Special Report
The Zip Code With the Worst Health Insurance Coverage in Every State
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 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, 10.3% 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 was 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 Tempo identified the ZIP code in every state with the worst health insurance coverage. Uninsured rates in some places on this list exceed 50%.
Click here to see the zip code with the worst health insurance coverage in every state
Click here to read our detailed methodology
Alabama: 36509
> Location: Bayou La Batre, Alabama
> Residents under 65, no health insurance: 27.2% (Alabama: 11.3%)
> Residents under 65, Medicare coverage (or multiple types): 3.8% (Alabama: 4.9%)
> Residents under 65, Medicaid coverage (or multiple types): 24.8% (Alabama: 20.9%)
> Residents under 65, VA coverage (or multiple types): 0.6% (Alabama: 1.7%)
> Residents under 65, employer-based insurance (or multiple types): 32.3% (Alabama: 57.8%)
> Residents under 65, direct-purchase insurance (or multiple types): 14.3% (Alabama: 10.5%)
> Residents under 65, Tricare/military insurance (or many types): 2.7% (Alabama: 3.3%)
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Alaska: 99661
> Location: Sand Point, Alaska
> Residents under 65, no health insurance: 55.4% (Alaska: 15.3%)
> Residents under 65, Medicare coverage (or multiple types): 0.9% (Alaska: 1.9%)
> Residents under 65, Medicaid coverage (or multiple types): 14.6% (Alaska: 21.1%)
> Residents under 65, VA coverage (or multiple types): 0.8% (Alaska: 3.0%)
> Residents under 65, employer-based insurance (or multiple types): 25.9% (Alaska: 54.4%)
> Residents under 65, direct-purchase insurance (or multiple types): 3.6% (Alaska: 6.9%)
> Residents under 65, Tricare/military insurance (or many types): 0.8% (Alaska: 9.6%)
Arizona: 86545
> Location: Rock Point, Arizona
> Residents under 65, no health insurance: 51.7% (Arizona: 12.4%)
> Residents under 65, Medicare coverage (or multiple types): 7.0% (Arizona: 2.6%)
> Residents under 65, Medicaid coverage (or multiple types): 21.6% (Arizona: 24.1%)
> Residents under 65, VA coverage (or multiple types): 0.4% (Arizona: 1.5%)
> Residents under 65, employer-based insurance (or multiple types): 21.3% (Arizona: 55.1%)
> Residents under 65, direct-purchase insurance (or multiple types): 0.5% (Arizona: 9.7%)
> Residents under 65, Tricare/military insurance (or many types): 0.0% reported (Arizona: 2.4%)
Arkansas: 72764
> Location: Springdale, Arkansas
> Residents under 65, no health insurance: 21.8% (Arkansas: 10.1%)
> Residents under 65, Medicare coverage (or multiple types): 2.8% (Arkansas: 5.1%)
> Residents under 65, Medicaid coverage (or multiple types): 26.5% (Arkansas: 28.6%)
> Residents under 65, VA coverage (or multiple types): 1.1% (Arkansas: 1.8%)
> Residents under 65, employer-based insurance (or multiple types): 48.7% (Arkansas: 51.8%)
> Residents under 65, direct-purchase insurance (or multiple types): 5.3% (Arkansas: 10.2%)
> Residents under 65, Tricare/military insurance (or many types): 1.0% (Arkansas: 2.3%)
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California: 90057
> Location: Los Angeles, California
> Residents under 65, no health insurance: 32.8% (California: 8.6%)
> Residents under 65, Medicare coverage (or multiple types): 1.9% (California: 2.2%)
> Residents under 65, Medicaid coverage (or multiple types): 40.3% (California: 27.1%)
> Residents under 65, VA coverage (or multiple types): 0.4% (California: 0.9%)
> Residents under 65, employer-based insurance (or multiple types): 22.0% (California: 55.7%)
> Residents under 65, direct-purchase insurance (or multiple types): 5.3% (California: 10.9%)
> Residents under 65, Tricare/military insurance (or many types): 0.4% (California: 1.4%)
Colorado: 81334
> Location: Towaoc, Colorado
> Residents under 65, no health insurance: 32.7% (Colorado: 8.7%)
> Residents under 65, Medicare coverage (or multiple types): 3.5% (Colorado: 2.1%)
> Residents under 65, Medicaid coverage (or multiple types): 38.4% (Colorado: 19.8%)
> Residents under 65, VA coverage (or multiple types): 0.0% reported (Colorado: 1.5%)
> Residents under 65, employer-based insurance (or multiple types): 27.5% (Colorado: 60.5%)
> Residents under 65, direct-purchase insurance (or multiple types): 0.4% (Colorado: 11.4%)
> Residents under 65, Tricare/military insurance (or many types): 0.0% reported (Colorado: 3.5%)
