In early 2026, the U.S. Census Bureau released new aggregated five-year data for 2020-2024, building on less detailed one-year estimates for 2024. These data provide a clearer picture of county-level trends in household income, poverty, and health coverage, among other measures. Overall, New Hampshire’s southeastern counties had higher median household incomes, while some of the state’s more rural regions experienced larger income gaps, higher poverty rates, and greater public health coverage utilization.

Here’s what we learned regarding health coverage in particular:

Based on aggregated data from 2020-2024, approximately 32.8% of New Hampshire’s population was enrolled in public health coverage, including Medicare, Medicaid, and U.S. Department of Veterans Affairs (VA) health coverage. Medicare is a federal program that provides health coverage primarily for older adults age 65 and older, as well as some younger people with certain disabilities. Medicaid, a state-federal fiscal partnership, provides health coverage for adults and children with low incomes, people with disabilities, certain older adults, pregnant mothers with low incomes, foster youth or former foster youth, and other eligible populations.

While approximately one-third of the state’s population relied on public health coverage alone during the five-year period, enrollment varied notably across the state’s ten counties. Coos County, which had the highest poverty rate and lowest median household income, had the largest share of residents enrolled in public health coverage, with about half of residents using these programs to access health services. During 2020-2024, about 30.9% of residents in Coos County were enrolled in Medicare alone or in combination with another form of health insurance, and about 21.7% were enrolled in Medicaid alone or in combination. Carroll County, the state’s oldest county in terms of median age, also had a large share of residents enrolled in public coverage. About 46.8% of Carroll County residents were enrolled in public health coverage, including the highest share enrolled in Medicare (31.8%) across the state’s counties. Lower median incomes, higher poverty rates, and greater shares of older adult populations could explain more public health coverage utilization in the state’s rural regions.

Counties in southeastern New Hampshire generally had fewer residents enrolled in public health coverage compared to other parts of the state. However, about one-third of residents in each of these counties still benefited from public health coverage. These forms of public coverage helps provide access to health services to Granite Staters who otherwise would likely face significant challenges affording these services.