Special Report
Metros With the Worst Health Insurance Coverage in the Nation
Published:
The share of Americans under the age of 65 without health insurance fell every year between 2010, when the Affordable Care Act was signed into law, and 2016, when President Barack Obama left office. Though the U.S. uninsured rate among Americans younger than 65 has inched up over the years since, it remains well below the reported 17%+ figures in the years leading up to the ACA.
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. And in some parts of the country, the 2019 rate is already close to or above the higher national uninsured rates of the era before the passing of the ACA.
Using data from the U.S. Census Bureau, 24/7 Wall St. identified the 50 metropolitan areas with the worst health insurance coverage. Metro areas are ranked on the share of residents under age 65 — the age of eligibility for Medicare — who are uninsured.
Well over half of the metro areas on this list are in Southern states — including 19 in Texas and another 13 in Florida.
Click here to see the metros with the worst health insurance coverage in the nation.
Click here to see our detailed methodology.
50. Farmington, NM
> Adults under 65, no health insurance: 16.3%
> Adults under 65, Medicare coverage (or multiple types): 4.0% — 96th highest of 384 metros
> Adults under 65, Medicaid coverage (or multiple types): 40.3% — 9th highest of 384 metros
> Adults under 65, VA coverage (or multiple types): 1.5% — 159th highest of 384 metros
> Adults under 65, employer-based insurance (or multiple types): 43.5% — 25th lowest of 384 metros
> Adults under 65, direct-purchase insurance (or multiple types): 3.5% — 1st lowest of 384 metros
> Adults under 65, Tricare/military insurance (or many types): 1.3% — 131st lowest of 384 metros
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49. Lubbock, TX
> Adults under 65, no health insurance: 16.4%
> Adults under 65, Medicare coverage (or multiple types): 2.5% — 113th lowest of 384 metros
> Adults under 65, Medicaid coverage (or multiple types): 17.2% — 101st lowest of 384 metros
> Adults under 65, VA coverage (or multiple types): 1.1% — 144th lowest of 384 metros
> Adults under 65, employer-based insurance (or multiple types): 58.2% — 167th lowest of 384 metros
> Adults under 65, direct-purchase insurance (or multiple types): 9.9% — 125th highest of 384 metros
> Adults under 65, Tricare/military insurance (or many types): 1.2% — 123rd lowest of 384 metros
48. Enid, OK
> Adults under 65, no health insurance: 16.4%
> Adults under 65, Medicare coverage (or multiple types): 2.4% — 100th lowest of 384 metros
> Adults under 65, Medicaid coverage (or multiple types): 15.0% — 57th lowest of 384 metros
> Adults under 65, VA coverage (or multiple types): 0.9% — 94th lowest of 384 metros
> Adults under 65, employer-based insurance (or multiple types): 57.8% — 158th lowest of 384 metros
> Adults under 65, direct-purchase insurance (or multiple types): 8.7% — 187th lowest of 384 metros
> Adults under 65, Tricare/military insurance (or many types): 5.3% — 53rd highest of 384 metros
47. Hickory-Lenoir-Morganton, NC
> Adults under 65, no health insurance: 16.6%
> Adults under 65, Medicare coverage (or multiple types): 4.2% — 82nd highest of 384 metros
> Adults under 65, Medicaid coverage (or multiple types): 21.5% — 172nd highest of 384 metros
> Adults under 65, VA coverage (or multiple types): 1.6% — 135th highest of 384 metros
> Adults under 65, employer-based insurance (or multiple types): 55.1% — 118th lowest of 384 metros
> Adults under 65, direct-purchase insurance (or multiple types): 9.0% — 177th highest of 384 metros
> Adults under 65, Tricare/military insurance (or many types): 1.0% — 100th lowest of 384 metros
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46. Hattiesburg, MS
> Adults under 65, no health insurance: 16.6%
> Adults under 65, Medicare coverage (or multiple types): 3.9% — 110th highest of 384 metros
> Adults under 65, Medicaid coverage (or multiple types): 25.1% — 104th highest of 384 metros
> Adults under 65, VA coverage (or multiple types): 1.8% — 94th highest of 384 metros
> Adults under 65, employer-based insurance (or multiple types): 50.1% — 61st lowest of 384 metros
> Adults under 65, direct-purchase insurance (or multiple types): 7.0% — 67th lowest of 384 metros
> Adults under 65, Tricare/military insurance (or many types): 2.5% — 106th highest of 384 metros
45. North Port-Sarasota-Bradenton, FL
> Adults under 65, no health insurance: 16.6%
