Data / Rankings / Uninsured rate, ages 18 to 64 (US model-based estimate) / Counties in Iowa

Counties in Iowa by uninsured rate, ages 18 to 64 (US model-based estimate)

Buena Vista County had the highest uninsured rate, ages 18 to 64 (US model-based estimate) of 99 counties in 2020, at 13.8%. Bremer County had the lowest, at 4.3%. The median was 7.1% and the figure for Iowa was 7%. Source: the U.S. Census Bureau.

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Highest13.8Buena Vista County
Lowest4.3Bremer County
Median7.199 counties
Iowa7History

Map of counties, 2020

Adair County: 6.6 %Adams County: 7 %Allamakee County: 9.6 %Appanoose County: 7.3 %Audubon County: 8.2 %Benton County: 6 %Black Hawk County: 7.1 %Boone County: 5.8 %Bremer County: 4.3 %Buchanan County: 6.4 %Buena Vista County: 13.8 %Butler County: 6.5 %Calhoun County: 6.7 %Carroll County: 6.1 %Cass County: 9.1 %Cedar County: 5.5 %Cerro Gordo County: 6.4 %Cherokee County: 6.6 %Chickasaw County: 7.2 %Clarke County: 8.9 %Clay County: 8.4 %Clayton County: 8 %Clinton County: 6.8 %Crawford County: 13 %Dallas County: 5.1 %Davis County: 12.6 %Decatur County: 8.4 %Delaware County: 5.8 %Des Moines County: 5.8 %Dickinson County: 6.2 %Dubuque County: 5.8 %Emmet County: 9 %Fayette County: 6.8 %Floyd County: 7.4 %Franklin County: 9.8 %Fremont County: 7.1 %Greene County: 6.7 %Grundy County: 6 %Guthrie County: 7.2 %Hamilton County: 7 %Hancock County: 6.6 %Hardin County: 7.7 %Harrison County: 7.1 %Henry County: 6.7 %Howard County: 7.3 %Humboldt County: 8 %Ida County: 7.2 %Iowa County: 5.2 %Jackson County: 6.7 %Jasper County: 5.3 %Jefferson County: 9.1 %Johnson County: 6.9 %Jones County: 7.1 %Keokuk County: 6.8 %Kossuth County: 6.6 %Lee County: 6 %Linn County: 6.2 %Louisa County: 9.8 %Lucas County: 6.7 %Lyon County: 7.6 %Madison County: 7 %Mahaska County: 6.8 %Marion County: 4.9 %Marshall County: 11 %Mills County: 5.7 %Mitchell County: 8.2 %Monona County: 7 %Monroe County: 7.4 %Montgomery County: 7.6 %Muscatine County: 7.4 %O'Brien County: 7.1 %Osceola County: 8.7 %Page County: 7 %Palo Alto County: 7.1 %Plymouth County: 7.1 %Pocahontas County: 8.4 %Polk County: 7.1 %Pottawattamie County: 6.6 %Poweshiek County: 6.2 %Ringgold County: 8 %Sac County: 7 %Scott County: 7 %Shelby County: 6.8 %Sioux County: 8.2 %Story County: 6.6 %Tama County: 9.9 %Taylor County: 9.2 %Union County: 7.5 %Van Buren County: 8.8 %Wapello County: 9.2 %Warren County: 5.1 %Washington County: 9.4 %Wayne County: 8.8 %Webster County: 7.3 %Winnebago County: 6.2 %Winneshiek County: 5.1 %Woodbury County: 10 %Worth County: 7.2 %Wright County: 8.2 %
  • Under 6.1
  • 6.1 to 6.7
  • 6.7 to 7.1
  • 7.1 to 7.4
  • 7.4 to 8.8
  • 8.8 and over
%, 2020. Source: U.S. Census Bureau, Small Area Health Insurance Estimates (SAHIE): percent uninsured, ages 18 to 64, all races, both sexes, all income levels, states and counties. Boundaries: U.S. Census Bureau cartographic boundary files.