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Connecticut: 06854
> Location: Norwalk, Connecticut
> Residents under 65, no health insurance: 26.4% (Connecticut: 6.3%)
> Residents under 65, Medicare coverage (or multiple types): 2.5% (Connecticut: 2.4%)
> Residents under 65, Medicaid coverage (or multiple types): 25.8% (Connecticut: 21.6%)
> Residents under 65, VA coverage (or multiple types): 0.3% (Connecticut: 0.7%)
> Residents under 65, employer-based insurance (or multiple types): 40.7% (Connecticut: 65.1%)
> Residents under 65, direct-purchase insurance (or multiple types): 7.6% (Connecticut: 9.4%)
> Residents under 65, Tricare/military insurance (or many types): 0.3% (Connecticut: 1.0%)
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Delaware: 19947
> Location: Georgetown, Delaware
> Residents under 65, no health insurance: 16.2% (Delaware: 6.8%)
> Residents under 65, Medicare coverage (or multiple types): 3.2% (Delaware: 3.3%)
> Residents under 65, Medicaid coverage (or multiple types): 31.9% (Delaware: 22.5%)
> Residents under 65, VA coverage (or multiple types): 0.6% (Delaware: 1.0%)
> Residents under 65, employer-based insurance (or multiple types): 47.3% (Delaware: 64.4%)
> Residents under 65, direct-purchase insurance (or multiple types): 6.4% (Delaware: 8.6%)
> Residents under 65, Tricare/military insurance (or many types): 0.8% (Delaware: 2.6%)
Florida: 34142
> Location: Immokalee, Florida
> Residents under 65, no health insurance: 43.8% (Florida: 15.7%)
> Residents under 65, Medicare coverage (or multiple types): 2.7% (Florida: 3.1%)
> Residents under 65, Medicaid coverage (or multiple types): 28.5% (Florida: 19.2%)
> Residents under 65, VA coverage (or multiple types): 0.2% (Florida: 1.6%)
> Residents under 65, employer-based insurance (or multiple types): 20.5% (Florida: 50.6%)
> Residents under 65, direct-purchase insurance (or multiple types): 7.0% (Florida: 14.5%)
> Residents under 65, Tricare/military insurance (or many types): 0.1% (Florida: 2.7%)
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Georgia: 30093
> Location: Norcross, Georgia
> Residents under 65, no health insurance: 40.0% (Georgia: 15.2%)
> Residents under 65, Medicare coverage (or multiple types): 1.5% (Georgia: 3.0%)
> Residents under 65, Medicaid coverage (or multiple types): 24.2% (Georgia: 17.9%)
> Residents under 65, VA coverage (or multiple types): 0.7% (Georgia: 1.5%)
> Residents under 65, employer-based insurance (or multiple types): 27.8% (Georgia: 56.9%)
> Residents under 65, direct-purchase insurance (or multiple types): 8.5% (Georgia: 10.2%)
> Residents under 65, Tricare/military insurance (or many types): 0.5% (Georgia: 3.4%)
Hawaii: 96796
> Location: Waimea (Kauai County), Hawaii
> Residents under 65, no health insurance: 11.4% (Hawaii: 4.6%)
> Residents under 65, Medicare coverage (or multiple types): 1.4% (Hawaii: 1.8%)
> Residents under 65, Medicaid coverage (or multiple types): 19.9% (Hawaii: 19.0%)
> Residents under 65, VA coverage (or multiple types): 0.2% (Hawaii: 1.5%)
> Residents under 65, employer-based insurance (or multiple types): 62.7% (Hawaii: 66.3%)
> Residents under 65, direct-purchase insurance (or multiple types): 10.1% (Hawaii: 9.5%)
> Residents under 65, Tricare/military insurance (or many types): 0.7% (Hawaii: 8.8%)
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Idaho: 83540
> Location: Lapwai, Idaho
> Residents under 65, no health insurance: 28.3% (Idaho: 12.4%)
> Residents under 65, Medicare coverage (or multiple types): 5.3% (Idaho: 2.8%)
> Residents under 65, Medicaid coverage (or multiple types): 20.7% (Idaho: 18.2%)
> Residents under 65, VA coverage (or multiple types): 0.8% (Idaho: 1.6%)
> Residents under 65, employer-based insurance (or multiple types): 45.8% (Idaho: 57.4%)
> Residents under 65, direct-purchase insurance (or multiple types): 6.6% (Idaho: 13.8%)
> Residents under 65, Tricare/military insurance (or many types): 0.5% (Idaho: 2.5%)
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Illinois: 61911
> Location: Arthur, Illinois
> Residents under 65, no health insurance: 45.0% (Illinois: 7.9%)
> Residents under 65, Medicare coverage (or multiple types): 1.3% (Illinois: 2.4%)
> Residents under 65, Medicaid coverage (or multiple types): 14.8% (Illinois: 21.0%)
> Residents under 65, VA coverage (or multiple types): 0.5% (Illinois: 0.8%)
> Residents under 65, employer-based insurance (or multiple types): 34.4% (Illinois: 63.6%)