> Adults under 65, Medicare coverage (or multiple types): 3.5% — 144th highest of 384 metros
> Adults under 65, Medicaid coverage (or multiple types): 16.6% — 86th lowest of 384 metros
> Adults under 65, VA coverage (or multiple types): 1.6% — 142nd highest of 384 metros
> Adults under 65, employer-based insurance (or multiple types): 50.6% — 70th lowest of 384 metros
> Adults under 65, direct-purchase insurance (or multiple types): 15.6% — 17th highest of 384 metros
> Adults under 65, Tricare/military insurance (or many types): 2.6% — 98th highest of 384 metros
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44. Grants Pass, OR
> Adults under 65, no health insurance: 16.6%
> Adults under 65, Medicare coverage (or multiple types): 3.9% — 108th highest of 384 metros
> Adults under 65, Medicaid coverage (or multiple types): 44.5% — 4th highest of 384 metros
> Adults under 65, VA coverage (or multiple types): 1.9% — 81st highest of 384 metros
> Adults under 65, employer-based insurance (or multiple types): 30.9% — 2nd lowest of 384 metros
> Adults under 65, direct-purchase insurance (or multiple types): 8.0% — 127th lowest of 384 metros
> Adults under 65, Tricare/military insurance (or many types): 1.5% — 161st lowest of 384 metros
43. Savannah, GA
> Adults under 65, no health insurance: 16.6%
> Adults under 65, Medicare coverage (or multiple types): 2.7% — 128th lowest of 384 metros
> Adults under 65, Medicaid coverage (or multiple types): 16.8% — 92nd lowest of 384 metros
> Adults under 65, VA coverage (or multiple types): 2.3% — 52nd highest of 384 metros
> Adults under 65, employer-based insurance (or multiple types): 56.0% — 131st lowest of 384 metros
> Adults under 65, direct-purchase insurance (or multiple types): 8.5% — 170th lowest of 384 metros
> Adults under 65, Tricare/military insurance (or many types): 7.1% — 36th highest of 384 metros
42. Port St. Lucie, FL
> Adults under 65, no health insurance: 16.7%
> Adults under 65, Medicare coverage (or multiple types): 4.1% — 85th highest of 384 metros
> Adults under 65, Medicaid coverage (or multiple types): 17.1% — 98th lowest of 384 metros
> Adults under 65, VA coverage (or multiple types): 1.3% — 184th lowest of 384 metros
> Adults under 65, employer-based insurance (or multiple types): 50.1% — 60th lowest of 384 metros
> Adults under 65, direct-purchase insurance (or multiple types): 16.7% — 12th highest of 384 metros
> Adults under 65, Tricare/military insurance (or many types): 1.8% — 171st highest of 384 metros
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41. Cape Coral-Fort Myers, FL
> Adults under 65, no health insurance: 16.9%
> Adults under 65, Medicare coverage (or multiple types): 3.9% — 104th highest of 384 metros
> Adults under 65, Medicaid coverage (or multiple types): 18.5% — 136th lowest of 384 metros
> Adults under 65, VA coverage (or multiple types): 1.4% — 169th highest of 384 metros
> Adults under 65, employer-based insurance (or multiple types): 50.2% — 62nd lowest of 384 metros
> Adults under 65, direct-purchase insurance (or multiple types): 15.2% — 18th highest of 384 metros
> Adults under 65, Tricare/military insurance (or many types): 1.3% — 145th lowest of 384 metros
40. Lakeland-Winter Haven, FL
> Adults under 65, no health insurance: 17.4%
> Adults under 65, Medicare coverage (or multiple types): 4.7% — 47th highest of 384 metros
> Adults under 65, Medicaid coverage (or multiple types): 22.9% — 143rd highest of 384 metros
> Adults under 65, VA coverage (or multiple types): 1.5% — 161st highest of 384 metros
> Adults under 65, employer-based insurance (or multiple types): 49.8% — 58th lowest of 384 metros
> Adults under 65, direct-purchase insurance (or multiple types): 9.8% — 137th highest of 384 metros
> Adults under 65, Tricare/military insurance (or many types): 1.6% — 182nd lowest of 384 metros
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39. Midland, TX
> Adults under 65, no health insurance: 17.4%
> Adults under 65, Medicare coverage (or multiple types): 1.1% — 5th lowest of 384 metros
> Adults under 65, Medicaid coverage (or multiple types): 10.6% — 6th lowest of 384 metros
> Adults under 65, VA coverage (or multiple types): 0.9% — 96th lowest of 384 metros
> Adults under 65, employer-based insurance (or multiple types): 67.4% — 72nd highest of 384 metros
> Adults under 65, direct-purchase insurance (or multiple types): 8.9% — 182nd highest of 384 metros
> Adults under 65, Tricare/military insurance (or many types): 1.7% — 183rd highest of 384 metros
24/7 Wall St.
