The number of Americans without health insurance dropped by about a fourth from 2019 to 2023, U.S. health researchers said, as the government tried to bolster coverage during and after the COVID-19 pandemic.

In 2023, 25 million Americans of all ages were uninsured, down from 33.2 million in 2019, according to preliminary survey results released Tuesday by the U.S. National Center for Health Statistics. Children without health insurance also declined from 5.1% in 2019 to 3.9% last year.

Health officials trying to limit the ravages of the pandemic scrambled to maintain health coverage, in part by putting off reviews of Medicaid eligibility that would have purged some beneficiaries from rolls of the program for low-income Americans. While that benefit persisted through 2023, states are now beginning to review their rolls again, with the possibility that health coverage will decrease.

“The data likely have not yet caught up to reality,” said Jennifer Tolbert, deputy director of the Program on Medicaid & Uninsured for the nonprofit health policy research group KFF. “Medicaid unwinding will likely contribute to increases in the number of people who are uninsured and in the uninsured rate.”

According to the survey, 23% of U.S. adults age 18 to 64 with health coverage were part of a public program, such as Medicaid, up by 3% since 2019. More than 64% of people under the age of 65 were covered by private insurance last year, according to the NCHS survey, while about 29% were covered by public insurance, including military programs, state employee plans, Medicaid and Medicare, the U.S. program for the elderly and disabled people.

People without health insurance tend to be lower-income families and reflect disparities in racial and ethnic groups, the researchers said. About one in four Hispanic adults still did not have health insurance coverage in 2023, the highest percentage of any racial group, even after the rate declined by 5% over the study period. Less than 5% of non-Hispanic Asian adults were uninsured last year, the lowest of any group.

The biannual report from the NCHS, a unit of the Centers for Disease Control and Prevention, is based on preliminary results from an interview survey conducted last year.

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