Special Report
States With the Best and Worst Health Insurance Coverage
Published:
Last Updated:
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. 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.
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.
Click here to see the states with the best and worst health insurance coverage.
Click here to see our detailed methodology.
50. Massachusetts
> Residents under 65, no health insurance: 3.5%
> Residents under 65, Medicare coverage (or multiple types): 2.6% (16th lowest)
> Residents under 65, Medicaid coverage (or multiple types): 23.0% (13th highest)
> Residents under 65, VA coverage (or multiple types): 0.6% (3rd lowest)
> Residents under 65, employer-based insurance (or multiple types): 68.1% (6th highest)
> Residents under 65, direct-purchase insurance (or multiple types): 10.2% (16th highest)
> Residents under 65, Tricare/military insurance (or many types): 0.8% (3rd lowest)
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49. Rhode Island
> Residents under 65, no health insurance: 4.8%
> Residents under 65, Medicare coverage (or multiple types): 3.9% (10th highest)
> Residents under 65, Medicaid coverage (or multiple types): 21.6% (20th highest)
> Residents under 65, VA coverage (or multiple types): 0.7% (4th lowest)
> Residents under 65, employer-based insurance (or multiple types): 66.8% (10th highest)
> Residents under 65, direct-purchase insurance (or multiple types): 11.7% (8th highest)
> Residents under 65, Tricare/military insurance (or many types): 1.3% (10th lowest)
48. Hawaii
> Residents under 65, no health insurance: 5.0%
> Residents under 65, Medicare coverage (or multiple types): 2.0% (5th lowest)
> Residents under 65, Medicaid coverage (or multiple types): 19.5% (22nd lowest)
> Residents under 65, VA coverage (or multiple types): 1.5% (24th highest)
> Residents under 65, employer-based insurance (or multiple types): 66.9% (9th highest)
> Residents under 65, direct-purchase insurance (or multiple types): 9.9% (19th highest)
> Residents under 65, Tricare/military insurance (or many types): 7.6% (2nd highest)
47. Vermont
> Residents under 65, no health insurance: 5.6%
> Residents under 65, Medicare coverage (or multiple types): 4.1% (7th highest)
> Residents under 65, Medicaid coverage (or multiple types): 25.8% (8th highest)
> Residents under 65, VA coverage (or multiple types): 1.1% (14th lowest)
> Residents under 65, employer-based insurance (or multiple types): 60.6% (22nd lowest)
> Residents under 65, direct-purchase insurance (or multiple types): 10.3% (15th highest)
> Residents under 65, Tricare/military insurance (or many types): 1.6% (17th lowest)
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46. Minnesota
> Residents under 65, no health insurance: 5.8%
> Residents under 65, Medicare coverage (or multiple types): 2.0% (3rd lowest)
> Residents under 65, Medicaid coverage (or multiple types): 18.9% (18th lowest)
> Residents under 65, VA coverage (or multiple types): 0.9% (9th lowest)
> Residents under 65, employer-based insurance (or multiple types): 69.8% (the highest)
> Residents under 65, direct-purchase insurance (or multiple types): 8.4% (11th lowest)
> Residents under 65, Tricare/military insurance (or many types): 1.0% (6th lowest)
45. Iowa
> Residents under 65, no health insurance: 6.0%
> Residents under 65, Medicare coverage (or multiple types): 2.7% (18th lowest)
> Residents under 65, Medicaid coverage (or multiple types): 21.3% (22nd highest)
> Residents under 65, VA coverage (or multiple types): 1.3% (22nd lowest)
> Residents under 65, employer-based insurance (or multiple types): 67.6% (7th highest)
> Residents under 65, direct-purchase insurance (or multiple types): 8.5% (14th lowest)
> Residents under 65, Tricare/military insurance (or many types): 1.3% (13th lowest)
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44. New York
> Residents under 65, no health insurance: 6.1%
> Residents under 65, Medicare coverage (or multiple types): 2.7% (22nd lowest)
> Residents under 65, Medicaid coverage (or multiple types): 26.9% (6th highest)
> Residents under 65, VA coverage (or multiple types): 0.6% (2nd lowest)
> Residents under 65, employer-based insurance (or multiple types): 60.2% (21st lowest)
> Residents under 65, direct-purchase insurance (or multiple types): 10.8% (9th highest)
> Residents under 65, Tricare/military insurance (or many types): 0.7% (the lowest)
24/7 Wall St.
