Health insurance in Lancaster County, Pennsylvania

Reviewed September 4, 2026 · 2024 Census data

Source: US Census Small Area Health Insurance Estimates, 2024 release. Income bands are measured against the federal poverty level.

Most of the uninsured here would qualify for help

Lancaster County has 28,522 uninsured residents earning inside the premium tax credit range, 56% of its uninsured total. That is near the 51% national median. Within that income band itself, 15.2% are uninsured — roughly one in 7 of the people the credit was designed for.

Coverage is worse here than across the state

11.6% of Lancaster County's 439,414 under-65 residents have no health coverage — 50,957 people. That is well above Pennsylvania as a whole at 7.2% — 4.4 points above its own state, and puts Lancaster County in the upper half of the 3,143 counties measured nationally (1,093rd).

Relatively few are under the Medicaid line

10,795 of Lancaster County's uninsured — 21%, below the 31% typical of counties nationally — earn under $22,025 a year, which in Pennsylvania is Medicaid territory rather than marketplace territory.

Older residents here are better covered

7,828 people aged 50 to 64 in Lancaster County have no coverage, a rate of 8.0% — lower than the 11.6% across all under-65 residents here, which is the usual pattern — people in their fifties and early sixties tend to be more settled in employer coverage. Age-rated premiums make this the most expensive group to cover before Medicare.

Lancaster County against Pennsylvania

Lancaster County is the 7th largest of the 28 Pennsylvania counties we publish. Its uninsured rate runs 4.4 points higher than Pennsylvania overall and 6 points more of its uninsured sit in the subsidy band than statewide. Coverage among 50 to 64 year olds is worse here than across Pennsylvania.

Counties of a similar size

With 15% of the subsidy band still uninsured here, how the credit is calculated is the useful place to start. Other Pennsylvania counties.