medicaid/FAMIS). It is not possible to compare the data in the 2023 Profile with previous Profiles of Virginia’s Uninsured, however. See below for details.

  • 8.0% of Virginians under age 65 were without health insurance – 559,000 uninsured Virginians.
  • Uninsured Virginians under age 65 represented every population in Virginia: 37.7% are white non-Hispanic, 16.8% are African American/Black, 30.7% are Hispanic, and 6.2% are Asian/Pacific Islander.
  • 9.4% of Virginians, ages 19 to 64, had no health insurance — 472,000 non-elderly adult Virginians.
  • The majority of uninsured Virginians under age 65 were part of working families (82.9%) — nearly 56.1% with at least one full time worker (392,000).
  • About a third (30.8%, 172,000) of all uninsured Virginians under age 65 lived in households below the Federal Poverty Level (FPL).
  • More than 40% uninsured Virginians, ages 19 – 64, lived in families with income 138% FPL, so are income-eligible for the adult Medicaid that became available in January 2019 (41.1%, 194,000).
  • The majority of Virginians eligible for adult Medicaid (73%, 141,000) do not have children.
  • Of the 87,000 children in Virginia without health insurance, 50,000 are income-eligible for Medicaid/FAMIS, representing 57.5% of all uninsured Virginia children.

For a thorough examination of the demographic characteristics of Virginia’s uninsured, see:

Please cite the Virginia Health Care Foundation and Urban Institute when using data from the Profile of Virginia’s Uninsured. When using PowerPoint slides from the Profile, please use the complete slide using notes and citations from the Urban Institute.

Please also note it is not possible to compare the data in the 2023 Profile with previous Profiles of Virginia’s Uninsured. Urban provided Virginia ACS data to show trends in uninsurance for key years (over an 8-year time period: 2013, 2018, 2019, 2021).

  • The federal policy response to the COVID-19 pandemic included provisions to protect access to health insurance through Medicaid/CHIP and the Marketplaces. As a result, very few people were disenrolled, starting in March 2020.
  • And, due to increased under reporting in Medicaid/CHIP enrollment in the 2021 US Census (survey respondents’ indication of Medicaid/CHIP coverage lower than actual enrollment numbers), Urban Institute did not adjust Census data for mis-reporting of Medicaid/CHIP coverage in this analysis, as it has in years past. 

What is the impact of being uninsured?

  • Do not receive the care they need: Uninsured Americans have less access to healthcare than people with insurance – including preventive and sick care. In 2021, about 20% of uninsured adults did not access medical care because they could not afford it (Source: Kaiser Family Foundation, 2022).
  • Financial Implications Can Be Significant: Many adults have some debt caused by medical or dental bills (41%) and those without health insurance are more likely to accrue medical debt than those with insurance. (Source:  Kaiser Family Foundation, 2022).
  • Children with health insurance have better health and educational outcomes: Children who are uninsured do not have a usual source of health care and are less likely to graduate from high school. Health coverage provides children access to needed care and promotes improved health, education, and financial success over the long-term. (Source: Center on Budget and Policy Priorities, 2017)

The Profile of Virginia’s Uninsured was prepared for the Virginia Health Care Foundation by the Urban Institute and completed in April 2023. For more information on the study, methodology or results, contact VHCF at 804/828-5804 or

Last Updated on April 19, 2023