43. Wisconsin
> Residents under 65, no health insurance: 6.8%
> Residents under 65, Medicare coverage (or multiple types): 2.7% (19th lowest)
> Residents under 65, Medicaid coverage (or multiple types): 17.6% (14th lowest)
> Residents under 65, VA coverage (or multiple types): 1.1% (13th lowest)
> Residents under 65, employer-based insurance (or multiple types): 69.5% (2nd highest)
> Residents under 65, direct-purchase insurance (or multiple types): 8.8% (19th lowest)
> Residents under 65, Tricare/military insurance (or many types): 1.0% (8th lowest)
42. Maryland
> Residents under 65, no health insurance: 6.9%
> Residents under 65, Medicare coverage (or multiple types): 2.8% (25th lowest)
> Residents under 65, Medicaid coverage (or multiple types): 19.6% (23rd lowest)
> Residents under 65, VA coverage (or multiple types): 1.2% (19th lowest)
> Residents under 65, employer-based insurance (or multiple types): 65.6% (13th highest)
> Residents under 65, direct-purchase insurance (or multiple types): 9.3% (24th highest)
> Residents under 65, Tricare/military insurance (or many types): 3.3% (11th highest)
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41. Michigan
> Residents under 65, no health insurance: 6.9%
> Residents under 65, Medicare coverage (or multiple types): 3.7% (11th highest)
> Residents under 65, Medicaid coverage (or multiple types): 23.8% (10th highest)
> Residents under 65, VA coverage (or multiple types): 1.0% (11th lowest)
> Residents under 65, employer-based insurance (or multiple types): 63.7% (21st highest)
> Residents under 65, direct-purchase insurance (or multiple types): 8.9% (20th lowest)
> Residents under 65, Tricare/military insurance (or many types): 0.9% (4th lowest)
40. Pennsylvania
> Residents under 65, no health insurance: 7.0%
> Residents under 65, Medicare coverage (or multiple types): 3.3% (17th highest)
> Residents under 65, Medicaid coverage (or multiple types): 22.0% (19th highest)
> Residents under 65, VA coverage (or multiple types): 1.0% (10th lowest)
> Residents under 65, employer-based insurance (or multiple types): 65.1% (14th highest)
> Residents under 65, direct-purchase insurance (or multiple types): 9.2% (24th lowest)
> Residents under 65, Tricare/military insurance (or many types): 1.1% (9th lowest)
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39. Connecticut
> Residents under 65, no health insurance: 7.0%
> Residents under 65, Medicare coverage (or multiple types): 2.5% (13th lowest)
> Residents under 65, Medicaid coverage (or multiple types): 23.2% (12th highest)
> Residents under 65, VA coverage (or multiple types): 0.8% (6th lowest)
> Residents under 65, employer-based insurance (or multiple types): 64.2% (19th highest)
> Residents under 65, direct-purchase insurance (or multiple types): 8.5% (12th lowest)
> Residents under 65, Tricare/military insurance (or many types): 1.0% (7th lowest)
38. New Hampshire
> Residents under 65, no health insurance: 7.6%
> Residents under 65, Medicare coverage (or multiple types): 3.2% (21st highest)
> Residents under 65, Medicaid coverage (or multiple types): 14.6% (8th lowest)
> Residents under 65, VA coverage (or multiple types): 1.2% (17th lowest)
> Residents under 65, employer-based insurance (or multiple types): 68.8% (4th highest)
> Residents under 65, direct-purchase insurance (or multiple types): 9.1% (21st lowest)
> Residents under 65, Tricare/military insurance (or many types): 1.5% (16th lowest)
37. Kentucky
> Residents under 65, no health insurance: 7.7%
> Residents under 65, Medicare coverage (or multiple types): 5.0% (2nd highest)
> Residents under 65, Medicaid coverage (or multiple types): 28.3% (5th highest)
> Residents under 65, VA coverage (or multiple types): 1.4% (25th lowest)
> Residents under 65, employer-based insurance (or multiple types): 57.1% (14th lowest)
> Residents under 65, direct-purchase insurance (or multiple types): 7.3% (4th lowest)
> Residents under 65, Tricare/military insurance (or many types): 2.2% (23rd lowest)
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36. Washington
> Residents under 65, no health insurance: 7.7%