> Residents under 65, direct-purchase insurance (or multiple types): 5.8% (Illinois: 9.5%)
> Residents under 65, Tricare/military insurance (or many types): 0.3% (Illinois: 0.9%)
Indiana: 46571
> Location: Topeka, Indiana
> Residents under 65, no health insurance: 72.0% (Indiana: 9.8%)
> Residents under 65, Medicare coverage (or multiple types): 1.0% (Indiana: 3.2%)
> Residents under 65, Medicaid coverage (or multiple types): 5.2% (Indiana: 19.1%)
> Residents under 65, VA coverage (or multiple types): 0.0% reported (Indiana: 1.2%)
> Residents under 65, employer-based insurance (or multiple types): 20.2% (Indiana: 64.2%)
> Residents under 65, direct-purchase insurance (or multiple types): 3.5% (Indiana: 8.8%)
> Residents under 65, Tricare/military insurance (or many types): 0.0% reported (Indiana: 1.2%)
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Iowa: 52590
> Location: Seymour, Iowa
> Residents under 65, no health insurance: 36.9% (Iowa: 5.5%)
> Residents under 65, Medicare coverage (or multiple types): 2.9% (Iowa: 2.5%)
> Residents under 65, Medicaid coverage (or multiple types): 35.8% (Iowa: 20.4%)
> Residents under 65, VA coverage (or multiple types): 0.7% (Iowa: 1.1%)
> Residents under 65, employer-based insurance (or multiple types): 27.2% (Iowa: 67.4%)
> Residents under 65, direct-purchase insurance (or multiple types): 4.5% (Iowa: 10.6%)
> Residents under 65, Tricare/military insurance (or many types): 1.4% (Iowa: 1.3%)
Kansas: 66105
> Location: Kansas City, Kansas
> Residents under 65, no health insurance: 40.9% (Kansas: 10.3%)
> Residents under 65, Medicare coverage (or multiple types): 3.8% (Kansas: 2.7%)
> Residents under 65, Medicaid coverage (or multiple types): 38.7% (Kansas: 14.5%)
> Residents under 65, VA coverage (or multiple types): 1.6% (Kansas: 1.4%)
> Residents under 65, employer-based insurance (or multiple types): 16.1% (Kansas: 65.2%)
> Residents under 65, direct-purchase insurance (or multiple types): 1.5% (Kansas: 11.4%)
> Residents under 65, Tricare/military insurance (or many types): 0.3% (Kansas: 3.4%)
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Kentucky: 42266
> Location: Pembroke, Kentucky
> Residents under 65, no health insurance: 31.4% (Kentucky: 6.7%)
> Residents under 65, Medicare coverage (or multiple types): 5.1% (Kentucky: 5.0%)
> Residents under 65, Medicaid coverage (or multiple types): 13.0% (Kentucky: 28.5%)
> Residents under 65, VA coverage (or multiple types): 5.4% (Kentucky: 1.5%)
> Residents under 65, employer-based insurance (or multiple types): 35.9% (Kentucky: 57.3%)
> Residents under 65, direct-purchase insurance (or multiple types): 8.3% (Kentucky: 8.2%)
> Residents under 65, Tricare/military insurance (or many types): 13.3% (Kentucky: 2.3%)
Louisiana: 71366
> Location: St. Joseph, Louisiana
> Residents under 65, no health insurance: 25.3% (Louisiana: 11.0%)
> Residents under 65, Medicare coverage (or multiple types): 6.3% (Louisiana: 4.0%)
> Residents under 65, Medicaid coverage (or multiple types): 39.2% (Louisiana: 28.4%)
> Residents under 65, VA coverage (or multiple types): 0.9% (Louisiana: 1.3%)
> Residents under 65, employer-based insurance (or multiple types): 26.6% (Louisiana: 52.3%)
> Residents under 65, direct-purchase insurance (or multiple types): 11.4% (Louisiana: 9.6%)
> Residents under 65, Tricare/military insurance (or many types): 0.9% (Louisiana: 2.2%)
Maine: 04988
> Location: Unity, Maine
> Residents under 65, no health insurance: 26.3% (Maine: 9.8%)
> Residents under 65, Medicare coverage (or multiple types): 1.3% (Maine: 4.5%)
> Residents under 65, Medicaid coverage (or multiple types): 15.6% (Maine: 19.3%)
> Residents under 65, VA coverage (or multiple types): 2.2% (Maine: 1.8%)
> Residents under 65, employer-based insurance (or multiple types): 45.5% (Maine: 61.5%)
> Residents under 65, direct-purchase insurance (or multiple types): 10.9% (Maine: 11.0%)
> Residents under 65, Tricare/military insurance (or many types): 1.2% (Maine: 2.3%)
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Maryland: 20783
> Location: Langley Park, Maryland
> Residents under 65, no health insurance: 32.6% (Maryland: 6.9%)
> Residents under 65, Medicare coverage (or multiple types): 1.1% (Maryland: 2.6%)
> Residents under 65, Medicaid coverage (or multiple types): 30.4% (Maryland: 19.1%)
> Residents under 65, VA coverage (or multiple types): 0.6% (Maryland: 1.2%)