38. Yuma, AZ
> Adults under 65, no health insurance: 17.4%
> Adults under 65, Medicare coverage (or multiple types): 1.8% — 36th lowest of 384 metros
> Adults under 65, Medicaid coverage (or multiple types): 35.9% — 20th highest of 384 metros
> Adults under 65, VA coverage (or multiple types): 1.7% — 109th highest of 384 metros
> Adults under 65, employer-based insurance (or multiple types): 40.8% — 13th lowest of 384 metros
> Adults under 65, direct-purchase insurance (or multiple types): 6.9% — 60th lowest of 384 metros
> Adults under 65, Tricare/military insurance (or many types): 5.4% — 50th highest of 384 metros
37. Ocala, FL
> Adults under 65, no health insurance: 17.5%
> Adults under 65, Medicare coverage (or multiple types): 5.5% — 24th highest of 384 metros
> Adults under 65, Medicaid coverage (or multiple types): 22.1% — 160th highest of 384 metros
> Adults under 65, VA coverage (or multiple types): 2.7% — 30th highest of 384 metros
> Adults under 65, employer-based insurance (or multiple types): 48.2% — 49th lowest of 384 metros
> Adults under 65, direct-purchase insurance (or multiple types): 11.2% — 80th highest of 384 metros
> Adults under 65, Tricare/military insurance (or many types): 2.3% — 122nd highest of 384 metros
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36. Sebring-Avon Park, FL
> Adults under 65, no health insurance: 17.5%
> Adults under 65, Medicare coverage (or multiple types): 5.0% — 39th highest of 384 metros
> Adults under 65, Medicaid coverage (or multiple types): 28.1% — 71st highest of 384 metros
> Adults under 65, VA coverage (or multiple types): 1.7% — 106th highest of 384 metros
> Adults under 65, employer-based insurance (or multiple types): 46.2% — 37th lowest of 384 metros
> Adults under 65, direct-purchase insurance (or multiple types): 7.6% — 99th lowest of 384 metros
> Adults under 65, Tricare/military insurance (or many types): 2.8% — 92nd highest of 384 metros
35. Deltona-Daytona Beach-Ormond Beach, FL
> Adults under 65, no health insurance: 17.6%
> Adults under 65, Medicare coverage (or multiple types): 4.5% — 53rd highest of 384 metros
> Adults under 65, Medicaid coverage (or multiple types): 17.7% — 116th lowest of 384 metros
> Adults under 65, VA coverage (or multiple types): 1.9% — 83rd highest of 384 metros
> Adults under 65, employer-based insurance (or multiple types): 49.7% — 57th lowest of 384 metros
> Adults under 65, direct-purchase insurance (or multiple types): 14.3% — 25th highest of 384 metros
> Adults under 65, Tricare/military insurance (or many types): 2.0% — 155th highest of 384 metros
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34. Dalton, GA
> Adults under 65, no health insurance: 17.6%
> Adults under 65, Medicare coverage (or multiple types): 3.2% — 186th highest of 384 metros
> Adults under 65, Medicaid coverage (or multiple types): 21.3% — 182nd highest of 384 metros
> Adults under 65, VA coverage (or multiple types): 0.6% — 24th lowest of 384 metros
> Adults under 65, employer-based insurance (or multiple types): 58.5% — 172nd lowest of 384 metros
> Adults under 65, direct-purchase insurance (or multiple types): 5.0% — 8th lowest of 384 metros
> Adults under 65, Tricare/military insurance (or many types): 0.5% — 16th lowest of 384 metros
24/7 Wall St.