> Residents under 65, Medicare coverage (or multiple types): 2.4% (11th lowest)
> Residents under 65, Medicaid coverage (or multiple types): 21.4% (21st highest)
> Residents under 65, VA coverage (or multiple types): 1.5% (23rd highest)
> Residents under 65, employer-based insurance (or multiple types): 63.7% (20th highest)
> Residents under 65, direct-purchase insurance (or multiple types): 8.3% (9th lowest)
> Residents under 65, Tricare/military insurance (or many types): 3.4% (8th highest)
35. Ohio
> Residents under 65, no health insurance: 7.8%
> Residents under 65, Medicare coverage (or multiple types): 3.1% (22nd highest)
> Residents under 65, Medicaid coverage (or multiple types): 22.2% (18th highest)
> Residents under 65, VA coverage (or multiple types): 1.2% (16th lowest)
> Residents under 65, employer-based insurance (or multiple types): 64.4% (16th highest)
> Residents under 65, direct-purchase insurance (or multiple types): 7.3% (3rd lowest)
> Residents under 65, Tricare/military insurance (or many types): 1.3% (12th lowest)
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34. North Dakota
> Residents under 65, no health insurance: 8.1%
> Residents under 65, Medicare coverage (or multiple types): 2.0% (4th lowest)
> Residents under 65, Medicaid coverage (or multiple types): 12.4% (3rd lowest)
> Residents under 65, VA coverage (or multiple types): 1.6% (18th highest)
> Residents under 65, employer-based insurance (or multiple types): 68.3% (5th highest)
> Residents under 65, direct-purchase insurance (or multiple types): 13.6% (2nd highest)
> Residents under 65, Tricare/military insurance (or many types): 3.5% (7th highest)
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33. Delaware
> Residents under 65, no health insurance: 8.1%
> Residents under 65, Medicare coverage (or multiple types): 3.3% (18th highest)
> Residents under 65, Medicaid coverage (or multiple types): 23.0% (15th highest)
> Residents under 65, VA coverage (or multiple types): 1.2% (15th lowest)
> Residents under 65, employer-based insurance (or multiple types): 63.6% (22nd highest)
> Residents under 65, direct-purchase insurance (or multiple types): 8.3% (7th lowest)
> Residents under 65, Tricare/military insurance (or many types): 3.2% (14th highest)
32. West Virginia
> Residents under 65, no health insurance: 8.3%
> Residents under 65, Medicare coverage (or multiple types): 5.5% (the highest)
> Residents under 65, Medicaid coverage (or multiple types): 30.0% (3rd highest)
> Residents under 65, VA coverage (or multiple types): 2.2% (4th highest)
> Residents under 65, employer-based insurance (or multiple types): 57.4% (15th lowest)
> Residents under 65, direct-purchase insurance (or multiple types): 5.7% (the lowest)
> Residents under 65, Tricare/military insurance (or many types): 1.8% (18th lowest)
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31. Oregon
> Residents under 65, no health insurance: 8.6%
> Residents under 65, Medicare coverage (or multiple types): 2.7% (20th lowest)
> Residents under 65, Medicaid coverage (or multiple types): 23.0% (14th highest)
> Residents under 65, VA coverage (or multiple types): 1.5% (22nd highest)
> Residents under 65, employer-based insurance (or multiple types): 61.4% (24th lowest)
> Residents under 65, direct-purchase insurance (or multiple types): 9.4% (22nd highest)
> Residents under 65, Tricare/military insurance (or many types): 1.4% (15th lowest)
30. Illinois
> Residents under 65, no health insurance: 8.6%
> Residents under 65, Medicare coverage (or multiple types): 2.5% (14th lowest)
> Residents under 65, Medicaid coverage (or multiple types): 19.7% (24th lowest)
> Residents under 65, VA coverage (or multiple types): 0.8% (7th lowest)
> Residents under 65, employer-based insurance (or multiple types): 64.9% (15th highest)
> Residents under 65, direct-purchase insurance (or multiple types): 8.3% (8th lowest)
> Residents under 65, Tricare/military insurance (or many types): 1.0% (5th lowest)
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29. California
> Residents under 65, no health insurance: 8.9%