Top 40 counties, 2020

Buena Vista County: 13.8 %Buena Vista County13.8Crawford County: 13 %Crawford County13Davis County: 12.6 %Davis County12.6Marshall County: 11 %Marshall County11Woodbury County: 10 %Woodbury County10Tama County: 9.9 %Tama County9.9Franklin County: 9.8 %Franklin County9.8Louisa County: 9.8 %Louisa County9.8Allamakee County: 9.6 %Allamakee County9.6Washington County: 9.4 %Washington County9.4Taylor County: 9.2 %Taylor County9.2Wapello County: 9.2 %Wapello County9.2Cass County: 9.1 %Cass County9.1Jefferson County: 9.1 %Jefferson County9.1Emmet County: 9 %Emmet County9Clarke County: 8.9 %Clarke County8.9Van Buren County: 8.8 %Van Buren County8.8Wayne County: 8.8 %Wayne County8.8Osceola County: 8.7 %Osceola County8.7Clay County: 8.4 %Clay County8.4Decatur County: 8.4 %Decatur County8.4Pocahontas County: 8.4 %Pocahontas County8.4Audubon County: 8.2 %Audubon County8.2Mitchell County: 8.2 %Mitchell County8.2Sioux County: 8.2 %Sioux County8.2Wright County: 8.2 %Wright County8.2Clayton County: 8 %Clayton County8Humboldt County: 8 %Humboldt County8Ringgold County: 8 %Ringgold County8Hardin County: 7.7 %Hardin County7.7Lyon County: 7.6 %Lyon County7.6Montgomery County: 7.6 %Montgomery County7.6Union County: 7.5 %Union County7.5Floyd County: 7.4 %Floyd County7.4Monroe County: 7.4 %Monroe County7.4Muscatine County: 7.4 %Muscatine County7.4Appanoose County: 7.3 %Appanoose County7.3Howard County: 7.3 %Howard County7.3Webster County: 7.3 %Webster County7.3Chickasaw County: 7.2 %Chickasaw County7.2Buena Vista County: 13.8 %Buena Vista County13.8Crawford County: 13 %Crawford County13Davis County: 12.6 %Davis County12.6Marshall County: 11 %Marshall County11Woodbury County: 10 %Woodbury County10Tama County: 9.9 %Tama County9.9Franklin County: 9.8 %Franklin County9.8Louisa County: 9.8 %Louisa County9.8Allamakee County: 9.6 %Allamakee County9.6Washington County: 9.4 %Washington County9.4Taylor County: 9.2 %Taylor County9.2Wapello County: 9.2 %Wapello County9.2Cass County: 9.1 %Cass County9.1Jefferson County: 9.1 %Jefferson County9.1Emmet County: 9 %Emmet County9Clarke County: 8.9 %Clarke County8.9Van Buren County: 8.8 %Van Buren County8.8Wayne County: 8.8 %Wayne County8.8Osceola County: 8.7 %Osceola County8.7Clay County: 8.4 %Clay County8.4Decatur County: 8.4 %Decatur County8.4Pocahontas County: 8.4 %Pocahontas County8.4Audubon County: 8.2 %Audubon County8.2Mitchell County: 8.2 %Mitchell County8.2Sioux County: 8.2 %Sioux County8.2Wright County: 8.2 %Wright County8.2Clayton County: 8 %Clayton County8Humboldt County: 8 %Humboldt County8Ringgold County: 8 %Ringgold County8Hardin County: 7.7 %Hardin County7.7Lyon County: 7.6 %Lyon County7.6Montgomery County: 7.6 %Montgomery County7.6Union County: 7.5 %Union County7.5Floyd County: 7.4 %Floyd County7.4Monroe County: 7.4 %Monroe County7.4Muscatine County: 7.4 %Muscatine County7.4Appanoose County: 7.3 %Appanoose County7.3Howard County: 7.3 %Howard County7.3Webster County: 7.3 %Webster County7.3Chickasaw County: 7.2 %Chickasaw County7.2
%. Source: U.S. Census Bureau, Small Area Health Insurance Estimates (SAHIE): percent uninsured, ages 18 to 64, all races, both sexes, all income levels, states and counties. Retrieved 2026-10-12.