33. Amarillo, TX
> Adults under 65, no health insurance: 17.7%
> Adults under 65, Medicare coverage (or multiple types): 2.1% — 66th lowest of 384 metros
> Adults under 65, Medicaid coverage (or multiple types): 13.3% — 27th lowest of 384 metros
> Adults under 65, VA coverage (or multiple types): 2.1% — 70th highest of 384 metros
> Adults under 65, employer-based insurance (or multiple types): 62.2% — 148th highest of 384 metros
> Adults under 65, direct-purchase insurance (or multiple types): 7.3% — 81st lowest of 384 metros
> Adults under 65, Tricare/military insurance (or many types): 2.5% — 105th highest of 384 metros
32. Rome, GA
> Adults under 65, no health insurance: 17.8%
> Adults under 65, Medicare coverage (or multiple types): 3.8% — 118th highest of 384 metros
> Adults under 65, Medicaid coverage (or multiple types): 21.0% — 186th highest of 384 metros
> Adults under 65, VA coverage (or multiple types): 1.4% — 178th highest of 384 metros
> Adults under 65, employer-based insurance (or multiple types): 52.7% — 86th lowest of 384 metros
> Adults under 65, direct-purchase insurance (or multiple types): 11.3% — 76th highest of 384 metros
> Adults under 65, Tricare/military insurance (or many types): 1.8% — 167th highest of 384 metros
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31. Joplin, MO
> Adults under 65, no health insurance: 17.8%
> Adults under 65, Medicare coverage (or multiple types): 4.0% — 95th highest of 384 metros
> Adults under 65, Medicaid coverage (or multiple types): 23.4% — 135th highest of 384 metros
> Adults under 65, VA coverage (or multiple types): 2.2% — 58th highest of 384 metros
> Adults under 65, employer-based insurance (or multiple types): 51.3% — 76th lowest of 384 metros
> Adults under 65, direct-purchase insurance (or multiple types): 8.8% — 188th highest of 384 metros
> Adults under 65, Tricare/military insurance (or many types): 1.1% — 113th lowest of 384 metros
30. Myrtle Beach-Conway-North Myrtle Beach, SC-NC
> Adults under 65, no health insurance: 18.2%
> Adults under 65, Medicare coverage (or multiple types): 4.3% — 67th highest of 384 metros
> Adults under 65, Medicaid coverage (or multiple types): 20.4% — 187th lowest of 384 metros
> Adults under 65, VA coverage (or multiple types): 2.6% — 36th highest of 384 metros
> Adults under 65, employer-based insurance (or multiple types): 48.5% — 50th lowest of 384 metros
> Adults under 65, direct-purchase insurance (or multiple types): 13.0% — 39th highest of 384 metros
> Adults under 65, Tricare/military insurance (or many types): 2.8% — 86th highest of 384 metros
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29. Wichita Falls, TX
> Adults under 65, no health insurance: 18.2%
> Adults under 65, Medicare coverage (or multiple types): 4.1% — 87th highest of 384 metros
> Adults under 65, Medicaid coverage (or multiple types): 17.8% — 118th lowest of 384 metros
> Adults under 65, VA coverage (or multiple types): 2.6% — 37th highest of 384 metros
> Adults under 65, employer-based insurance (or multiple types): 53.0% — 89th lowest of 384 metros
> Adults under 65, direct-purchase insurance (or multiple types): 8.5% — 169th lowest of 384 metros
> Adults under 65, Tricare/military insurance (or many types): 7.8% — 32nd highest of 384 metros
28. Punta Gorda, FL
> Adults under 65, no health insurance: 18.3%
> Adults under 65, Medicare coverage (or multiple types): 6.9% — 7th highest of 384 metros
> Adults under 65, Medicaid coverage (or multiple types): 20.2% — 182nd lowest of 384 metros
> Adults under 65, VA coverage (or multiple types): 1.1% — 138th lowest of 384 metros
> Adults under 65, employer-based insurance (or multiple types): 45.3% — 29th lowest of 384 metros
> Adults under 65, direct-purchase insurance (or multiple types): 14.8% — 20th highest of 384 metros
> Adults under 65, Tricare/military insurance (or many types): 1.9% — 162nd highest of 384 metros
27. San Antonio-New Braunfels, TX
> Adults under 65, no health insurance: 18.4%
> Adults under 65, Medicare coverage (or multiple types): 2.7% — 126th lowest of 384 metros
> Adults under 65, Medicaid coverage (or multiple types): 17.4% — 108th lowest of 384 metros
> Adults under 65, VA coverage (or multiple types): 2.5% — 42nd highest of 384 metros
> Adults under 65, employer-based insurance (or multiple types): 53.8% — 99th lowest of 384 metros
> Adults under 65, direct-purchase insurance (or multiple types): 8.0% — 130th lowest of 384 metros