> Residents under 65, Medicare coverage (or multiple types): 2.1% (6th lowest)
> Residents under 65, Medicaid coverage (or multiple types): 26.4% (7th highest)
> Residents under 65, VA coverage (or multiple types): 0.9% (8th lowest)
> Residents under 65, employer-based insurance (or multiple types): 56.9% (12th lowest)
> Residents under 65, direct-purchase insurance (or multiple types): 10.4% (14th highest)
> Residents under 65, Tricare/military insurance (or many types): 1.4% (14th lowest)
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28. New Jersey
> Residents under 65, no health insurance: 9.2%
> Residents under 65, Medicare coverage (or multiple types): 2.5% (15th lowest)
> Residents under 65, Medicaid coverage (or multiple types): 17.4% (12th lowest)
> Residents under 65, VA coverage (or multiple types): 0.5% (the lowest)
> Residents under 65, employer-based insurance (or multiple types): 66.4% (11th highest)
> Residents under 65, direct-purchase insurance (or multiple types): 8.7% (18th lowest)
> Residents under 65, Tricare/military insurance (or many types): 0.7% (2nd lowest)
27. Virginia
> Residents under 65, no health insurance: 9.3%
> Residents under 65, Medicare coverage (or multiple types): 2.8% (23rd lowest)
> Residents under 65, Medicaid coverage (or multiple types): 14.5% (7th lowest)
> Residents under 65, VA coverage (or multiple types): 2.3% (2nd highest)
> Residents under 65, employer-based insurance (or multiple types): 64.4% (18th highest)
> Residents under 65, direct-purchase insurance (or multiple types): 9.3% (23rd highest)
> Residents under 65, Tricare/military insurance (or many types): 6.9% (3rd highest)
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26. Colorado
> Residents under 65, no health insurance: 9.3%
> Residents under 65, Medicare coverage (or multiple types): 1.9% (2nd lowest)
> Residents under 65, Medicaid coverage (or multiple types): 18.1% (16th lowest)
> Residents under 65, VA coverage (or multiple types): 1.7% (13th highest)
> Residents under 65, employer-based insurance (or multiple types): 62.4% (25th highest)
> Residents under 65, direct-purchase insurance (or multiple types): 10.5% (12th highest)
> Residents under 65, Tricare/military insurance (or many types): 3.4% (9th highest)
25. Nebraska
> Residents under 65, no health insurance: 9.8%
> Residents under 65, Medicare coverage (or multiple types): 2.2% (7th lowest)
> Residents under 65, Medicaid coverage (or multiple types): 13.4% (4th lowest)
> Residents under 65, VA coverage (or multiple types): 1.2% (21st lowest)
> Residents under 65, employer-based insurance (or multiple types): 67.2% (8th highest)
> Residents under 65, direct-purchase insurance (or multiple types): 12.1% (7th highest)
> Residents under 65, Tricare/military insurance (or many types): 2.6% (23rd highest)
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24. Maine
> Residents under 65, no health insurance: 10.1%
> Residents under 65, Medicare coverage (or multiple types): 4.4% (6th highest)
> Residents under 65, Medicaid coverage (or multiple types): 20.2% (25th highest)
> Residents under 65, VA coverage (or multiple types): 1.7% (9th highest)
> Residents under 65, employer-based insurance (or multiple types): 61.4% (23rd lowest)
> Residents under 65, direct-purchase insurance (or multiple types): 10.5% (13th highest)
> Residents under 65, Tricare/military insurance (or many types): 2.4% (25th highest)
23. Montana
> Residents under 65, no health insurance: 10.2%
> Residents under 65, Medicare coverage (or multiple types): 3.0% (24th highest)
> Residents under 65, Medicaid coverage (or multiple types): 23.6% (11th highest)
> Residents under 65, VA coverage (or multiple types): 2.2% (3rd highest)
> Residents under 65, employer-based insurance (or multiple types): 55.0% (8th lowest)
> Residents under 65, direct-purchase insurance (or multiple types): 13.6% (3rd highest)
> Residents under 65, Tricare/military insurance (or many types): 3.0% (15th highest)
22. Indiana
> Residents under 65, no health insurance: 10.3%
> Residents under 65, Medicare coverage (or multiple types): 3.2% (20th highest)