Full ranking

RankCounties2020 (%)Change on 2019
1Buena Vista County13.8+1.1 pts
2Crawford County13-1.3 pts
3Davis County12.6+0.1 pts
4Marshall County11+1.4 pts
5Woodbury County10+0.2 pts
6Tama County9.9-0.1 pts
7Franklin County9.8+1.3 pts
7Louisa County9.8-0.7 pts
9Allamakee County9.6-0.8 pts
10Washington County9.4+1.5 pts
11Taylor County9.2-0.7 pts
11Wapello County9.2-0.8 pts
13Cass County9.1+0.3 pts
13Jefferson County9.1-1.3 pts
15Emmet County9+0.6 pts
16Clarke County8.90 pts
17Van Buren County8.8-0.3 pts
17Wayne County8.8-0.7 pts
19Osceola County8.7-0.3 pts
20Clay County8.4+1.2 pts
20Decatur County8.4-0.2 pts
20Pocahontas County8.4+0.1 pts
23Audubon County8.2+0.1 pts
23Mitchell County8.2-0.9 pts
23Sioux County8.2+0.2 pts
23Wright County8.20 pts
27Clayton County8-0.5 pts
27Humboldt County8+1.1 pts
27Ringgold County8-0.3 pts
30Hardin County7.7+0.9 pts
31Lyon County7.6-0.3 pts
31Montgomery County7.6+0.3 pts
33Union County7.5-0.2 pts
34Floyd County7.4-0.2 pts
34Monroe County7.4+0.2 pts
34Muscatine County7.4-0.1 pts
37Appanoose County7.3-0.3 pts
37Howard County7.3+0.1 pts
37Webster County7.3-0.6 pts
40Chickasaw County7.2-0.4 pts
40Guthrie County7.2-0.3 pts
40Ida County7.2+1.1 pts
40Worth County7.2+1.2 pts
44Black Hawk County7.1+0.1 pts
44Fremont County7.1+1 pts
44Harrison County7.1+1 pts
44Jones County7.1+0.5 pts
44O'Brien County7.1-0.3 pts
44Palo Alto County7.1+0.3 pts
44Plymouth County7.1+0.8 pts
44Polk County7.1-0.2 pts
52Adams County7+0.1 pts
52Hamilton County7+0.4 pts
52Madison County7+1 pts
52Monona County7-0.1 pts
52Page County70 pts
52Sac County7+0.4 pts
52Scott County7+0.3 pts
59Johnson County6.9+0.1 pts
60Clinton County6.8+0.4 pts
60Fayette County6.80 pts
60Keokuk County6.8-0.3 pts
60Mahaska County6.8-0.1 pts
60Shelby County6.8+0.1 pts
65Calhoun County6.7+0.7 pts
65Greene County6.7+0.6 pts
65Henry County6.7+0.4 pts
65Jackson County6.7+0.2 pts
65Lucas County6.7-0.1 pts
70Adair County6.6+0.6 pts
70Cherokee County6.6+0.1 pts
70Hancock County6.6+0.5 pts
70Kossuth County6.6+0.9 pts
70Pottawattamie County6.6-0.9 pts
70Story County6.6-0.9 pts
76Butler County6.5+0.3 pts
77Buchanan County6.4+0.4 pts
77Cerro Gordo County6.4+0.7 pts
79Dickinson County6.2+0.8 pts
79Linn County6.2+0.3 pts
79Poweshiek County6.20 pts
79Winnebago County6.2+0.2 pts
83Carroll County6.1+0.6 pts
84Benton County6+0.6 pts
84Grundy County6+1.2 pts
84Lee County6-0.4 pts
87Boone County5.8+0.4 pts
87Delaware County5.8-0.8 pts
87Des Moines County5.8-0.4 pts
87Dubuque County5.8-0.1 pts
91Mills County5.7-0.1 pts
92Cedar County5.5+0.6 pts
93Jasper County5.3-0.1 pts
94Iowa County5.2+0.3 pts
95Dallas County5.1+0.3 pts
95Warren County5.1+0.4 pts
95Winneshiek County5.1-0.4 pts
98Marion County4.9-0.2 pts
99Bremer County4.3-0.2 pts

Other periods

About this ranking

People aged 18 to 64 without health insurance coverage of any kind, as a percentage of all people aged 18 to 64. United States: Census Bureau Small Area Health Insurance Estimates (SAHIE) for states and counties, all races, both sexes and all income levels.

A model-based single-year estimate that combines the American Community Survey with administrative records and population estimates, so every county gets a figure. Covers states and counties only, because the SAHIE dataset files have no national row. The Census Bureau advises comparing years from 2008 on only; 2013 is the updated release. Working-age adults; the rate for everyone under 65 is uninsured_rate_under_65.

Every value in the ranking comes from the same publisher and the same period, so the counties are compared on one definition. Equal values share a rank.

How to cite

U.S. Census Bureau. Small Area Health Insurance Estimates (SAHIE): percent uninsured, ages 18 to 64, all races, both sexes, all income levels, states and counties. https://www2.census.gov/programs-surveys/sahie/datasets/time-series/estimates-acs/sahie-2020-csv.zip. Retrieved 2026-10-12.

Citation styles

The publisher is the author. Invokely is named only as the place the figures were read, where a style asks for it.

APA 7

U.S. Census Bureau. (2026). Small Area Health Insurance Estimates (SAHIE): percent uninsured, ages 18 to 64, all races, both sexes, all income levels, states and counties (Counties in Iowa by uninsured rate, ages 18 to 64 (US model-based estimate), 2020) [Data set]. Retrieved October 12, 2026, from https://www2.census.gov/programs-surveys/sahie/datasets/time-series/estimates-acs/sahie-2020-csv.zip

MLA 9

Small Area Health Insurance Estimates (SAHIE): percent uninsured, ages 18 to 64, all races, both sexes, all income levels, states and counties, Counties in Iowa by uninsured rate, ages 18 to 64 (US model-based estimate), 2020. U.S. Census Bureau, 6 Aug. 2026, https://www2.census.gov/programs-surveys/sahie/datasets/time-series/estimates-acs/sahie-2020-csv.zip. Invokely, https://invokely.ai/rankings/uninsured-rate-ages-18-64/iowa-counties?period=2020. Accessed 12 Oct. 2026.