> Residents under 65, employer-based insurance (or multiple types): 31.0% (Maryland: 65.7%)
> Residents under 65, direct-purchase insurance (or multiple types): 6.6% (Maryland: 9.6%)
> Residents under 65, Tricare/military insurance (or many types): 0.2% (Maryland: 3.1%)
Massachusetts: 02601
> Location: Barnstable Town, Massachusetts
> Residents under 65, no health insurance: 10.3% (Massachusetts: 3.2%)
> Residents under 65, Medicare coverage (or multiple types): 4.2% (Massachusetts: 2.5%)
> Residents under 65, Medicaid coverage (or multiple types): 47.0% (Massachusetts: 24.0%)
> Residents under 65, VA coverage (or multiple types): 0.5% (Massachusetts: 0.6%)
> Residents under 65, employer-based insurance (or multiple types): 36.9% (Massachusetts: 67.5%)
> Residents under 65, direct-purchase insurance (or multiple types): 7.2% (Massachusetts: 9.9%)
> Residents under 65, Tricare/military insurance (or many types): 1.4% (Massachusetts: 0.8%)
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Michigan: 49255
> Location: Montgomery, Michigan
> Residents under 65, no health insurance: 40.5% (Michigan: 6.5%)
> Residents under 65, Medicare coverage (or multiple types): 1.9% (Michigan: 3.7%)
> Residents under 65, Medicaid coverage (or multiple types): 21.6% (Michigan: 24.2%)
> Residents under 65, VA coverage (or multiple types): 0.5% (Michigan: 1.0%)
> Residents under 65, employer-based insurance (or multiple types): 35.7% (Michigan: 63.3%)
> Residents under 65, direct-purchase insurance (or multiple types): 3.1% (Michigan: 9.1%)
> Residents under 65, Tricare/military insurance (or many types): 0.4% (Michigan: 0.9%)
Minnesota: 56671
> Location: Red Lake, Minnesota
> Residents under 65, no health insurance: 31.8% (Minnesota: 5.2%)
> Residents under 65, Medicare coverage (or multiple types): 2.8% (Minnesota: 2.1%)
> Residents under 65, Medicaid coverage (or multiple types): 45.6% (Minnesota: 19.4%)
> Residents under 65, VA coverage (or multiple types): 1.1% (Minnesota: 1.0%)
> Residents under 65, employer-based insurance (or multiple types): 19.8% (Minnesota: 68.6%)
> Residents under 65, direct-purchase insurance (or multiple types): 0.8% (Minnesota: 9.9%)
> Residents under 65, Tricare/military insurance (or many types): 0.3% (Minnesota: 1.0%)
Mississippi: 38841
> Location: Ecru, Mississippi
> Residents under 65, no health insurance: 31.5% (Mississippi: 14.5%)
> Residents under 65, Medicare coverage (or multiple types): 4.6% (Mississippi: 4.7%)
> Residents under 65, Medicaid coverage (or multiple types): 22.1% (Mississippi: 25.1%)
> Residents under 65, VA coverage (or multiple types): 0.4% (Mississippi: 1.4%)
> Residents under 65, employer-based insurance (or multiple types): 40.5% (Mississippi: 51.2%)
> Residents under 65, direct-purchase insurance (or multiple types): 6.5% (Mississippi: 9.5%)
> Residents under 65, Tricare/military insurance (or many types): 1.8% (Mississippi: 3.0%)
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Missouri: 64648
> Location: Jamesport, Missouri
> Residents under 65, no health insurance: 57.6% (Missouri: 11.1%)
> Residents under 65, Medicare coverage (or multiple types): 1.9% (Missouri: 3.8%)
> Residents under 65, Medicaid coverage (or multiple types): 11.3% (Missouri: 15.8%)
> Residents under 65, VA coverage (or multiple types): 0.7% (Missouri: 1.4%)
> Residents under 65, employer-based insurance (or multiple types): 22.3% (Missouri: 62.9%)
> Residents under 65, direct-purchase insurance (or multiple types): 9.9% (Missouri: 10.5%)
> Residents under 65, Tricare/military insurance (or many types): 0.3% (Missouri: 2.0%)
Montana: 59417
> Location: North Browning, Montana
> Residents under 65, no health insurance: 54.5% (Montana: 10.9%)
> Residents under 65, Medicare coverage (or multiple types): 1.5% (Montana: 3.0%)
> Residents under 65, Medicaid coverage (or multiple types): 29.9% (Montana: 21.4%)
> Residents under 65, VA coverage (or multiple types): 0.6% (Montana: 2.1%)
> Residents under 65, employer-based insurance (or multiple types): 13.4% (Montana: 54.9%)
> Residents under 65, direct-purchase insurance (or multiple types): 2.6% (Montana: 13.9%)
> Residents under 65, Tricare/military insurance (or many types): 0.1% (Montana: 3.0%)
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Nebraska: 68039
> Location: Macy, Nebraska
> Residents under 65, no health insurance: 39.6% (Nebraska: 9.5%)
> Residents under 65, Medicare coverage (or multiple types): 2.0% (Nebraska: 2.2%)