> Residents under 65, Medicaid coverage (or multiple types): 19.1% (20th lowest)
> Residents under 65, VA coverage (or multiple types): 1.1% (12th lowest)
> Residents under 65, employer-based insurance (or multiple types): 64.4% (17th highest)
> Residents under 65, direct-purchase insurance (or multiple types): 7.8% (6th lowest)
> Residents under 65, Tricare/military insurance (or many types): 1.3% (11th lowest)
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21. Louisiana
> Residents under 65, no health insurance: 10.5%
> Residents under 65, Medicare coverage (or multiple types): 4.0% (8th highest)
> Residents under 65, Medicaid coverage (or multiple types): 31.6% (2nd highest)
> Residents under 65, VA coverage (or multiple types): 1.2% (20th lowest)
> Residents under 65, employer-based insurance (or multiple types): 50.9% (2nd lowest)
> Residents under 65, direct-purchase insurance (or multiple types): 8.4% (10th lowest)
> Residents under 65, Tricare/military insurance (or many types): 2.0% (20th lowest)
20. Utah
> Residents under 65, no health insurance: 10.8%
> Residents under 65, Medicare coverage (or multiple types): 1.5% (the lowest)
> Residents under 65, Medicaid coverage (or multiple types): 9.8% (the lowest)
> Residents under 65, VA coverage (or multiple types): 0.8% (5th lowest)
> Residents under 65, employer-based insurance (or multiple types): 68.8% (3rd highest)
> Residents under 65, direct-purchase insurance (or multiple types): 12.5% (6th highest)
> Residents under 65, Tricare/military insurance (or many types): 1.9% (19th lowest)
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19. Kansas
> Residents under 65, no health insurance: 10.9%
> Residents under 65, Medicare coverage (or multiple types): 2.7% (17th lowest)
> Residents under 65, Medicaid coverage (or multiple types): 14.3% (6th lowest)
> Residents under 65, VA coverage (or multiple types): 1.3% (23rd lowest)
> Residents under 65, employer-based insurance (or multiple types): 66.4% (12th highest)
> Residents under 65, direct-purchase insurance (or multiple types): 10.1% (17th highest)
> Residents under 65, Tricare/military insurance (or many types): 3.2% (13th highest)
18. Arkansas
> Residents under 65, no health insurance: 10.9%
> Residents under 65, Medicare coverage (or multiple types): 4.9% (3rd highest)
> Residents under 65, Medicaid coverage (or multiple types): 29.1% (4th highest)
> Residents under 65, VA coverage (or multiple types): 1.7% (14th highest)
> Residents under 65, employer-based insurance (or multiple types): 51.4% (4th lowest)
> Residents under 65, direct-purchase insurance (or multiple types): 9.1% (22nd lowest)
> Residents under 65, Tricare/military insurance (or many types): 2.0% (21st lowest)
17. Alabama
> Residents under 65, no health insurance: 11.7%
> Residents under 65, Medicare coverage (or multiple types): 4.8% (4th highest)
> Residents under 65, Medicaid coverage (or multiple types): 20.8% (24th highest)
> Residents under 65, VA coverage (or multiple types): 1.6% (21st highest)
> Residents under 65, employer-based insurance (or multiple types): 58.2% (17th lowest)
> Residents under 65, direct-purchase insurance (or multiple types): 9.7% (20th highest)
> Residents under 65, Tricare/military insurance (or many types): 3.6% (5th highest)
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16. New Mexico
> Residents under 65, no health insurance: 12.0%
> Residents under 65, Medicare coverage (or multiple types): 3.7% (12th highest)
> Residents under 65, Medicaid coverage (or multiple types): 37.0% (the highest)
> Residents under 65, VA coverage (or multiple types): 1.7% (11th highest)
> Residents under 65, employer-based insurance (or multiple types): 46.1% (the lowest)
> Residents under 65, direct-purchase insurance (or multiple types): 7.6% (5th lowest)
> Residents under 65, Tricare/military insurance (or many types): 2.9% (17th highest)
15. Missouri
> Residents under 65, no health insurance: 12.0%
> Residents under 65, Medicare coverage (or multiple types): 3.7% (14th highest)
> Residents under 65, Medicaid coverage (or multiple types): 15.6% (9th lowest)
> Residents under 65, VA coverage (or multiple types): 1.4% (25th highest)
