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

US counties by uninsured rate, ages 18 to 64 (US model-based estimate)

Hidalgo County had the highest uninsured rate, ages 18 to 64 (US model-based estimate) of 3132 counties in 2018, at 42.8%. Los Alamos County had the lowest, at 2.7%. The median was 12.5%. Source: the U.S. Census Bureau.

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Highest42.8Hidalgo County
Lowest2.7Los Alamos County
Median12.53132 counties

Map of counties, 2018

%, 2018. Hatched areas have no value for this period. 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, 2018

Hidalgo County: 42.8 %Hidalgo County42.8Presidio County: 39.7 %Presidio County39.7Webb County: 39.5 %Webb County39.5Starr County: 39 %Starr County39Cameron County: 38.9 %Cameron County38.9Zapata County: 38.4 %Zapata County38.4Gaines County: 37.4 %Gaines County37.4Maverick County: 36.6 %Maverick County36.6Bailey County: 35.8 %Bailey County35.8Castro County: 35.8 %Castro County35.8Dallam County: 35.6 %Dallam County35.6Collingsworth County: 34.6 %Collingsworth County34.6Hendry County: 34.6 %Hendry County34.6Hall County: 34.2 %Hall County34.2Ochiltree County: 32.6 %Ochiltree County32.6Cochran County: 32.5 %Cochran County32.5Hudspeth County: 32.5 %Hudspeth County32.5Parmer County: 32.4 %Parmer County32.4San Saba County: 32.1 %San Saba County32.1Clark County: 32 %Clark County32Hansford County: 31.9 %Hansford County31.9Kenedy County: 31.9 %Kenedy County31.9Deaf Smith County: 31.8 %Deaf Smith County31.8Sherman County: 31.1 %Sherman County31.1Atkinson County: 31 %Atkinson County31Echols County: 31 %Echols County31Lamb County: 31 %Lamb County31Menard County: 31 %Menard County31Moore County: 31 %Moore County31Gonzales County: 30.9 %Gonzales County30.9Potter County: 30.7 %Potter County30.7Jeff Davis County: 30.4 %Jeff Davis County30.4Mills County: 30.4 %Mills County30.4Terry County: 30.4 %Terry County30.4El Paso County: 30.1 %El Paso County30.1Shelby County: 30.1 %Shelby County30.1Colquitt County: 29.9 %Colquitt County29.9Haskell County: 29.9 %Haskell County29.9DeSoto County: 29.8 %DeSoto County29.8Lipscomb County: 29.8 %Lipscomb County29.8Hidalgo County: 42.8 %Hidalgo County42.8Presidio County: 39.7 %Presidio County39.7Webb County: 39.5 %Webb County39.5Starr County: 39 %Starr County39Cameron County: 38.9 %Cameron County38.9Zapata County: 38.4 %Zapata County38.4Gaines County: 37.4 %Gaines County37.4Maverick County: 36.6 %Maverick County36.6Bailey County: 35.8 %Bailey County35.8Castro County: 35.8 %Castro County35.8Dallam County: 35.6 %Dallam County35.6Collingsworth County: 34.6 %Collingsworth County34.6Hendry County: 34.6 %Hendry County34.6Hall County: 34.2 %Hall County34.2Ochiltree County: 32.6 %Ochiltree County32.6Cochran County: 32.5 %Cochran County32.5Hudspeth County: 32.5 %Hudspeth County32.5Parmer County: 32.4 %Parmer County32.4San Saba County: 32.1 %San Saba County32.1Clark County: 32 %Clark County32Hansford County: 31.9 %Hansford County31.9Kenedy County: 31.9 %Kenedy County31.9Deaf Smith County: 31.8 %Deaf Smith County31.8Sherman County: 31.1 %Sherman County31.1Atkinson County: 31 %Atkinson County31Echols County: 31 %Echols County31Lamb County: 31 %Lamb County31Menard County: 31 %Menard County31Moore County: 31 %Moore County31Gonzales County: 30.9 %Gonzales County30.9Potter County: 30.7 %Potter County30.7Jeff Davis County: 30.4 %Jeff Davis County30.4Mills County: 30.4 %Mills County30.4Terry County: 30.4 %Terry County30.4El Paso County: 30.1 %El Paso County30.1Shelby County: 30.1 %Shelby County30.1Colquitt County: 29.9 %Colquitt County29.9Haskell County: 29.9 %Haskell County29.9DeSoto County: 29.8 %DeSoto County29.8Lipscomb County: 29.8 %Lipscomb County29.8
%. 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