> Residents under 65, Medicaid coverage (or multiple types): 36.4% (Nebraska: 13.4%)
> Residents under 65, VA coverage (or multiple types): 0.7% (Nebraska: 1.4%)
> Residents under 65, employer-based insurance (or multiple types): 23.6% (Nebraska: 66.1%)
> Residents under 65, direct-purchase insurance (or multiple types): 0.7% (Nebraska: 12.9%)
> Residents under 65, Tricare/military insurance (or many types): 0.0% reported (Nebraska: 2.7%)
Nevada: 89030
> Location: North Las Vegas, Nevada
> Residents under 65, no health insurance: 27.1% (Nevada: 12.9%)
> Residents under 65, Medicare coverage (or multiple types): 2.6% (Nevada: 2.5%)
> Residents under 65, Medicaid coverage (or multiple types): 40.5% (Nevada: 20.0%)
> Residents under 65, VA coverage (or multiple types): 0.7% (Nevada: 1.7%)
> Residents under 65, employer-based insurance (or multiple types): 31.2% (Nevada: 58.7%)
> Residents under 65, direct-purchase insurance (or multiple types): 3.4% (Nevada: 9.1%)
> Residents under 65, Tricare/military insurance (or many types): 0.7% (Nevada: 2.7%)
New Hampshire: 03816
> Location: Center Tuftonboro, New Hampshire
> Residents under 65, no health insurance: 26.5% (New Hampshire: 7.1%)
> Residents under 65, Medicare coverage (or multiple types): 4.1% (New Hampshire: 3.2%)
> Residents under 65, Medicaid coverage (or multiple types): 19.3% (New Hampshire: 14.6%)
> Residents under 65, VA coverage (or multiple types): 0.4% (New Hampshire: 1.3%)
> Residents under 65, employer-based insurance (or multiple types): 46.5% (New Hampshire: 69.8%)
> Residents under 65, direct-purchase insurance (or multiple types): 13.1% (New Hampshire: 9.3%)
> Residents under 65, Tricare/military insurance (or many types): 0.4% (New Hampshire: 1.5%)
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New Jersey: 07105
> Location: Newark, New Jersey
> Residents under 65, no health insurance: 36.8% (New Jersey: 9.0%)
> Residents under 65, Medicare coverage (or multiple types): 2.2% (New Jersey: 2.4%)
> Residents under 65, Medicaid coverage (or multiple types): 27.4% (New Jersey: 17.7%)
> Residents under 65, VA coverage (or multiple types): 0.1% (New Jersey: 0.4%)
> Residents under 65, employer-based insurance (or multiple types): 31.3% (New Jersey: 66.5%)
> Residents under 65, direct-purchase insurance (or multiple types): 6.0% (New Jersey: 8.9%)
> Residents under 65, Tricare/military insurance (or many types): 0.2% (New Jersey: 0.7%)
New Mexico: 87001
> Location: San Felipe Pueblo, New Mexico
> Residents under 65, no health insurance: 46.7% (New Mexico: 11.4%)
> Residents under 65, Medicare coverage (or multiple types): 3.9% (New Mexico: 3.6%)
> Residents under 65, Medicaid coverage (or multiple types): 30.4% (New Mexico: 35.6%)
> Residents under 65, VA coverage (or multiple types): 0.2% (New Mexico: 1.7%)
> Residents under 65, employer-based insurance (or multiple types): 24.4% (New Mexico: 46.4%)
> Residents under 65, direct-purchase insurance (or multiple types): 2.5% (New Mexico: 8.0%)
> Residents under 65, Tricare/military insurance (or many types): 0.0% reported (New Mexico: 3.3%)
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New York: 14726
> Location: Conewango Valley, New York
> Residents under 65, no health insurance: 57.9% (New York: 6.7%)
> Residents under 65, Medicare coverage (or multiple types): 1.2% (New York: 2.8%)
> Residents under 65, Medicaid coverage (or multiple types): 17.8% (New York: 26.9%)
> Residents under 65, VA coverage (or multiple types): 0.9% (New York: 0.6%)
> Residents under 65, employer-based insurance (or multiple types): 21.1% (New York: 59.7%)
> Residents under 65, direct-purchase insurance (or multiple types): 6.2% (New York: 10.8%)
> Residents under 65, Tricare/military insurance (or many types): 0.2% (New York: 0.7%)
North Carolina: 28747
> Location: Lake Toxaway, North Carolina
> Residents under 65, no health insurance: 45.8% (North Carolina: 12.6%)
> Residents under 65, Medicare coverage (or multiple types): 2.5% (North Carolina: 3.5%)
> Residents under 65, Medicaid coverage (or multiple types): 19.3% (North Carolina: 19.4%)
> Residents under 65, VA coverage (or multiple types): 0.3% (North Carolina: 1.7%)
> Residents under 65, employer-based insurance (or multiple types): 28.6% (North Carolina: 55.9%)
> Residents under 65, direct-purchase insurance (or multiple types): 9.2% (North Carolina: 11.7%)
> Residents under 65, Tricare/military insurance (or many types): 1.2% (North Carolina: 3.8%)