> Residents under 65, employer-based insurance (or multiple types): 63.3% (23rd highest)
> Residents under 65, direct-purchase insurance (or multiple types): 9.3% (25th highest)
> Residents under 65, Tricare/military insurance (or many types): 2.1% (22nd lowest)
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14. Tennessee
> Residents under 65, no health insurance: 12.1%
> Residents under 65, Medicare coverage (or multiple types): 3.4% (15th highest)
> Residents under 65, Medicaid coverage (or multiple types): 21.0% (23rd highest)
> Residents under 65, VA coverage (or multiple types): 1.6% (17th highest)
> Residents under 65, employer-based insurance (or multiple types): 58.4% (18th lowest)
> Residents under 65, direct-purchase insurance (or multiple types): 9.6% (21st highest)
> Residents under 65, Tricare/military insurance (or many types): 2.9% (19th highest)
13. South Dakota
> Residents under 65, no health insurance: 12.2%
> Residents under 65, Medicare coverage (or multiple types): 2.9% (25th highest)
> Residents under 65, Medicaid coverage (or multiple types): 14.2% (5th lowest)
> Residents under 65, VA coverage (or multiple types): 1.8% (6th highest)
> Residents under 65, employer-based insurance (or multiple types): 61.8% (25th lowest)
> Residents under 65, direct-purchase insurance (or multiple types): 12.8% (5th highest)
> Residents under 65, Tricare/military insurance (or many types): 2.9% (16th highest)
12. Idaho
> Residents under 65, no health insurance: 12.8%
> Residents under 65, Medicare coverage (or multiple types): 2.7% (21st lowest)
> Residents under 65, Medicaid coverage (or multiple types): 17.3% (11th lowest)
> Residents under 65, VA coverage (or multiple types): 1.6% (16th highest)
> Residents under 65, employer-based insurance (or multiple types): 58.7% (19th lowest)
> Residents under 65, direct-purchase insurance (or multiple types): 12.9% (4th highest)
> Residents under 65, Tricare/military insurance (or many types): 2.5% (24th highest)
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11. South Carolina
> Residents under 65, no health insurance: 13.2%
> Residents under 65, Medicare coverage (or multiple types): 3.7% (13th highest)
> Residents under 65, Medicaid coverage (or multiple types): 20.2% (25th lowest)
> Residents under 65, VA coverage (or multiple types): 1.8% (7th highest)
> Residents under 65, employer-based insurance (or multiple types): 57.0% (13th lowest)
> Residents under 65, direct-purchase insurance (or multiple types): 10.1% (18th highest)
> Residents under 65, Tricare/military insurance (or many types): 3.7% (4th highest)
10. North Carolina
> Residents under 65, no health insurance: 13.4%
> Residents under 65, Medicare coverage (or multiple types): 3.3% (16th highest)
> Residents under 65, Medicaid coverage (or multiple types): 19.2% (21st lowest)
> Residents under 65, VA coverage (or multiple types): 1.7% (10th highest)
> Residents under 65, employer-based insurance (or multiple types): 56.7% (11th lowest)
> Residents under 65, direct-purchase insurance (or multiple types): 10.7% (11th highest)
> Residents under 65, Tricare/military insurance (or many types): 3.6% (6th highest)
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9. Nevada
> Residents under 65, no health insurance: 13.4%
> Residents under 65, Medicare coverage (or multiple types): 2.4% (10th lowest)
> Residents under 65, Medicaid coverage (or multiple types): 18.9% (19th lowest)
> Residents under 65, VA coverage (or multiple types): 1.8% (8th highest)
> Residents under 65, employer-based insurance (or multiple types): 59.4% (20th lowest)
> Residents under 65, direct-purchase insurance (or multiple types): 8.7% (17th lowest)
> Residents under 65, Tricare/military insurance (or many types): 2.6% (22nd highest)
8. Arizona
> Residents under 65, no health insurance: 13.6%
> Residents under 65, Medicare coverage (or multiple types): 2.8% (24th lowest)
> Residents under 65, Medicaid coverage (or multiple types): 22.8% (17th highest)
> Residents under 65, VA coverage (or multiple types): 1.6% (20th highest)
