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 2019, at 43.4%. Norfolk County had the lowest, at 2.8%. The median was 12.8%. Source: the U.S. Census Bureau.

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Highest43.4Hidalgo County
Lowest2.8Norfolk County
Median12.83132 counties

Map of counties, 2019

%, 2019. 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, 2019

Hidalgo County: 43.4 %Hidalgo County43.4Starr County: 41 %Starr County41Gaines County: 40.4 %Gaines County40.4Cameron County: 39.8 %Cameron County39.8Presidio County: 39.8 %Presidio County39.8Webb County: 39 %Webb County39Zapata County: 38.9 %Zapata County38.9Dallam County: 37.8 %Dallam County37.8Collingsworth County: 36.4 %Collingsworth County36.4Maverick County: 36.2 %Maverick County36.2Hall County: 36 %Hall County36Clark County: 35.3 %Clark County35.3Hudspeth County: 35 %Hudspeth County35San Saba County: 34.7 %San Saba County34.7Castro County: 34.2 %Castro County34.2Hendry County: 33.8 %Hendry County33.8Bailey County: 33.4 %Bailey County33.4Deaf Smith County: 32.9 %Deaf Smith County32.9Cochran County: 32.8 %Cochran County32.8Hansford County: 32.7 %Hansford County32.7DeSoto County: 32.3 %DeSoto County32.3Jackson County: 32.2 %Jackson County32.2Moore County: 32.2 %Moore County32.2Terry County: 32.2 %Terry County32.2Lamb County: 32 %Lamb County32Parmer County: 31.6 %Parmer County31.6Ochiltree County: 31.5 %Ochiltree County31.5Swisher County: 31.4 %Swisher County31.4Floyd County: 30.9 %Floyd County30.9Menard County: 30.8 %Menard County30.8Mason County: 30.6 %Mason County30.6Shelby County: 30.6 %Shelby County30.6Titus County: 30.5 %Titus County30.5Haskell County: 30.2 %Haskell County30.2Potter County: 30.2 %Potter County30.2El Paso County: 30.1 %El Paso County30.1Uvalde County: 30.1 %Uvalde County30.1Caldwell County: 30 %Caldwell County30Gonzales County: 29.9 %Gonzales County29.9Mills County: 29.9 %Mills County29.9Hidalgo County: 43.4 %Hidalgo County43.4Starr County: 41 %Starr County41Gaines County: 40.4 %Gaines County40.4Cameron County: 39.8 %Cameron County39.8Presidio County: 39.8 %Presidio County39.8Webb County: 39 %Webb County39Zapata County: 38.9 %Zapata County38.9Dallam County: 37.8 %Dallam County37.8Collingsworth County: 36.4 %Collingsworth County36.4Maverick County: 36.2 %Maverick County36.2Hall County: 36 %Hall County36Clark County: 35.3 %Clark County35.3Hudspeth County: 35 %Hudspeth County35San Saba County: 34.7 %San Saba County34.7Castro County: 34.2 %Castro County34.2Hendry County: 33.8 %Hendry County33.8Bailey County: 33.4 %Bailey County33.4Deaf Smith County: 32.9 %Deaf Smith County32.9Cochran County: 32.8 %Cochran County32.8Hansford County: 32.7 %Hansford County32.7DeSoto County: 32.3 %DeSoto County32.3Jackson County: 32.2 %Jackson County32.2Moore County: 32.2 %Moore County32.2Terry County: 32.2 %Terry County32.2Lamb County: 32 %Lamb County32Parmer County: 31.6 %Parmer County31.6Ochiltree County: 31.5 %Ochiltree County31.5Swisher County: 31.4 %Swisher County31.4Floyd County: 30.9 %Floyd County30.9Menard County: 30.8 %Menard County30.8Mason County: 30.6 %Mason County30.6Shelby County: 30.6 %Shelby County30.6Titus County: 30.5 %Titus County30.5Haskell County: 30.2 %Haskell County30.2Potter County: 30.2 %Potter County30.2El Paso County: 30.1 %El Paso County30.1Uvalde County: 30.1 %Uvalde County30.1Caldwell County: 30 %Caldwell County30Gonzales County: 29.9 %Gonzales County29.9Mills County: 29.9 %Mills County29.9
%. 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