North Dakota: 58329
> Location: Dunseith, North Dakota
> Residents under 65, no health insurance: 35.1% (North Dakota: 8.5%)
> Residents under 65, Medicare coverage (or multiple types): 2.4% (North Dakota: 2.1%)
> Residents under 65, Medicaid coverage (or multiple types): 38.6% (North Dakota: 11.4%)
> Residents under 65, VA coverage (or multiple types): 0.0% reported (North Dakota: 1.4%)
> Residents under 65, employer-based insurance (or multiple types): 21.5% (North Dakota: 67.6%)
> Residents under 65, direct-purchase insurance (or multiple types): 4.6% (North Dakota: 14.3%)
> Residents under 65, Tricare/military insurance (or many types): 0.7% (North Dakota: 3.4%)
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Ohio: 44627
> Location: Fredericksburg, Ohio
> Residents under 65, no health insurance: 75.0% (Ohio: 7.2%)
> Residents under 65, Medicare coverage (or multiple types): 0.3% (Ohio: 3.3%)
> Residents under 65, Medicaid coverage (or multiple types): 4.6% (Ohio: 22.8%)
> Residents under 65, VA coverage (or multiple types): 0.0% reported (Ohio: 1.2%)
> Residents under 65, employer-based insurance (or multiple types): 15.7% (Ohio: 64.0%)
> Residents under 65, direct-purchase insurance (or multiple types): 4.9% (Ohio: 7.8%)
> Residents under 65, Tricare/military insurance (or many types): 0.0% reported (Ohio: 1.2%)
Oklahoma: 74964
> Location: Watts, Oklahoma
> Residents under 65, no health insurance: 35.3% (Oklahoma: 16.5%)
> Residents under 65, Medicare coverage (or multiple types): 8.8% (Oklahoma: 3.9%)
> Residents under 65, Medicaid coverage (or multiple types): 26.5% (Oklahoma: 18.8%)
> Residents under 65, VA coverage (or multiple types): 0.9% (Oklahoma: 1.8%)
> Residents under 65, employer-based insurance (or multiple types): 27.2% (Oklahoma: 54.4%)
> Residents under 65, direct-purchase insurance (or multiple types): 10.5% (Oklahoma: 9.9%)
> Residents under 65, Tricare/military insurance (or many types): 1.0% (Oklahoma: 3.1%)
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Oregon: 97824
> Location: Cove, Oregon
> Residents under 65, no health insurance: 22.3% (Oregon: 8.0%)
> Residents under 65, Medicare coverage (or multiple types): 2.7% (Oregon: 2.8%)
> Residents under 65, Medicaid coverage (or multiple types): 19.8% (Oregon: 24.7%)
> Residents under 65, VA coverage (or multiple types): 3.3% (Oregon: 1.6%)
> Residents under 65, employer-based insurance (or multiple types): 49.9% (Oregon: 59.2%)
> Residents under 65, direct-purchase insurance (or multiple types): 11.7% (Oregon: 11.0%)
> Residents under 65, Tricare/military insurance (or many types): 3.7% (Oregon: 1.4%)
Pennsylvania: 16256
> Location: Smicksburg, Pennsylvania
> Residents under 65, no health insurance: 64.4% (Pennsylvania: 6.8%)
> Residents under 65, Medicare coverage (or multiple types): 0.2% (Pennsylvania: 3.2%)
> Residents under 65, Medicaid coverage (or multiple types): 11.6% (Pennsylvania: 21.1%)
> Residents under 65, VA coverage (or multiple types): 0.0% reported (Pennsylvania: 1.0%)
> Residents under 65, employer-based insurance (or multiple types): 21.4% (Pennsylvania: 65.2%)
> Residents under 65, direct-purchase insurance (or multiple types): 3.7% (Pennsylvania: 10.2%)
> Residents under 65, Tricare/military insurance (or many types): 0.1% (Pennsylvania: 1.0%)
Rhode Island: 02863
> Location: Central Falls, Rhode Island
> Residents under 65, no health insurance: 18.2% (Rhode Island: 5.3%)
> Residents under 65, Medicare coverage (or multiple types): 5.5% (Rhode Island: 3.4%)
> Residents under 65, Medicaid coverage (or multiple types): 51.7% (Rhode Island: 23.2%)
> Residents under 65, VA coverage (or multiple types): 0.4% (Rhode Island: 1.0%)
> Residents under 65, employer-based insurance (or multiple types): 26.8% (Rhode Island: 64.1%)
> Residents under 65, direct-purchase insurance (or multiple types): 5.2% (Rhode Island: 10.8%)
> Residents under 65, Tricare/military insurance (or many types): 0.4% (Rhode Island: 1.4%)
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South Carolina: 29470
> Location: Ravenel, South Carolina
> Residents under 65, no health insurance: 32.3% (South Carolina: 12.6%)
> Residents under 65, Medicare coverage (or multiple types): 5.2% (South Carolina: 3.8%)
> Residents under 65, Medicaid coverage (or multiple types): 21.3% (South Carolina: 20.7%)
> Residents under 65, VA coverage (or multiple types): 0.5% (South Carolina: 1.8%)