RankCounties2018 (%)Change on 2017
1Hidalgo County42.8+0.4 pts
2Presidio County39.7+3.1 pts
3Webb County39.5+0.8 pts
4Starr County39-0.6 pts
5Cameron County38.9+0.9 pts
6Zapata County38.4-1.1 pts
7Gaines County37.4-1 pts
8Maverick County36.6+1.4 pts
9Bailey County35.8+1.3 pts
9Castro County35.8+1 pts
11Dallam County35.6+0.7 pts
12Collingsworth County34.6-3 pts
12Hendry County34.6+0.5 pts
14Hall County34.2+0.9 pts
15Ochiltree County32.6-1.7 pts
16Cochran County32.5-0.6 pts
16Hudspeth County32.5-1.5 pts
18Parmer County32.4-1.6 pts
19San Saba County32.1-1.5 pts
20Clark County320 pts
21Hansford County31.9+1.4 pts
21Kenedy County31.9+4.5 pts
23Deaf Smith County31.8-0.4 pts
24Sherman County31.1-0.8 pts
25Atkinson County31+3.1 pts
25Echols County31-2.9 pts
25Lamb County31+0.6 pts
25Menard County31+2.9 pts
25Moore County31-2.6 pts
30Gonzales County30.9+0.5 pts
31Potter County30.7+1.5 pts
32Jeff Davis County30.4+0.2 pts
32Mills County30.4+2.2 pts
32Terry County30.4-0.1 pts
35El Paso County30.1+1 pts
35Shelby County30.10 pts
37Colquitt County29.9-0.3 pts
37Haskell County29.9+0.4 pts
39DeSoto County29.8+2.1 pts
39Lipscomb County29.8-0.7 pts
39Texas County29.8+3.7 pts
42Glades County29.7+0.1 pts
43Mason County29.5+0.3 pts
43Uvalde County29.5+1.5 pts
45Owyhee County29.4-0.1 pts
45Willacy County29.4+0.5 pts
47Briscoe County29.2-4.5 pts
47Knox County29.2+0.7 pts
49Adair County29-0.6 pts
50Gray County28.8-0.7 pts
50Hardeman County28.8-1.2 pts
50Swisher County28.8+0.6 pts
53Culberson County28.7-2.5 pts
53Dawson County28.7+2.7 pts
53Titus County28.7-2.2 pts
53Wheeler County28.7+0.8 pts
57Buffalo County28.5+1.1 pts
57Comanche County28.5-0.6 pts
57Stephens County28.5-1.9 pts
60Floyd County28.4-0.7 pts
60Gilmer County28.4+2.1 pts
60Jackson County28.4-2.7 pts
60Leon County28.4+0.3 pts
60Pecos County28.4+0.9 pts
65Corson County28.3-0.1 pts
66Cottle County28.1-2.5 pts
66Dallas County28.1+0.9 pts
66Frio County28.1+0.1 pts
66Todd County28.1+2.6 pts
70Coleman County27.9+1.6 pts
71Edwards County27.8-0.2 pts
71Hale County27.8-1.1 pts
71Hemphill County27.8+0.5 pts
71Marshall County27.8+0.1 pts
75Cherokee County27.7-2.1 pts
76Delaware County27.6-1.2 pts
77Wharton County27.4+1.9 pts
78Bennett County27.3-1.2 pts
79Garza County27.2-2.3 pts
79Harper County27.2-1.4 pts
79Hill County27.2+2.4 pts
79Jack County27.2-1 pts
79Schleicher County27.2-1.2 pts
79Val Verde County27.2-2.1 pts
79Waller County27.2-1.5 pts
79Whitfield County27.2-1.6 pts
87Aransas County27.1+1.4 pts
87Cherokee County27.1+0.2 pts
87Harris County27.1+0.1 pts
87Hockley County27.1+2 pts
91Burnet County27+2.6 pts
91Hopkins County27+1.2 pts
91Real County27+1.8 pts
94Aleutians East Borough26.9-2.3 pts
95Navarro County26.8-0.5 pts
95Yoakum County26.8-2 pts
95Yukon-Koyukuk Census Area26.8-3.5 pts
98Bosque County26.7+1 pts
98Okeechobee County26.7-0.7 pts
100Candler County26.6+0.7 pts
100Reeves County26.6-1.1 pts
102Collier County26.50 pts
102Dimmit County26.5+1.5 pts
102Gooding County26.5+0.4 pts
102Ziebach County26.5-1.7 pts
106Liberty County26.4+0.7 pts
106Montague County26.4-0.7 pts
108Throckmorton County26.3-3.1 pts
109Hamilton County26.2-1.5 pts
109Henderson County26.2+1.2 pts
109McCurtain County26.2-0.3 pts
112Haskell County26.1+0.9 pts
112San Jacinto County26.1-0.7 pts
112Scott County26.1-0.5 pts
115Cimarron County26-2.6 pts
115Dewey County26-0.9 pts
115Murray County26+0.8 pts
115Seward County26+0.1 pts
115Zavala County26+0.4 pts
120Childress County25.9+1.3 pts
120Palo Pinto County25.9+0.1 pts
122Angelina County25.8-0.4 pts
122Grimes County25.8-1.2 pts
122Harmon County25.8-2.8 pts
122Limestone County25.8+0.4 pts
122Smith County25.8+1.9 pts
127Duplin County25.7+1.2 pts