> Adults under 65, Tricare/military insurance (or many types): 6.6% — 40th highest of 384 metros
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26. St. George, UT
> Adults under 65, no health insurance: 18.4%
> Adults under 65, Medicare coverage (or multiple types): 2.0% — 56th lowest of 384 metros
> Adults under 65, Medicaid coverage (or multiple types): 11.0% — 8th lowest of 384 metros
> Adults under 65, VA coverage (or multiple types): 1.1% — 134th lowest of 384 metros
> Adults under 65, employer-based insurance (or multiple types): 56.6% — 140th lowest of 384 metros
> Adults under 65, direct-purchase insurance (or multiple types): 15.9% — 15th highest of 384 metros
> Adults under 65, Tricare/military insurance (or many types): 1.3% — 139th lowest of 384 metros
25. Elkhart-Goshen, IN
> Adults under 65, no health insurance: 18.4%
> Adults under 65, Medicare coverage (or multiple types): 2.2% — 81st lowest of 384 metros
> Adults under 65, Medicaid coverage (or multiple types): 17.8% — 120th lowest of 384 metros
> Adults under 65, VA coverage (or multiple types): 0.4% — 6th lowest of 384 metros
> Adults under 65, employer-based insurance (or multiple types): 59.5% — 192nd lowest of 384 metros
> Adults under 65, direct-purchase insurance (or multiple types): 6.0% — 22nd lowest of 384 metros
> Adults under 65, Tricare/military insurance (or many types): 0.6% — 26th lowest of 384 metros
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24. Miami-Fort Lauderdale-Pompano Beach, FL
> Adults under 65, no health insurance: 18.5%
> Adults under 65, Medicare coverage (or multiple types): 2.4% — 98th lowest of 384 metros
> Adults under 65, Medicaid coverage (or multiple types): 17.7% — 115th lowest of 384 metros
> Adults under 65, VA coverage (or multiple types): 0.7% — 36th lowest of 384 metros
> Adults under 65, employer-based insurance (or multiple types): 47.8% — 43rd lowest of 384 metros
> Adults under 65, direct-purchase insurance (or multiple types): 17.2% — 9th highest of 384 metros
> Adults under 65, Tricare/military insurance (or many types): 0.7% — 45th lowest of 384 metros
23. Carson City, NV
> Adults under 65, no health insurance: 18.7%
> Adults under 65, Medicare coverage (or multiple types): 2.9% — 162nd lowest of 384 metros
> Adults under 65, Medicaid coverage (or multiple types): 18.2% — 131st lowest of 384 metros
> Adults under 65, VA coverage (or multiple types): 1.5% — 148th highest of 384 metros
> Adults under 65, employer-based insurance (or multiple types): 53.9% — 101st lowest of 384 metros
> Adults under 65, direct-purchase insurance (or multiple types): 9.3% — 164th highest of 384 metros
> Adults under 65, Tricare/military insurance (or many types): 0.5% — 19th lowest of 384 metros
22. Brunswick, GA
> Adults under 65, no health insurance: 18.7%
> Adults under 65, Medicare coverage (or multiple types): 4.5% — 58th highest of 384 metros
> Adults under 65, Medicaid coverage (or multiple types): 22.3% — 156th highest of 384 metros
> Adults under 65, VA coverage (or multiple types): 1.1% — 139th lowest of 384 metros
> Adults under 65, employer-based insurance (or multiple types): 48.6% — 51st lowest of 384 metros
> Adults under 65, direct-purchase insurance (or multiple types): 10.7% — 90th highest of 384 metros
> Adults under 65, Tricare/military insurance (or many types): 2.9% — 84th highest of 384 metros
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21. Homosassa Springs, FL
> Adults under 65, no health insurance: 18.7%
> Adults under 65, Medicare coverage (or multiple types): 11.3% — 2nd highest of 384 metros
> Adults under 65, Medicaid coverage (or multiple types): 23.6% — 131st highest of 384 metros
> Adults under 65, VA coverage (or multiple types): 2.7% — 31st highest of 384 metros
> Adults under 65, employer-based insurance (or multiple types): 38.1% — 10th lowest of 384 metros
> Adults under 65, direct-purchase insurance (or multiple types): 16.2% — 14th highest of 384 metros
> Adults under 65, Tricare/military insurance (or many types): 2.8% — 88th highest of 384 metros
20. Naples-Marco Island, FL
> Adults under 65, no health insurance: 19.2%
> Adults under 65, Medicare coverage (or multiple types): 1.9% — 44th lowest of 384 metros
> Adults under 65, Medicaid coverage (or multiple types): 14.5% — 43rd lowest of 384 metros
> Adults under 65, VA coverage (or multiple types): 0.7% — 50th lowest of 384 metros