> Residents under 65, employer-based insurance (or multiple types): 41.0% (South Carolina: 56.5%)
> Residents under 65, direct-purchase insurance (or multiple types): 8.5% (South Carolina: 10.4%)
> Residents under 65, Tricare/military insurance (or many types): 1.6% (South Carolina: 3.7%)
South Dakota: 57339
> Location: Fort Thompson, South Dakota
> Residents under 65, no health insurance: 46.2% (South Dakota: 11.2%)
> Residents under 65, Medicare coverage (or multiple types): 6.2% (South Dakota: 2.7%)
> Residents under 65, Medicaid coverage (or multiple types): 39.4% (South Dakota: 15.3%)
> Residents under 65, VA coverage (or multiple types): 1.2% (South Dakota: 1.9%)
> Residents under 65, employer-based insurance (or multiple types): 9.4% (South Dakota: 61.1%)
> Residents under 65, direct-purchase insurance (or multiple types): 1.5% (South Dakota: 13.7%)
> Residents under 65, Tricare/military insurance (or many types): 0.7% (South Dakota: 3.4%)
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Tennessee: 37097
> Location: Lobelville, Tennessee
> Residents under 65, no health insurance: 31.1% (Tennessee: 11.4%)
> Residents under 65, Medicare coverage (or multiple types): 3.9% (Tennessee: 3.8%)
> Residents under 65, Medicaid coverage (or multiple types): 33.7% (Tennessee: 21.6%)
> Residents under 65, VA coverage (or multiple types): 0.3% (Tennessee: 1.6%)
> Residents under 65, employer-based insurance (or multiple types): 31.3% (Tennessee: 57.8%)
> Residents under 65, direct-purchase insurance (or multiple types): 5.4% (Tennessee: 10.1%)
> Residents under 65, Tricare/military insurance (or many types): 0.4% (Tennessee: 2.7%)
Texas: 78594
> Location: Sebastian, Texas
> Residents under 65, no health insurance: 48.0% (Texas: 19.4%)
> Residents under 65, Medicare coverage (or multiple types): 4.2% (Texas: 2.2%)
> Residents under 65, Medicaid coverage (or multiple types): 31.6% (Texas: 17.2%)
> Residents under 65, VA coverage (or multiple types): 0.7% (Texas: 1.3%)
> Residents under 65, employer-based insurance (or multiple types): 18.0% (Texas: 54.5%)
> Residents under 65, direct-purchase insurance (or multiple types): 2.9% (Texas: 9.4%)
> Residents under 65, Tricare/military insurance (or many types): 0.0% reported (Texas: 2.3%)
Utah: 84026
> Location: Fort Duchesne, Utah
> Residents under 65, no health insurance: 53.6% (Utah: 10.4%)
> Residents under 65, Medicare coverage (or multiple types): 2.0% (Utah: 1.5%)
> Residents under 65, Medicaid coverage (or multiple types): 19.4% (Utah: 10.7%)
> Residents under 65, VA coverage (or multiple types): 0.5% (Utah: 0.8%)
> Residents under 65, employer-based insurance (or multiple types): 22.7% (Utah: 68.4%)
> Residents under 65, direct-purchase insurance (or multiple types): 6.4% (Utah: 12.5%)
> Residents under 65, Tricare/military insurance (or many types): 0.0% reported (Utah: 1.8%)
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Vermont: 05843
> Location: Hardwick, Vermont
> Residents under 65, no health insurance: 13.5% (Vermont: 4.8%)
> Residents under 65, Medicare coverage (or multiple types): 14.2% (Vermont: 3.8%)
> Residents under 65, Medicaid coverage (or multiple types): 39.1% (Vermont: 27.1%)
> Residents under 65, VA coverage (or multiple types): 0.2% (Vermont: 1.2%)
> Residents under 65, employer-based insurance (or multiple types): 50.3% (Vermont: 60.5%)
> Residents under 65, direct-purchase insurance (or multiple types): 8.9% (Vermont: 10.1%)
> Residents under 65, Tricare/military insurance (or many types): 0.2% (Vermont: 1.6%)
Virginia: 23421
> Location: Parksley, Virginia
> Residents under 65, no health insurance: 34.3% (Virginia: 10.0%)
> Residents under 65, Medicare coverage (or multiple types): 1.4% (Virginia: 2.7%)
> Residents under 65, Medicaid coverage (or multiple types): 25.7% (Virginia: 12.6%)
> Residents under 65, VA coverage (or multiple types): 1.1% (Virginia: 2.1%)
> Residents under 65, employer-based insurance (or multiple types): 36.4% (Virginia: 63.9%)
> Residents under 65, direct-purchase insurance (or multiple types): 4.2% (Virginia: 11.0%)
> Residents under 65, Tricare/military insurance (or many types): 0.7% (Virginia: 7.1%)
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Washington: 99349
> Location: Mattawa, Washington
> Residents under 65, no health insurance: 31.9% (Washington: 7.3%)
> Residents under 65, Medicare coverage (or multiple types): 0.3% (Washington: 2.5%)
> Residents under 65, Medicaid coverage (or multiple types): 44.1% (Washington: 22.0%)
