This Is the State With the Worst Health Care Insurance

Photo of Douglas A. McIntyre
By Douglas A. McIntyre Updated Published
This post may contain links from our sponsors and affiliates, and Flywheel Publishing may receive compensation for actions taken through them.
This Is the State With the Worst Health Care Insurance

© f11photo / iStock via Getty Images

Americans spend more on health care than any nation in the developed world according to the OECD. In 2019, the number was $10,948 per capita. The next country on the list, Switzerland, had a comparable figure of $7,138. And, a number of studies show the American health care system produces worse outcomes than some nations where spending is much lower.

A large portion of this mediocre care is paid for by the government, mostly at the federal and state level. And, the level of health care insurance varies widely by state. Most of the balance of people have their health care insurance provided by their employers.

Without a universal health care program, most Americans under age 65 receive employer-based health insurance coverage. Under this system, 10.8% of Americans younger than 65, approximately 29 million people, lacked health insurance in 2019 — and that was before the COVID-19 pandemic put over 22 million Americans out of work.

While most of those jobs have since been restored, the official uninsured rate for Americans younger than 65 for 2020 will likely be higher than the 2019 rate. In some parts of the country, the 2019 rate was already close to or above those higher national uninsured rates of the era before the passing of the ACA.

[nativounit]

Using data from the U.S. Census Bureau, 24/7 Wall St. ranked all 50 states based on the percentage of the population under 65 with health insurance coverage. The percentage of uninsured Americans under 65 ranges from 3.5% to more than 20%. Most of the states with the worst coverage are in the South.

To determine the state with the worst health insurance coverage, 24/7 Wall St. reviewed one-year estimates of the percentage of the noninstitutionalized civilian population under 65 without health insurance from the U.S. Census Bureau’s 2019 American Community Survey.

We selected the under 65 age group because Americans become eligible for Medicare at age 65, and the uninsured rate for the population above this age is less than 1% nationwide. However, because the census does not publish insurance coverage estimates specifically for the under 65 age group, we aggregated the data from more granular age breakdowns.

Each state was ranked based on its under 65 uninsured rate. The share of the population covered by each type of insurance — Medicare, Medicaid, VA, employer, direct-purchase, and Tricare/military — are for the same cohort and are also aggregated from one-year ACS estimates. The estimates reflect people who are covered by that type of insurance alone or in combination with other types on the list. So, when a person is covered by more than one type of insurance, they are included in each group.

The state with the worst health care is Texas. Here are the details:

> Residents under 65, no health insurance: 20.8%
> Residents under 65, Medicare coverage (or multiple types): 2.3% (eighth lowest)
> Residents under 65, Medicaid coverage (or multiple types): 16.2% (10th lowest)
> Residents under 65, VA coverage (or multiple types): 1.4% (24th lowest)
> Residents under 65, employer-based insurance (or multiple types): 54.8% (sixth lowest)
> Residents under 65, direct-purchase insurance (or multiple types): 8.6% (15th lowest)
> Residents under 65, Tricare/military insurance (or many types): 2.3% (24th lowest)

Click here to see which states have the best and worst health insurance coverage.
[wallst_email_signup]

Photo of Douglas A. McIntyre
About the Author Douglas A. McIntyre →

Douglas A. McIntyre is the co-founder, chief executive officer and editor in chief of 24/7 Wall St. and 24/7 Tempo. He has held these jobs since 2006.

McIntyre has written thousands of articles for 24/7 Wall St. He is an expert on corporate finance, the automotive industry, media companies and international finance. He has edited articles on national demographics, sports, personal income and travel.

His work has been quoted or mentioned in The New York Times, The Wall Street Journal, Los Angeles Times, The Washington Post, NBC News, Time, The New Yorker, HuffPost USA Today, Business Insider, Yahoo, AOL, MarketWatch, The Atlantic, Bloomberg, New York Post, Chicago Tribune, Forbes, The Guardian and many other major publications. McIntyre has been a guest on CNBC, the BBC and television and radio stations across the country.

A magna cum laude graduate of Harvard College, McIntyre also was president of The Harvard Advocate. Founded in 1866, the Advocate is the oldest college publication in the United States.

TheStreet.com, Comps.com and Edgar Online are some of the public companies for which McIntyre served on the board of directors. He was a Vicinity Corporation board member when the company was sold to Microsoft in 2002. He served on the audit committees of some of these companies.

McIntyre has been the CEO of FutureSource, a provider of trading terminals and news to commodities and futures traders. He was president of Switchboard, the online phone directory company. He served as chairman and CEO of On2 Technologies, the video compression company that provided video compression software for Adobe’s Flash. Google bought On2 in 2009.

Featured Reads

Our top personal finance-related articles today. Your wallet will thank you later.

Continue Reading

Top Gaining Stocks

CBOE Vol: 1,568,143
PSKY Vol: 12,285,993
STX Vol: 7,378,346
ORCL Vol: 26,317,675
DDOG Vol: 6,247,779

Top Losing Stocks

LKQ
LKQ Vol: 4,367,433
CLX Vol: 13,260,523
SYK Vol: 4,519,455
MHK Vol: 1,859,865
AMGN Vol: 3,818,618