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More young adults uninsured

New census estimates offer county-by-county look at state

By: David M. zimmer
NorthJersey.com
USA Today Network - New Jersey

..... About one in five adults ages 21 to 29 in Passaic and Essex counties lacked health insurance in 2024, based on new census estimates that offer the first county-by-county look at coverage for the age group.
..... Passaic County has the highest rate in New Jersey, at 20.3%, followed by Essex at 19.7% and Union at 18.7%.
..... Statewide, 13.1% of New Jersey residents ages 21 to 29 were uninsured, or an estimated 134,176 people. The rate climbed to 24% among young adults living at or below twice the federal poverty level.
..... The figures are part of a Census Bureau's Small Area Heath Insurance Estimates released August 6. [2026] The release is the first to report insurance coverage separately for residents ages 21 to 29.
..... The estimates found that young men were more likely to lack coverage. Statewide, 14.7% of men ages 21 to 29 were uninsured, compared with 11.5% of women.
..... The difference was larger in Passaic County, where 24.6% of men in that ager group were uninsured, compared with 15.9% of women. In Essex, the rate were 22.8% for men and 16.6% for women.
..... Through many young adults in New Jersey remain uninsured, the state does offer some of them a way to stay on a parent's health plan long. under the state's Dependent Under 21 law, eligible young adults can remain on or join a parent's group plan until their 31st birthday. However, employers are not required to contribute toward the added coverage, so the young adult may have to pay the full premium.
..... The census estimates identify where uninsured rates are highest but do not explain the reasons. Health policy experts say young adults are often more likely to work part-time or gig-economy jobs without benefits, experience frequent job changes, or decide to forgo coverage because of cost. Lower-income residents can face additional barriers to enrolling Medicaid or marketplace plans.

Where Young Adults had the highest insurance rates

County ...... Ages 21-29 uninsured rate ..... Uninsured residents
Passaic ...... 20.3%................................. 12,138
Essex......... 19.7%................................. 18,241
Union......... 18.7% ................................ 11,832
Cumberland. 17.3% ................................ 2,801
Hudson ....... 15.1% ............................... 16,354
Mercer ........ 15.0% ............................... 6,124
New Jersey .. 13.1% ............................... 134,176
Source U.S. Census Bureau Small Area Health Insurance Estimate 2024.

NJ uninsured rate rose in 2024

..... Among all New Jersey residents under 65, the census estimates found that nearly 687,000 lacked helaht insurance in 2024, about 52,000 more than a year earlier. The statewide uninsured rate rose form 8.5% in 2023 to 9% in 2024.
..... Passaic again had the highest rate, at 13.9%, followed by Union at 13.5% and Essex at 13.2%. Cumberland and Hudson were the only other counties at 12% or higher.
..... Essex had the largest number of uninsured residents under 65, at 94,796, Hudson had 75,371, and Union had 66,715.
..... The uninsured are was higher than a year earlier in 17 of New Jersey's 21 counties. It was lower in Mercer, Middlesex and Cumberland and unchanged in Camden. Some of the changes, however, were small enough to fall within the Census Bureau's margins of error.
..... Nationally, uninsured rate among residents under 65 rose in 427 counties from 2023 to 2024 and fell in 65, according to the Census Bureau. The median county rate increased from 9.3% to 9.8%.

NJ Counties with highest under-65 uninsured rates

County............................ 2024 rate ... 2023 rate .... Total in 2024
Passaic ........................... 13.5% ....... 12.7% ........ 59,715
Union ............................. 13.5% ....... 12.6% ........ 66,715
Essex ............................. 13.2% ....... 12.0% ........ 94,796
Cumberland ..................... 12.1% ....... 12.2% ........ 14,744
Hudson ............................ 12.0% ...... 11.2% ........ 75,371
Atlantic ............................ 9.7% ........ 9.0% ......... 20,769
Mercer ............................. 9.4% ........ 10.0% ........ 29,174
New Jersey ....................... 9.0% ........ 9.5% ..........686,755
Source: U.S. Census Bureau Small Area Health Insurance Estimates 2024. Rates are for resident sunder 65.

NJ FamilyCare enrollment fell as marketplace sign-up rose

..... The increase in uninsured residents came as enrollment in NJ FamilyCare, the state's Medicaid program, was falling sharply.
..... NJ FamilyCare resumed annual eligibility reviews in April 2023 after they had been suspended during the pandemic, said the state Department of Human Services. enrollment fell from about 2.3 million members in June 2023 to 1.9 million a year later.
..... For people who lost NJ FamilyCar4e because their incomes were too high, the state directed them to Get Covered New Jersey. Bu June 30, 2024,53,128 people who had been enrolled in NJ FamilyCare when the reviews began had singed up thorough the marketplace, Human Services reported.
..... Overall enrollment through Get Covered New Jersey was rising at the same time. It increased from 341,901 people in 2023 coverage to 397,942 in 2024, a 16% increase, said the state Department of Banking and Insurance.
..... It is not clear how much the drop in NJ FamilyCare enrollment contributed to the rise in uninsured residents. The census estimates do not track what coverage an uninsured person had previously.
..... Marketplace enrollment continued to climb, reaching a record 513,217 people for 2025, nearly 30% more than the year before. Nine in 10 people enrolling qualified for clinician help, and 48% of those receiving assistance paid $10 a month or less, Banking and Insurance reported.
..... That financial help became much less generous in 2026 after enhanced federal premium tax credits expired at the end of 2025.
..... Get Covered New Jersey ended open enrollment for 2026 with 509,192 people signed up, only slightly below the previous year's record. By April 15, [2026] enrollment has fallen to 440,362, a loss of 68,830. Banking and Insurance reported that tens of thousands lost coverage after failing to pay the higher premiums.
..... "We are seeing the heartbreaking consequences of the federal government;s failure to extend the enhanced premium tax credit for tens of thousands across the garden State," acting Banking and Insurance commissioner Susan Ochs said in April. [2026]
..... Ochs said those who lost coverage could put off preventive care and wind up relying on more expensive emergency services.
..... Plan selections also shifted toward cheaper Bronze coverage. Among consumers who actively selected plans, 31% chose Bronze plans for 2026, up from 16% the year before, while Silver lecithins fell from 83% to 68%, Banking and Insurance records show.
..... The share receiving enough financial help to pay $10 a month or less fell from 48% in 2025 to 11% in 2026.

Impact of New Jersey's insurance cost increases

..... New Jersey residents are feeling the impact of sharp health insurance prices increases this year. [2026] After federal subsidies expired, many Affordable care Act premiums rose significantly, with some plans in New Jersey increasing by as much as 175%. State officials said the higher costs caused major sticker shock for many families and made it harder to keep up with monthly payments.
..... As a result, nearly 69,000 who had signed up for coverage through Get Covered New Jersey did not pay their premiums and lost their insurance over the last tow months. State officials say those residents many now delay preventive care or rely on expensive emergency services if they get sic. Many people who kept coverage also switched to cheaper plans with higher deductibles, showing how rising cost are forcing New Jerseyans to make difficult choices about their health care.

..... Staff writer Scott Fallon contributed to this story.

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