Health insurance coverage in the United States is delivered through a patchwork of employer-sponsored coverage, government-run programs such as Medicaid, Medicare, Tricare, VA Health Care, and privately purchased plans. While state and federal governments offer some Americans financial assistance to purchase health insurance, the United States remains unique as one of the only high-income countries where a high proportion of residents lack health insurance coverage.
In the United States, insurance is regulated at the state level, so there are wide differences between the health care financing systems between states. The varying levels of policy support for health insurance, as well as varying levels of income between states, lead to wide differences in the health insurance coverage and health outcomes in different states. In this study, AdvisorSmith examined the percentage of state residents who do not have health insurance in all 50 states and the District of Columbia.
Nationwide, 9.2% of all Americans were uninsured, which is approximately 29.6 million people. The range of the uninsured population ranged from as low as 3% in Massachusetts to as high as 18.4% uninsured in the state of Texas.
States with the Most Uninsured
The top 15 states with the highest percentage of their population who lack health insurance are listed in the table below. In these states, 10% or more of the population does not have health insurance coverage. The top 5 positions in this ranking were all taken by southern states. Texas led the way, with almost 1 in 5 Texans lacking health insurance coverage, followed by Oklahoma, Georgia, Florida, and Mississippi.
| Rank | State | Uninsured Population |
|---|---|---|
| 1 | Texas | 18.4% |
| 2 | Oklahoma | 14.3% |
| 3 | Georgia | 13.4% |
| 4 | Florida | 13.2% |
| 5 | Mississippi | 13.0% |
| 6 | Wyoming | 12.3% |
| 7 | Alaska | 12.2% |
| 8 | Nevada | 11.4% |
| 9 | Arizona | 11.3% |
| 10 | North Carolina | 11.3% |
| 11 | Idaho | 10.8% |
| 12 | South Carolina | 10.8% |
| 13 | South Dakota | 10.2% |
| 14 | Tennessee | 10.1% |
| 15 | Missouri | 10.0% |
States with the Least Uninsured
The following table shows the 15 states with the least percentage of their population who are uninsured. In these states, over 93% of the population is covered by health insurance. Leading the way for the least uninsured residents is the state of Massachusetts, where only 3% of the population lacks health insurance. A major driver of the low rate of uninsured in the state was the passage of health care reform legislation in the state in 2006, which is commonly known as Romneycare.
| Rank | State | Uninsured Population |
|---|---|---|
| 1 | Massachusetts | 3.0% |
| 2 | District of Columbia | 3.5% |
| 3 | Rhode Island | 4.1% |
| 4 | Hawaii | 4.2% |
| 5 | Vermont | 4.5% |
| 6 | Minnesota | 4.9% |
| 7 | Iowa | 5.0% |
| 8 | New York | 5.2% |
| 9 | Wisconsin | 5.7% |
| 10 | Pennsylvania | 5.8% |
| 11 | Michigan | 5.8% |
| 12 | Connecticut | 5.9% |
| 13 | Maryland | 6.0% |
| 14 | New Hampshire | 6.3% |
| 15 | Kentucky | 6.4% |
Percentage of Residents Uninsured in Each State
The table below shows the 50 states and the District of Columbia ranked by the percentage of their population that is uninsured. Additionally, the table lists the population in thousands that is uninsured in each state.
| Rank | State | Uninsured Population (in thousands) | Uninsured Percentage |
|---|---|---|---|
| 1 | Texas | 5,234 | 18.4% |
| 2 | Oklahoma | 553 | 14.3% |
| 3 | Georgia | 1,398 | 13.4% |
| 4 | Florida | 2,784 | 13.2% |
| 5 | Mississippi | 377 | 13.0% |
| 6 | Wyoming | 70 | 12.3% |
| 7 | Alaska | 86 | 12.2% |
| 8 | Nevada | 348 | 11.4% |
| 9 | Arizona | 809 | 11.3% |
| 10 | North Carolina | 1,157 | 11.3% |
| 11 | Idaho | 191 | 10.8% |
| 12 | South Carolina | 548 | 10.8% |
| 13 | South Dakota | 88 | 10.2% |
| 14 | Tennessee | 682 | 10.1% |
| 15 | Missouri | 604 | 10.0% |
| 16 | New Mexico | 205 | 10.0% |
| 17 | Alabama | 469 | 9.7% |
| 18 | Utah | 307 | 9.7% |
| 19 | Kansas | 262 | 9.2% |
| 20 | Arkansas | 271 | 9.1% |
| 21 | Louisiana | 404 | 8.9% |
| 22 | Indiana | 578 | 8.7% |
| 23 | Montana | 87 | 8.3% |
| 24 | Nebraska | 158 | 8.3% |
| 25 | Colorado | 453 | 8.0% |
| 26 | Maine | 107 | 8.0% |
| 27 | New Jersey | 692 | 7.9% |
| 28 | Virginia | 658 | 7.9% |
| 29 | California | 3,002 | 7.7% |
| 30 | Illinois | 923 | 7.4% |
| 31 | Oregon | 299 | 7.2% |
| 32 | North Dakota | 51 | 6.9% |
| 33 | West Virginia | 118 | 6.7% |
| 34 | Delaware | 63 | 6.6% |
| 35 | Ohio | 758 | 6.6% |
| 36 | Washington | 496 | 6.6% |
| 37 | Kentucky | 283 | 6.4% |
| 38 | New Hampshire | 84 | 6.3% |
| 39 | Maryland | 357 | 6.0% |
| 40 | Connecticut | 207 | 5.9% |
| 41 | Michigan | 571 | 5.8% |
| 42 | Pennsylvania | 726 | 5.8% |
| 43 | Wisconsin | 329 | 5.7% |
| 44 | New York | 1,007 | 5.2% |
| 45 | Iowa | 156 | 5.0% |
| 46 | Minnesota | 273 | 4.9% |
| 47 | Vermont | 28 | 4.5% |
| 48 | Hawaii | 56 | 4.2% |
| 49 | Rhode Island | 43 | 4.1% |
| 50 | District of Columbia | 25 | 3.5% |
| 51 | Massachusetts | 204 | 3.0% |
Methodology
AdvisorSmith used data from the U.S. Census Bureau’s American Community Survey to determine the percentage of the population in all 50 states and the District of Columbia that were not covered by health insurance. We used this population data to rank the states by the proportion of their population that did not have health insurance. Our study found the states with the highest and lowest proportion of their population that was uninsured.
Sources
- U.S. Census Bureau, American Community Survey, Health Insurance Coverage