> Residents under 65, VA coverage (or multiple types): 0.1% (Washington: 1.6%)
> Residents under 65, employer-based insurance (or multiple types): 20.9% (Washington: 62.3%)
> Residents under 65, direct-purchase insurance (or multiple types): 3.4% (Washington: 9.7%)
> Residents under 65, Tricare/military insurance (or many types): 0.5% (Washington: 3.6%)
West Virginia: 25159
> Location: Poca, West Virginia
> Residents under 65, no health insurance: 19.0% (West Virginia: 7.4%)
> Residents under 65, Medicare coverage (or multiple types): 3.4% (West Virginia: 5.4%)
> Residents under 65, Medicaid coverage (or multiple types): 28.5% (West Virginia: 30.3%)
> Residents under 65, VA coverage (or multiple types): 1.7% (West Virginia: 1.8%)
> Residents under 65, employer-based insurance (or multiple types): 50.0% (West Virginia: 57.1%)
> Residents under 65, direct-purchase insurance (or multiple types): 2.3% (West Virginia: 6.4%)
> Residents under 65, Tricare/military insurance (or many types): 1.3% (West Virginia: 1.6%)
Wisconsin: 54422
> Location: Curtiss, Wisconsin
> Residents under 65, no health insurance: 47.6% (Wisconsin: 6.4%)
> Residents under 65, Medicare coverage (or multiple types): 0.9% (Wisconsin: 2.7%)
> Residents under 65, Medicaid coverage (or multiple types): 12.1% (Wisconsin: 18.0%)
> Residents under 65, VA coverage (or multiple types): 0.5% (Wisconsin: 1.1%)
> Residents under 65, employer-based insurance (or multiple types): 35.1% (Wisconsin: 69.1%)
> Residents under 65, direct-purchase insurance (or multiple types): 7.2% (Wisconsin: 9.4%)
> Residents under 65, Tricare/military insurance (or many types): 0.2% (Wisconsin: 1.0%)
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Wyoming: 82514
> Location: Fort Washakie, Wyoming
> Residents under 65, no health insurance: 38.1% (Wyoming: 13.5%)
> Residents under 65, Medicare coverage (or multiple types): 3.7% (Wyoming: 2.3%)
> Residents under 65, Medicaid coverage (or multiple types): 32.2% (Wyoming: 12.1%)
> Residents under 65, VA coverage (or multiple types): 1.4% (Wyoming: 1.8%)
> Residents under 65, employer-based insurance (or multiple types): 26.9% (Wyoming: 64.1%)
> Residents under 65, direct-purchase insurance (or multiple types): 0.5% (Wyoming: 11.4%)
> Residents under 65, Tricare/military insurance (or many types): 0.1% (Wyoming: 3.0%)
Methodology
To determine the ZIP code with the worst health insurance coverage in every state, 24/7 Wall St. reviewed five-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 used ZIP Code Tabulation Areas — a census geography type that defines areal representations of United States Postal Service ZIP codes (USPS ZIP codes do not define geographic boundaries but instead are a network of mail delivery routes in a service area). We refer to Census ZCTAs as ZIP codes.
Of the 33,120 ZIP codes the Census publishes data for, 32,936 had boundaries that fell within one of the 50 states, while the rest were in the District of Columbia or Puerto Rico.
ZIP codes were excluded if the noninstitutionalized civilian population under 65 was less than 1,000, or if the sampling error associated with a ZIP code’s data was deemed too high.
The sampling error was defined as too high if the coefficient of variation — a statistical assessment of how reliable an estimate is — for a ZIP code’s under 65 uninsured rate was above 15% and greater than two standard deviations above the mean CV for all ZIP codes’ under 65 uninsured rates. We similarly excluded ZIP codes that had a sampling error too high for their under 65 noninstitutionalized civilian population, using the same definition.
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 doesn’t publish insurance coverage estimates specifically for the under 65 age group, we aggregated the data from more granular age breakouts.
To ensure each aggregate estimate’s sampling error could be assessed using the definition above, we derived a margin of error for each aggregate estimate using the successive differences replication variance estimation methodology recommended and used by the U.S. Census Bureau.
The remaining 19,534 places were ranked within their state based on their under 65 uninsured rates. To break ties, we used the number of insured people in the same population group.
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 five-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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