> Adults under 65, employer-based insurance (or multiple types): 50.5% — 68th lowest of 384 metros
> Adults under 65, direct-purchase insurance (or multiple types): 17.2% — 10th highest of 384 metros
> Adults under 65, Tricare/military insurance (or many types): 0.6% — 29th lowest of 384 metros
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19. Dallas-Fort Worth-Arlington, TX
> Adults under 65, no health insurance: 19.4%
> Adults under 65, Medicare coverage (or multiple types): 1.9% — 41st lowest of 384 metros
> Adults under 65, Medicaid coverage (or multiple types): 13.6% — 31st lowest of 384 metros
> Adults under 65, VA coverage (or multiple types): 1.0% — 105th lowest of 384 metros
> Adults under 65, employer-based insurance (or multiple types): 59.3% — 187th lowest of 384 metros
> Adults under 65, direct-purchase insurance (or multiple types): 8.6% — 175th lowest of 384 metros
> Adults under 65, Tricare/military insurance (or many types): 1.3% — 140th lowest of 384 metros
18. The Villages, FL
> Adults under 65, no health insurance: 19.7%
> Adults under 65, Medicare coverage (or multiple types): 8.1% — 3rd highest of 384 metros
> Adults under 65, Medicaid coverage (or multiple types): 18.9% — 150th lowest of 384 metros
> Adults under 65, VA coverage (or multiple types): 4.5% — 11th highest of 384 metros
> Adults under 65, employer-based insurance (or multiple types): 37.4% — 8th lowest of 384 metros
> Adults under 65, direct-purchase insurance (or multiple types): 18.7% — 5th highest of 384 metros
> Adults under 65, Tricare/military insurance (or many types): 7.4% — 35th highest of 384 metros
17. Longview, TX
> Adults under 65, no health insurance: 19.7%
> Adults under 65, Medicare coverage (or multiple types): 3.5% — 149th highest of 384 metros
> Adults under 65, Medicaid coverage (or multiple types): 21.4% — 175th highest of 384 metros
> Adults under 65, VA coverage (or multiple types): 1.2% — 154th lowest of 384 metros
> Adults under 65, employer-based insurance (or multiple types): 50.5% — 69th lowest of 384 metros
> Adults under 65, direct-purchase insurance (or multiple types): 9.8% — 134th highest of 384 metros
> Adults under 65, Tricare/military insurance (or many types): 1.5% — 158th lowest of 384 metros
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16. Corpus Christi, TX
> Adults under 65, no health insurance: 19.9%
> Adults under 65, Medicare coverage (or multiple types): 2.6% — 117th lowest of 384 metros
> Adults under 65, Medicaid coverage (or multiple types): 18.7% — 143rd lowest of 384 metros
> Adults under 65, VA coverage (or multiple types): 1.8% — 100th highest of 384 metros
> Adults under 65, employer-based insurance (or multiple types): 54.6% — 110th lowest of 384 metros
> Adults under 65, direct-purchase insurance (or multiple types): 5.9% — 19th lowest of 384 metros
> Adults under 65, Tricare/military insurance (or many types): 2.5% — 107th highest of 384 metros
15. Valdosta, GA
> Adults under 65, no health insurance: 19.9%
> Adults under 65, Medicare coverage (or multiple types): 3.9% — 114th highest of 384 metros
> Adults under 65, Medicaid coverage (or multiple types): 23.2% — 137th highest of 384 metros
> Adults under 65, VA coverage (or multiple types): 2.6% — 34th highest of 384 metros
> Adults under 65, employer-based insurance (or multiple types): 57.7% — 156th lowest of 384 metros
> Adults under 65, direct-purchase insurance (or multiple types): 5.6% — 14th lowest of 384 metros
> Adults under 65, Tricare/military insurance (or many types): 7.6% — 33rd highest of 384 metros
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14. Sebastian-Vero Beach, FL
> Adults under 65, no health insurance: 19.9%
> Adults under 65, Medicare coverage (or multiple types): 2.6% — 124th lowest of 384 metros
> Adults under 65, Medicaid coverage (or multiple types): 18.6% — 140th lowest of 384 metros
> Adults under 65, VA coverage (or multiple types): 1.6% — 136th highest of 384 metros
> Adults under 65, employer-based insurance (or multiple types): 46.1% — 35th lowest of 384 metros
> Adults under 65, direct-purchase insurance (or multiple types): 17.1% — 11th highest of 384 metros
> Adults under 65, Tricare/military insurance (or many types): 2.3% — 117th highest of 384 metros
13. Albany, GA
> Adults under 65, no health insurance: 20.2%
> Adults under 65, Medicare coverage (or multiple types): 3.0% — 177th lowest of 384 metros
> Adults under 65, Medicaid coverage (or multiple types): 27.5% — 78th highest of 384 metros
