Cities and States With the Most (and Least) Uninsured Residents

In 2010, the year the Affordable Care Act (ACA, or Obamacare) was passed, there were 48.6 million Americans of all ages who had no health insurance coverage. By the first quarter of 2016, that number had fallen to 27.3 million (8.6% of the U.S. population) according to the U.S. National Center for Health Statistics (NCHS).

That quarter marked the point where the number of uninsured had dropped to its lowest point. By the first quarter of this year, the NCHS reported that the number of uninsured had risen to 28.1 million (8.8% of the population) over the course of 12 months. Among children from birth to age 17, the uninsured rate rose from 5% in the first quarter of 2016 to 5.3% in the first quarter of this year.

Researchers at consumer finance website WalletHub analyzed the uninsured rates for 547 U.S. cities and all 50 states to determine where uninsured rates were highest and lowest. The city data were broken down by large (more than 300,000 population), medium (100,000 to 300,000) and small (less than 100,000), along with a number of other data points that are described in the methodology section of the report, to rank all 547 cities. Statewide data on health insurance rates by age, race or ethnicity, and household income was combined to rank the states.

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According to the WalletHub analysis, the 10 states with the lowest uninsured rates in the first quarter of 2017 are:

1. Massachusetts, 2.54%
2. Hawaii, 3.53%
3. Vermont, 3.72%
4. Minnesota, 4.12%
5. Iowa, 4.26%
6. Rhode Island, 4.32%
7. Connecticut, 4.89%
8. Kentucky, 5.13%
9. Wisconsin, 5.26%
10. West Virginia, 5.32%

The 10 states with the highest rate of uninsured residents are:

1. Texas, 16.6%
2. Alaska, 14.01%
3. Oklahoma, 13.77%
4. Georgia, 12.94%
5. Florida, 12.54%
6. Mississippi, 11.84%
7. Wyoming, 11.55%
8. Nevada, 11.37%
9. North Carolina, 10.43%
10. Louisiana, 10.26%

Among 64 large U.S. cities, the five with the lowest uninsured rates are Boston; San Francisco; Honolulu; Washington, D.C.; and Seattle. The five with the highest uninsured rates are Dallas, Houston, Miami, Fort Worth and El Paso.

Among 252 medium-sized cities, the five with the lowest uninsured rates are Elk Grove, California; Fremont, California; Highland Ranch, Colorado; Berkeley, California; and Ann Arbor, Michigan. The five cities with the highest uninsured rates are Brownsville, Texas; Laredo, Texas; Pasadena, Texas; Hialeah, Florida; and McAllen, Texas.

Among 231 small cities, the five with the lowest uninsured rates are Folsom, California; Ellicott City, Maryland; Redondo Beach, California; Newton, Massachusetts; and Union City, California. The five with the highest rates are Mission, Texas; Pharr, Texas; Baytown, Texas; Passaic, New Jersey; and Harlingen, Texas.

See the full study and data on U.S. cities and the results of the statewide study.

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