127Ector County25.7-0.2 pts
129Bastrop County25.6-0.5 pts
129Caldwell County25.6-0.5 pts
129Gregg County25.6-0.3 pts
129Hartley County25.6+2.2 pts
129Le Flore County25.6+0.2 pts
129Lincoln County25.6+2.8 pts
129Mellette County25.6-3.4 pts
129Roosevelt County25.6+0.6 pts
129Rusk County25.6+0.7 pts
129Young County25.6-0.7 pts
139Hall County25.5-1.5 pts
139Kusilvak Census Area25.5-0.2 pts
141Polk County25.4-0.6 pts
141Wilbarger County25.4-0.1 pts
143Duval County25.3-0.2 pts
143Foard County25.3-1.2 pts
143Grady County25.3-0.1 pts
143Houston County25.3+1.7 pts
143Jasper County25.3+0.1 pts
143Pushmataha County25.3-0.1 pts
149Camp County25.2-0.8 pts
149Crockett County25.2-0.8 pts
149Jefferson County25.2+0.9 pts
149Matagorda County25.2-1 pts
149McIntosh County25.2+0.7 pts
149Mitchell County25.2+0.2 pts
155Andrews County25.1-1.5 pts
155Banks County25.1+1.9 pts
155Gordon County25.1-0.7 pts
155Jefferson County25.1+0.7 pts
155Jim Wells County25.1-0.1 pts
160Jim Hogg County25-0.1 pts
160Kerr County25-1 pts
160McDonald County25+0.3 pts
160Nacogdoches County25-2.7 pts
164Rabun County24.9+0.3 pts
164Rains County24.9-1 pts
164Van Zandt County24.9+0.5 pts
164Winkler County24.9-1.7 pts
168Haskell County24.8-0.3 pts
168Jefferson Davis County24.8+3.6 pts
170Berrien County24.7+1 pts
170Colorado County24.7-1 pts
170Lake and Peninsula Borough24.7-5.2 pts
170Sequoyah County24.7+0.2 pts
174Atascosa County24.6+1.4 pts
174Eastland County24.6-1.1 pts
174Lamar County24.6+1.8 pts
174Nueces County24.6+1.5 pts
178Apache County24.5+1.5 pts
178DeKalb County24.5+1.7 pts
178Madison County24.5-1.6 pts
178Reagan County24.5-3.7 pts
178Trinity County24.5+0.6 pts
183Hamilton County24.4-2.5 pts
183Hardee County24.4-1.4 pts
183Holmes County24.4+0.4 pts
183Jeff Davis County24.4+0.9 pts
183Minidoka County24.4+0.8 pts
183Oglala Lakota County24.4+0.4 pts
183Robertson County24.4+2.6 pts
183Tift County24.4+2.1 pts
191Brooks County24.3+0.9 pts
191Coal County24.3-0.5 pts
191Crosby County24.3-2.5 pts
191Dickens County24.3-2.5 pts
191Falls County24.3-1.5 pts
191Freestone County24.3+1.2 pts
191Gillespie County24.3-2.1 pts
198Coffee County24.20 pts
198Cooke County24.2+0.1 pts
198Garvin County24.2+1.9 pts
198Hutchinson County24.2+0.4 pts
202Bethel Census Area24.1-3.2 pts
202Jerome County24.1-3.8 pts
202King County24.1-2.4 pts
202Scotland County24.1-1.4 pts
206Bandera County24+3.9 pts
206Carter County24+1.9 pts
206Habersham County24+1 pts
206Hughes County24-0.5 pts
206Leake County24-0.1 pts
206Sampson County24+0.5 pts
206Seminole County24-0.3 pts
206Tillman County24-0.1 pts
206Upshur County24+2.4 pts
206Wise County24-1.3 pts
216Beaver County23.9+0.5 pts
216Bryan County23.9+0.4 pts
216Erath County23.9-2.6 pts
216Kimble County23.9-0.9 pts
216LaGrange County23.9-0.4 pts
216Tattnall County23.9+0.5 pts
222Anderson County23.8+0.5 pts
222Greene County23.8+0.5 pts
222La Paz County23.8+0.9 pts
222Lee County23.8-1.6 pts
222Robeson County23.8-0.3 pts
227Grayson County23.7+0.8 pts
227Jasper County23.7+2.5 pts
227Oglethorpe County23.7+2.1 pts
227Ottawa County23.7-0.5 pts
231Clayton County23.6-1.3 pts
231Crane County23.6-1.3 pts
231Hunt County23.6+1.6 pts
231Macon County23.6+0.2 pts
231Miami-Dade County23.6-0.7 pts
231Wilkes County23.6+2.2 pts
237Live Oak County23.5+0.3 pts
237Swain County23.5+1.1 pts
237Toombs County23.5+0.2 pts
240Blanco County23.4+0.7 pts
240Brooks County23.4+1.3 pts
240Burleson County23.4+0.3 pts
240Calhoun County23.4-0.1 pts
240Cook County23.4+0.3 pts
240Fannin County23.4-1.9 pts
240Highlands County23.4+0.9 pts
240Kleberg County23.4-1 pts
240Lynn County23.4+1 pts
240Muskogee County23.4+0.5 pts
240Neshoba County23.4-0.7 pts