> Adults under 65, VA coverage (or multiple types): 2.0% — 80th highest of 384 metros
> Adults under 65, employer-based insurance (or multiple types): 44.6% — 27th lowest of 384 metros
> Adults under 65, direct-purchase insurance (or multiple types): 8.2% — 148th lowest of 384 metros
> Adults under 65, Tricare/military insurance (or many types): 2.8% — 87th highest of 384 metros
12. Tyler, TX
> Adults under 65, no health insurance: 20.4%
> Adults under 65, Medicare coverage (or multiple types): 3.5% — 142nd highest of 384 metros
> Adults under 65, Medicaid coverage (or multiple types): 14.8% — 51st lowest of 384 metros
> Adults under 65, VA coverage (or multiple types): 1.3% — 171st lowest of 384 metros
> Adults under 65, employer-based insurance (or multiple types): 50.7% — 71st lowest of 384 metros
> Adults under 65, direct-purchase insurance (or multiple types): 14.7% — 21st highest of 384 metros
> Adults under 65, Tricare/military insurance (or many types): 1.1% — 105th lowest of 384 metros
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11. Abilene, TX
> Adults under 65, no health insurance: 20.5%
> Adults under 65, Medicare coverage (or multiple types): 2.0% — 52nd lowest of 384 metros
> Adults under 65, Medicaid coverage (or multiple types): 17.3% — 105th lowest of 384 metros
> Adults under 65, VA coverage (or multiple types): 2.5% — 40th highest of 384 metros
> Adults under 65, employer-based insurance (or multiple types): 52.3% — 84th lowest of 384 metros
> Adults under 65, direct-purchase insurance (or multiple types): 7.5% — 95th lowest of 384 metros
> Adults under 65, Tricare/military insurance (or many types): 6.5% — 44th highest of 384 metros
10. Beaumont-Port Arthur, TX
> Adults under 65, no health insurance: 21.3%
> Adults under 65, Medicare coverage (or multiple types): 3.3% — 168th highest of 384 metros
> Adults under 65, Medicaid coverage (or multiple types): 18.7% — 142nd lowest of 384 metros
> Adults under 65, VA coverage (or multiple types): 1.7% — 113th highest of 384 metros
> Adults under 65, employer-based insurance (or multiple types): 53.6% — 97th lowest of 384 metros
> Adults under 65, direct-purchase insurance (or multiple types): 8.3% — 154th lowest of 384 metros
> Adults under 65, Tricare/military insurance (or many types): 1.7% — 178th highest of 384 metros
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9. Gainesville, GA
> Adults under 65, no health insurance: 21.6%
> Adults under 65, Medicare coverage (or multiple types): 2.5% — 111th lowest of 384 metros
> Adults under 65, Medicaid coverage (or multiple types): 17.2% — 103rd lowest of 384 metros
> Adults under 65, VA coverage (or multiple types): 1.0% — 109th lowest of 384 metros
> Adults under 65, employer-based insurance (or multiple types): 52.2% — 83rd lowest of 384 metros
> Adults under 65, direct-purchase insurance (or multiple types): 9.2% — 168th highest of 384 metros
> Adults under 65, Tricare/military insurance (or many types): 0.9% — 70th lowest of 384 metros
8. Houston-The Woodlands-Sugar Land, TX
> Adults under 65, no health insurance: 21.8%
> Adults under 65, Medicare coverage (or multiple types): 1.8% — 28th lowest of 384 metros
> Adults under 65, Medicaid coverage (or multiple types): 15.9% — 76th lowest of 384 metros
> Adults under 65, VA coverage (or multiple types): 0.9% — 90th lowest of 384 metros
> Adults under 65, employer-based insurance (or multiple types): 55.0% — 116th lowest of 384 metros
> Adults under 65, direct-purchase insurance (or multiple types): 8.4% — 161st lowest of 384 metros
> Adults under 65, Tricare/military insurance (or many types): 1.0% — 92nd lowest of 384 metros
7. Victoria, TX
> Adults under 65, no health insurance: 22.6%
> Adults under 65, Medicare coverage (or multiple types): 3.4% — 154th highest of 384 metros
> Adults under 65, Medicaid coverage (or multiple types): 14.9% — 53rd lowest of 384 metros
> Adults under 65, VA coverage (or multiple types): 1.2% — 149th lowest of 384 metros
> Adults under 65, employer-based insurance (or multiple types): 52.1% — 81st lowest of 384 metros
> Adults under 65, direct-purchase insurance (or multiple types): 9.0% — 176th highest of 384 metros
> Adults under 65, Tricare/military insurance (or many types): 1.5% — 166th lowest of 384 metros
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6. Sherman-Denison, TX
> Adults under 65, no health insurance: 23.7%