Chicago (author-date)

U.S. Census Bureau. 2026. Small Area Health Insurance Estimates (SAHIE): percent uninsured, ages 18 to 64, all races, both sexes, all income levels, states and counties. Counties in Iowa by uninsured rate, ages 18 to 64 (US model-based estimate), 2020. Dataset. Accessed October 12, 2026. https://www2.census.gov/programs-surveys/sahie/datasets/time-series/estimates-acs/sahie-2020-csv.zip. Also distributed by Invokely, https://invokely.ai/rankings/uninsured-rate-ages-18-64/iowa-counties?period=2020.

Harvard

U.S. Census Bureau (2026) Small Area Health Insurance Estimates (SAHIE): percent uninsured, ages 18 to 64, all races, both sexes, all income levels, states and counties, Counties in Iowa by uninsured rate, ages 18 to 64 (US model-based estimate), 2020 [Dataset]. Available at: https://www2.census.gov/programs-surveys/sahie/datasets/time-series/estimates-acs/sahie-2020-csv.zip, via Invokely: https://invokely.ai/rankings/uninsured-rate-ages-18-64/iowa-counties?period=2020 (Accessed: 12 October 2026).

BibTeX
@misc{census_counties_in_iowa_by_2020,
  author = {{U.S. Census Bureau}},
  title = {{Small Area Health Insurance Estimates (SAHIE): percent uninsured, ages 18 to 64, all races, both sexes, all income levels, states and counties: Counties in Iowa by uninsured rate, ages 18 to 64 (US model-based estimate), 2020}},
  year = {2026},
  howpublished = {Data set},
  url = {https://www2.census.gov/programs-surveys/sahie/datasets/time-series/estimates-acs/sahie-2020-csv.zip},
  urldate = {2026-10-12},
  note = {Accessed via Invokely, https://invokely.ai/rankings/uninsured-rate-ages-18-64/iowa-counties?period=2020. Publisher attribution: U.S. Census Bureau. Small Area Health Insurance Estimates (SAHIE): percent uninsured, ages 18 to 64, all races, both sexes, all income levels, states and counties. https://www2.census.gov/programs-surveys/sahie/datasets/time-series/estimates-acs/sahie-2020-csv.zip. Retrieved 2026-10-12.},
}
RIS
TY  - DATA
AU  - U.S. Census Bureau
TI  - Small Area Health Insurance Estimates (SAHIE): percent uninsured, ages 18 to 64, all races, both sexes, all income levels, states and counties: Counties in Iowa by uninsured rate, ages 18 to 64 (US model-based estimate), 2020
PY  - 2026
DA  - 2026/08/06
PB  - U.S. Census Bureau
DB  - Invokely
UR  - https://www2.census.gov/programs-surveys/sahie/datasets/time-series/estimates-acs/sahie-2020-csv.zip
L2  - https://invokely.ai/rankings/uninsured-rate-ages-18-64/iowa-counties?period=2020
Y2  - 2026/10/12
N1  - Accessed via Invokely, https://invokely.ai/rankings/uninsured-rate-ages-18-64/iowa-counties?period=2020.
N1  - Publisher attribution: U.S. Census Bureau. Small Area Health Insurance Estimates (SAHIE): percent uninsured, ages 18 to 64, all races, both sexes, all income levels, states and counties. https://www2.census.gov/programs-surveys/sahie/datasets/time-series/estimates-acs/sahie-2020-csv.zip. Retrieved 2026-10-12.
ER  -
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Questions

Which county has the highest uninsured rate, ages 18 to 64 (US model-based estimate)?

Buena Vista County, with 13.8% in 2020, according to the U.S. Census Bureau.

Which county has the lowest uninsured rate, ages 18 to 64 (US model-based estimate)?

Bremer County, with 4.3% in 2020.

Where does this ranking come from?

Every value comes from one source and one period, so the places are comparable: U.S. Census Bureau, Small Area Health Insurance Estimates (SAHIE): percent uninsured, ages 18 to 64, all races, both sexes, all income levels, states and counties. Retrieved 2026-10-12.

Uninsured rate, ages 18 to 64 (US model-based estimate): other rankings

Counties in Iowa: more rankings