RankCounties2019 (%)Change on 2018
1Hidalgo County43.4+0.6 pts
2Starr County41+2 pts
3Gaines County40.4+3 pts
4Cameron County39.8+0.9 pts
4Presidio County39.8+0.1 pts
6Webb County39-0.5 pts
7Zapata County38.9+0.5 pts
8Dallam County37.8+2.2 pts
9Collingsworth County36.4+1.8 pts
10Maverick County36.2-0.4 pts
11Hall County36+1.8 pts
12Clark County35.3+3.3 pts
13Hudspeth County35+2.5 pts
14San Saba County34.7+2.6 pts
15Castro County34.2-1.6 pts
16Hendry County33.8-0.8 pts
17Bailey County33.4-2.4 pts
18Deaf Smith County32.9+1.1 pts
19Cochran County32.8+0.3 pts
20Hansford County32.7+0.8 pts
21DeSoto County32.3+2.5 pts
22Jackson County32.2+3.8 pts
22Moore County32.2+1.2 pts
22Terry County32.2+1.8 pts
25Lamb County32+1 pts
26Parmer County31.6-0.8 pts
27Ochiltree County31.5-1.1 pts
28Swisher County31.4+2.6 pts
29Floyd County30.9+2.5 pts
30Menard County30.8-0.2 pts
31Mason County30.6+1.1 pts
31Shelby County30.6+0.5 pts
33Titus County30.5+1.8 pts
34Haskell County30.2+0.3 pts
34Potter County30.2-0.5 pts
36El Paso County30.10 pts
36Uvalde County30.1+0.6 pts
38Caldwell County30+4.4 pts
39Gonzales County29.9-1 pts
39Mills County29.9-0.5 pts
41Val Verde County29.8+2.6 pts
41Wharton County29.8+2.4 pts
43Hardeman County29.7+0.9 pts
43Texas County29.7-0.1 pts
45Colquitt County29.6-0.3 pts
45Glades County29.6-0.1 pts
45Willacy County29.6+0.2 pts
48Atkinson County29.5-1.5 pts
48Sherman County29.5-1.6 pts
50Yoakum County29.3+2.5 pts
51Hale County29.2+1.4 pts
52Dallas County29.1+1 pts
52Echols County29.1-1.9 pts
52Kenedy County29.1-2.8 pts
52Owyhee County29.1-0.3 pts
56Edwards County29+1.2 pts
57Bennett County28.9+1.6 pts
57Lipscomb County28.9-0.9 pts
59Wheeler County28.8+0.1 pts
60Adair County28.7-0.3 pts
60Gray County28.7-0.1 pts
60Mellette County28.7+3.1 pts
63Cherokee County28.6+0.9 pts
63Pecos County28.6+0.2 pts
65Harmon County28.5+2.7 pts
65Whitfield County28.5+1.3 pts
67Coleman County28.4+0.5 pts
67Dawson County28.4-0.3 pts
67Harris County28.4+1.3 pts
67Zavala County28.4+2.4 pts
71Leon County28.3-0.1 pts
72Dewey County28.1+2.1 pts
73Candler County28+1.4 pts
73Jerome County28+3.9 pts
73McCurtain County28+1.8 pts
73Navarro County28+1.2 pts
77Aransas County27.9+0.8 pts
77Frio County27.9-0.2 pts
77Knox County27.9-1.3 pts
77Stephens County27.9-0.6 pts
81Colorado County27.8+3.1 pts
81Neshoba County27.8+4.4 pts
81Todd County27.8-0.3 pts
84Waller County27.7+0.5 pts
85Eastland County27.6+3 pts
86Marshall County27.5-0.3 pts
86Scott County27.5+1.4 pts
88Hopkins County27.4+0.4 pts
88Jack County27.4+0.2 pts
88Jeff Davis County27.4-3 pts
88Madison County27.4+2.9 pts
92McDonald County27.3+2.3 pts
93Culberson County27.2-1.5 pts
93Duplin County27.2+1.5 pts
93Hamilton County27.2+1 pts
93Le Flore County27.2+1.6 pts
93Van Zandt County27.2+2.3 pts
98Comanche County27.1-1.4 pts
98Leake County27.1+3.1 pts
100Corson County27-1.3 pts
100Delaware County27-0.6 pts
100Duval County27+1.7 pts
100Garza County27-0.2 pts
104Henderson County26.9+0.7 pts
104Jim Wells County26.9+1.8 pts
106Cherokee County26.7-0.4 pts
106Childress County26.7+0.8 pts
106Kerr County26.7+1.7 pts
106Kimble County26.7+2.8 pts
106Liberty County26.7+0.3 pts
111Hill County26.6-0.6 pts
111Okeechobee County26.6-0.1 pts
111Palo Pinto County26.6+0.7 pts
114Erath County26.5+2.6 pts
114Scurry County26.5+3.1 pts
114Swain County26.5+3 pts
117Gregg County26.4+0.8 pts
117Schleicher County26.4-0.8 pts
117Young County26.4+0.8 pts
120Atascosa County26.3+1.7 pts
120Berrien County26.3+1.6 pts
120Hall County26.3+0.8 pts
123Bastrop County26.2+0.6 pts
123Coffee County26.2+2 pts
123LaGrange County26.2+2.3 pts
126Angelina County26.1+0.3 pts
126Buffalo County26.1-2.4 pts
126Hockley County26.1-1 pts
126McIntosh County26.1+0.9 pts
130Polk County26+0.6 pts
130Sequoyah County26+1.3 pts
132Bosque County25.9-0.8 pts
132Jefferson County25.9+0.8 pts
132Limestone County25.9+0.1 pts
135Harper County25.8-1.4 pts
136Gooding County25.7-0.8 pts
136McKinley County25.7+4.9 pts
138Ector County25.6-0.1 pts