> Adults under 65, Medicare coverage (or multiple types): 3.2% — 181st highest of 384 metros
> Adults under 65, Medicaid coverage (or multiple types): 18.6% — 137th lowest of 384 metros
> Adults under 65, VA coverage (or multiple types): 1.9% — 90th highest of 384 metros
> Adults under 65, employer-based insurance (or multiple types): 51.4% — 77th lowest of 384 metros
> Adults under 65, direct-purchase insurance (or multiple types): 6.0% — 24th lowest of 384 metros
> Adults under 65, Tricare/military insurance (or many types): 1.0% — 95th lowest of 384 metros
5. Odessa, TX
> Adults under 65, no health insurance: 24.0%
> Adults under 65, Medicare coverage (or multiple types): 1.8% — 35th lowest of 384 metros
> Adults under 65, Medicaid coverage (or multiple types): 11.6% — 15th lowest of 384 metros
> Adults under 65, VA coverage (or multiple types): 0.5% — 12th lowest of 384 metros
> Adults under 65, employer-based insurance (or multiple types): 61.2% — 174th highest of 384 metros
> Adults under 65, direct-purchase insurance (or multiple types): 6.4% — 45th lowest of 384 metros
> Adults under 65, Tricare/military insurance (or many types): 0.9% — 65th lowest of 384 metros
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4. El Paso, TX
> Adults under 65, no health insurance: 25.2%
> Adults under 65, Medicare coverage (or multiple types): 2.5% — 103rd lowest of 384 metros
> Adults under 65, Medicaid coverage (or multiple types): 21.8% — 166th highest of 384 metros
> Adults under 65, VA coverage (or multiple types): 2.4% — 44th highest of 384 metros
> Adults under 65, employer-based insurance (or multiple types): 41.6% — 15th lowest of 384 metros
> Adults under 65, direct-purchase insurance (or multiple types): 9.8% — 135th highest of 384 metros
> Adults under 65, Tricare/military insurance (or many types): 6.6% — 41st highest of 384 metros
3. Laredo, TX
> Adults under 65, no health insurance: 31.4%
> Adults under 65, Medicare coverage (or multiple types): 1.6% — 14th lowest of 384 metros
> Adults under 65, Medicaid coverage (or multiple types): 22.2% — 157th highest of 384 metros
> Adults under 65, VA coverage (or multiple types): 0.7% — 48th lowest of 384 metros
> Adults under 65, employer-based insurance (or multiple types): 39.9% — 11th lowest of 384 metros
> Adults under 65, direct-purchase insurance (or multiple types): 7.6% — 104th lowest of 384 metros
> Adults under 65, Tricare/military insurance (or many types): 0.6% — 22nd lowest of 384 metros
2. Brownsville-Harlingen, TX
> Adults under 65, no health insurance: 34.1%
> Adults under 65, Medicare coverage (or multiple types): 2.8% — 154th lowest of 384 metros
> Adults under 65, Medicaid coverage (or multiple types): 28.3% — 70th highest of 384 metros
> Adults under 65, VA coverage (or multiple types): 0.6% — 32nd lowest of 384 metros
> Adults under 65, employer-based insurance (or multiple types): 33.0% — 3rd lowest of 384 metros
> Adults under 65, direct-purchase insurance (or multiple types): 4.9% — 7th lowest of 384 metros
> Adults under 65, Tricare/military insurance (or many types): 1.0% — 97th lowest of 384 metros
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1. McAllen-Edinburg-Mission, TX
> Adults under 65, no health insurance: 35.7%
> Adults under 65, Medicare coverage (or multiple types): 3.1% — 180th lowest of 384 metros
> Adults under 65, Medicaid coverage (or multiple types): 27.0% — 79th highest of 384 metros
> Adults under 65, VA coverage (or multiple types): 0.6% — 30th lowest of 384 metros
> Adults under 65, employer-based insurance (or multiple types): 30.8% — 1st lowest of 384 metros
> Adults under 65, direct-purchase insurance (or multiple types): 6.5% — 48th lowest of 384 metros
> Adults under 65, Tricare/military insurance (or many types): 0.8% — 63rd lowest of 384 metros
Methodology
To determine the metros with the worst health insurance coverage in the nation, 24/7 Wall St. reviewed one-year estimates of the percentage of the noninstitutionalized civilian population under 65 without health insurance in each metropolitan area from the U.S. Census Bureau’s 2019 American Community Survey.
We used the 384 metropolitan statistical areas as delineated by the United States Office of Management and Budget and used by the Census Bureau as our definition of metros.
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 breakouts.
Each metro 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.
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