Health insurance coverage — Sebastian, Florida

In the ACS 2020-2024 5-year estimates, 23,003 of Sebastian's 26,233 civilian noninstitutionalized residents (87.7%) had health insurance coverage and 3,230 (12.3%) had none.

The figures come from the Census Bureau's economic profile DP03 for Sebastian city and the more detailed subject table S2701 for Sebastian city. Both use the same base, the civilian noninstitutionalized population, which in Sebastian is 26,233 people. That is the universe the American Community Survey uses for coverage estimates, so it differs a little from other Sebastian population totals.

In the S2701 variable list the Census Bureau splits Sebastian's population into Insured and Uninsured columns, with matching percent columns, and repeats the split for each age band, sex, work status and income group.

Sampling error is large for a city the size of Sebastian. S2701 gives the 12.3% uninsured share a margin of error of plus or minus 2.9 percentage points and the 3,230 uninsured count a margin of plus or minus 754 people, so the Sebastian rate is best read as a range from 9.4% to 15.2% (12.3 plus or minus 2.9).

Sebastian's uninsured rate of 12.3% is higher than Indian River County's 10.0% and Florida's 11.5% in the ACS 2020-2024 estimates.

The county column is DP03 for Indian River County with S2701 for the county, and the state column is DP03 for Florida with S2701 for Florida. Indian River County counted 16,491 uninsured residents, so Sebastian's 3,230 make up 19.6% of the county's uninsured (3,230 divided by 16,491).

Private coverage is less common in Sebastian than in either comparison area. DP03 shows 15,440 Sebastian residents (58.9%) with private health insurance, against 63.3% in Indian River County and 63.9% statewide. Public coverage reached 12,558 Sebastian residents (47.9%), close to the county's 48.5% and well above Florida's 36.9%. Sebastian's 9,636 residents aged 65 and older make up 36.7% of its survey base (9,636 divided by 26,233).

Private and public shares add to more than 100% because a Sebastian resident with Medicare and an employer plan counts in both rows. The single clean measure for comparison is the uninsured line, where Sebastian sits 2.3 points above the county and 0.8 points above Florida (12.3 minus 10.0, and 12.3 minus 11.5).

None of Sebastian's 9,636 residents aged 65 and older were counted as uninsured in the ACS 2020-2024 estimates, while 22.7% of Sebastian residents aged 19 to 64 had no coverage.

Working-age adults hold almost all of the gap. Of the 3,230 uninsured people in Sebastian, 2,989 were aged 19 to 64 and 241 were under 19, according to S2701. The 19 to 64 rate of 22.7% compares with 17.4% in Indian River County and 16.8% in Florida.

The single highest Sebastian rate in the table is for ages 26 to 34: 951 of 2,096 residents in that band (45.4%) were uninsured. That band is small in a city where the 65 and older group is far larger, and S2701 puts a margin of plus or minus 16.8 percentage points on the 45.4%, so the number is better read as clearly above the county's 23.7% than as an exact rate.

Sebastian residents aged 55 to 64 were uninsured at 17.6%, or 803 people, against 12.8% countywide and 11.7% statewide. Children fared better: 5.8% of Sebastian residents under 6 and 7.6% of those aged 6 to 18 lacked coverage.

Among Sebastian residents 65 and over, 3,891 had Medicare coverage only and 5,489 had two or more types of coverage, according to ACS 2020-2024 table B27010.

Detailed table B27010 for Sebastian city sorts Sebastian residents by type and combination of coverage. In the 65 and over group the largest named pairings were employer-based coverage with Medicare (1,687 people), direct-purchase coverage with Medicare (1,083) and Medicare with Medicaid or means-tested public coverage (596), while another 1,807 fell under other coverage combinations.

Employer plans lead in the middle years. Of 9,919 Sebastian residents aged 35 to 64, 4,757 had employer-based health insurance only, 1,849 had direct-purchase insurance only, 441 had Medicaid or means-tested public coverage only, and 1,793 had no health insurance coverage.

For Sebastian's 3,415 residents under 19, employer-based insurance only (1,325) and Medicaid or means-tested public coverage only (1,309) were almost even, with 325 on direct-purchase plans and 241 uninsured. Among the 3,263 residents aged 19 to 34, 1,311 had employer coverage only and 1,196 had no coverage.

Among employed Sebastian residents aged 19 to 64, 21.6% had no health insurance in the ACS 2020-2024 estimates, compared with 16.8% in Indian River County and 15.0% in Florida.

In numbers, DP03 counts 9,127 employed Sebastian residents aged 19 to 64, of whom 1,971 were uninsured. The rate was higher for the 714 unemployed residents in that age range, 480 of whom (67.2%) had no coverage, and lower for the 3,341 who were not in the labor force, at 16.1%.

Schedule matters in the Sebastian numbers. S2701 shows 15.0% uninsured among Sebastian residents aged 19 to 64 who worked full-time, year round in the past 12 months, against 38.8% among those who worked less than full-time, year round. The county figures for the same two groups were 15.7% and 21.6%.

Income does not sort Sebastian coverage the way it does statewide. Residents in Sebastian households earning under $25,000 were uninsured at 10.1%, below Florida's 15.5%, while residents in households earning $100,000 and over were uninsured at 13.4%, above the county's 8.2% and Florida's 8.0%. By poverty ratio, 11.6% of Sebastian residents at or above 400 percent of the poverty threshold lacked coverage, against 5.5% in Indian River County.

Sebastian's uninsured rate rose from 9.2% in the ACS 2015-2019 estimates to 12.3% in 2020-2024, while nearby Micco and Vero Lake Estates reported rates near 6% in the later period.

The earlier figure is from S2701 for Sebastian, 2015-2019, which counted 2,307 uninsured residents out of 25,071, and 16.0% of residents aged 19 to 64 without coverage. The two survey windows share no years. The 3.1-point rise (12.3 minus 9.2) is smaller than the combined margin of error of the two estimates, about 4.0 points (the square root of 2.9 squared plus 2.7 squared), so the survey does not confirm that the rate rose.

Each neighbor is a separate Census geography outside the Sebastian city limits or, for Vero Beach, a separate city. Vero Lake Estates reported 420 uninsured residents (6.4%) and Micco 544 (6.1%), both below Sebastian. Vero Beach was at 9.1%.

Fellsmere, also in Indian River County, stands apart, with 1,704 of 4,953 residents (34.4%) uninsured and 49.9% of residents aged 19 to 64 without coverage. Its rate is 2.8 times Sebastian's (34.4 divided by 12.3), a reminder that the Indian River County average blends very different local pictures.