> Residents under 65, employer-based insurance (or multiple types): 56.2% (10th lowest)
> Residents under 65, direct-purchase insurance (or multiple types): 8.5% (13th lowest)
> Residents under 65, Tricare/military insurance (or many types): 2.4% (25th lowest)
7. Alaska
> Residents under 65, no health insurance: 13.9%
> Residents under 65, Medicare coverage (or multiple types): 2.3% (9th lowest)
> Residents under 65, Medicaid coverage (or multiple types): 22.8% (16th highest)
> Residents under 65, VA coverage (or multiple types): 3.1% (the highest)
> Residents under 65, employer-based insurance (or multiple types): 55.0% (9th lowest)
> Residents under 65, direct-purchase insurance (or multiple types): 6.4% (2nd lowest)
> Residents under 65, Tricare/military insurance (or many types): 9.6% (the highest)
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6. Wyoming
> Residents under 65, no health insurance: 14.8%
> Residents under 65, Medicare coverage (or multiple types): 2.4% (12th lowest)
> Residents under 65, Medicaid coverage (or multiple types): 12.3% (2nd lowest)
> Residents under 65, VA coverage (or multiple types): 1.7% (15th highest)
> Residents under 65, employer-based insurance (or multiple types): 62.6% (24th highest)
> Residents under 65, direct-purchase insurance (or multiple types): 10.8% (10th highest)
> Residents under 65, Tricare/military insurance (or many types): 2.8% (20th highest)
5. Mississippi
> Residents under 65, no health insurance: 15.4%
> Residents under 65, Medicare coverage (or multiple types): 4.5% (5th highest)
> Residents under 65, Medicaid coverage (or multiple types): 25.1% (9th highest)
> Residents under 65, VA coverage (or multiple types): 1.2% (18th lowest)
> Residents under 65, employer-based insurance (or multiple types): 50.9% (3rd lowest)
> Residents under 65, direct-purchase insurance (or multiple types): 8.6% (16th lowest)
> Residents under 65, Tricare/military insurance (or many types): 2.9% (18th highest)
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4. Georgia
> Residents under 65, no health insurance: 15.5%
> Residents under 65, Medicare coverage (or multiple types): 3.1% (23rd highest)
> Residents under 65, Medicaid coverage (or multiple types): 17.5% (13th lowest)
> Residents under 65, VA coverage (or multiple types): 1.7% (12th highest)
> Residents under 65, employer-based insurance (or multiple types): 58.1% (16th lowest)
> Residents under 65, direct-purchase insurance (or multiple types): 9.2% (23rd lowest)
> Residents under 65, Tricare/military insurance (or many types): 3.3% (12th highest)
3. Florida
> Residents under 65, no health insurance: 16.3%
> Residents under 65, Medicare coverage (or multiple types): 3.2% (19th highest)
> Residents under 65, Medicaid coverage (or multiple types): 18.1% (15th lowest)
> Residents under 65, VA coverage (or multiple types): 1.6% (19th highest)
> Residents under 65, employer-based insurance (or multiple types): 51.4% (5th lowest)
> Residents under 65, direct-purchase insurance (or multiple types): 14.2% (the highest)
> Residents under 65, Tricare/military insurance (or many types): 2.7% (21st highest)
2. Oklahoma
> Residents under 65, no health insurance: 16.8%
> Residents under 65, Medicare coverage (or multiple types): 4.0% (9th highest)
> Residents under 65, Medicaid coverage (or multiple types): 18.7% (17th lowest)
> Residents under 65, VA coverage (or multiple types): 1.9% (5th highest)
> Residents under 65, employer-based insurance (or multiple types): 54.8% (7th lowest)
> Residents under 65, direct-purchase insurance (or multiple types): 9.3% (25th lowest)
> Residents under 65, Tricare/military insurance (or many types): 3.4% (10th highest)
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1. Texas
> Residents under 65, no health insurance: 20.8%
> Residents under 65, Medicare coverage (or multiple types): 2.3% (8th 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% (6th 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)
Methodology
To determine the states with the best and 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.
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