Showing the top 250 of 3132. The Excel download has every row.

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. 11 counties with data in other periods have no value for 2018 and are left out rather than filled from another source. 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-2018-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 (US counties by uninsured rate, ages 18 to 64 (US model-based estimate), 2018) [Data set]. Retrieved October 12, 2026, from https://www2.census.gov/programs-surveys/sahie/datasets/time-series/estimates-acs/sahie-2018-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, US counties by uninsured rate, ages 18 to 64 (US model-based estimate), 2018. U.S. Census Bureau, 6 Aug. 2026, https://www2.census.gov/programs-surveys/sahie/datasets/time-series/estimates-acs/sahie-2018-csv.zip. Invokely, https://invokely.ai/rankings/uninsured-rate-ages-18-64/us-counties?period=2018. 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. US counties by uninsured rate, ages 18 to 64 (US model-based estimate), 2018. Dataset. Accessed October 12, 2026. https://www2.census.gov/programs-surveys/sahie/datasets/time-series/estimates-acs/sahie-2018-csv.zip. Also distributed by Invokely, https://invokely.ai/rankings/uninsured-rate-ages-18-64/us-counties?period=2018.

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, US counties by uninsured rate, ages 18 to 64 (US model-based estimate), 2018 [Dataset]. Available at: https://www2.census.gov/programs-surveys/sahie/datasets/time-series/estimates-acs/sahie-2018-csv.zip, via Invokely: https://invokely.ai/rankings/uninsured-rate-ages-18-64/us-counties?period=2018 (Accessed: 12 October 2026).

BibTeX
@misc{census_us_counties_by_uninsured_2018,
  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: US counties by uninsured rate, ages 18 to 64 (US model-based estimate), 2018}},
  year = {2026},
  howpublished = {Data set},
  url = {https://www2.census.gov/programs-surveys/sahie/datasets/time-series/estimates-acs/sahie-2018-csv.zip},
  urldate = {2026-10-12},
  note = {Accessed via Invokely, https://invokely.ai/rankings/uninsured-rate-ages-18-64/us-counties?period=2018. 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-2018-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: US counties by uninsured rate, ages 18 to 64 (US model-based estimate), 2018
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-2018-csv.zip
L2  - https://invokely.ai/rankings/uninsured-rate-ages-18-64/us-counties?period=2018
Y2  - 2026/10/12
N1  - Accessed via Invokely, https://invokely.ai/rankings/uninsured-rate-ages-18-64/us-counties?period=2018.
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-2018-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)?

Hidalgo County, with 42.8% in 2018, according to the U.S. Census Bureau.

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

Los Alamos County, with 2.7% in 2018.

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. 11 counties have no value for 2018 and are not ranked.

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

US counties: more rankings