138Scotland County25.6+1.5 pts
138Wilbarger County25.6+0.2 pts
141Dimmit County25.5-1 pts
141Gillespie County25.5+1.2 pts
141Greene County25.5+1.7 pts
141Grimes County25.5-0.3 pts
141Hardee County25.5+1.1 pts
141Llano County25.5+2.3 pts
141San Jacinto County25.5-0.6 pts
141Seward County25.5-0.5 pts
149Banks County25.4+0.3 pts
149Briscoe County25.4-3.8 pts
149Camp County25.4+0.2 pts
149Crosby County25.4+1.1 pts
149Gilmer County25.4-3 pts
149Lincoln County25.4-0.2 pts
149Seminole County25.4+1.4 pts
149Throckmorton County25.4-0.9 pts
157Houston County25.30 pts
157Lamar County25.3+0.7 pts
157Roosevelt County25.3-0.3 pts
160Appling County25.2+2.4 pts
160Cimarron County25.2-0.8 pts
160Grady County25.2-0.1 pts
160Reeves County25.2-1.4 pts
160Wood County25.2+2.3 pts
165Charlton County25.1+2.5 pts
165Hamilton County25.1+0.7 pts
165Nacogdoches County25.1+0.1 pts
165Sampson County25.1+1.1 pts
165Smith County25.1-0.7 pts
170Beaver County25+1.1 pts
170Grayson County25+1.3 pts
170Yukon-Koyukuk Census Area25-1.8 pts
173Falls County24.9+0.6 pts
173Habersham County24.9+0.9 pts
173Haskell County24.9-1.2 pts
173Montague County24.9-1.5 pts
173Murray County24.9-1.1 pts
173Ziebach County24.9-1.6 pts
179Caddo County24.8+2 pts
179Coal County24.8+0.5 pts
179Collier County24.8-1.7 pts
179Cooke County24.8+0.6 pts
179Hemphill County24.8-3 pts
179Jackson County24.8+2.8 pts
179Ottawa County24.8+1.1 pts
179Rabun County24.8-0.1 pts
187Atoka County24.7+1.4 pts
187Red River County24.7+2.5 pts
189Live Oak County24.6+1.1 pts
189Real County24.6-2.4 pts
189Tillman County24.6+0.6 pts
189Trinity County24.6+0.1 pts
193Bryan County24.5+0.6 pts
193Fannin County24.5+1.1 pts
193Highlands County24.5+1.1 pts
193Lee County24.5+0.7 pts
193Lynn County24.5+1.1 pts
193Newton County24.5+2 pts
193Wise County24.5+0.5 pts
200Austin County24.4+1.3 pts
200Custer County24.4+1.3 pts
200Dickens County24.4+0.1 pts
200Foard County24.4-0.9 pts
200Glacier County24.4+1.1 pts
200Haskell County24.4-0.4 pts
200Hughes County24.4+0.4 pts
200Jeff Davis County24.40 pts
200McCulloch County24.4+1.3 pts
200Motley County24.4+2.7 pts
200Pushmataha County24.4-0.9 pts
200Toombs County24.4+0.9 pts
212Apache County24.3-0.2 pts
212DeKalb County24.3-0.2 pts
212La Paz County24.3+0.5 pts
212Tattnall County24.3+0.4 pts
212Ward County24.3+2.1 pts
217Bacon County24.2+1 pts
217Fremont County24.2+2.7 pts
217Morgan County24.2+1.5 pts
217Noxubee County24.2+1.2 pts
217Power County24.2+0.8 pts
217Rains County24.2-0.7 pts
223Cottle County24.1-4 pts
223Matagorda County24.1-1.1 pts
223Nolan County24.1+1.7 pts
223Rusk County24.1-1.5 pts
223Shackelford County24.1+1 pts
223Winkler County24.1-0.8 pts
229Evans County24+1.6 pts
229Nueces County24-0.6 pts
229Oglala Lakota County24-0.4 pts
232Aleutians East Borough23.9-3 pts
232Freestone County23.9-0.4 pts
232Jefferson County23.9-1.3 pts
232San Augustine County23.9+1 pts
236Anderson County23.80 pts
236Concho County23.8+1.3 pts
236Hartley County23.8-1.8 pts
236Love County23.8+2.4 pts
236Quitman County23.8+0.8 pts
236Robeson County23.80 pts
236Treutlen County23.8+2.1 pts
243Andrews County23.7-1.4 pts
243Big Horn County23.7+3.7 pts
243Brooks County23.7+0.3 pts
243Burnet County23.7-3.3 pts
243Choctaw County23.7+0.6 pts
243Gordon County23.7-1.4 pts
243Holmes County23.7-0.7 pts
243Jim Hogg County23.7-1.3 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 2019 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-2019-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), 2019) [Data set]. Retrieved October 12, 2026, from https://www2.census.gov/programs-surveys/sahie/datasets/time-series/estimates-acs/sahie-2019-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), 2019. U.S. Census Bureau, 6 Aug. 2026, https://www2.census.gov/programs-surveys/sahie/datasets/time-series/estimates-acs/sahie-2019-csv.zip. Invokely, https://invokely.ai/rankings/uninsured-rate-ages-18-64/us-counties?period=2019. 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), 2019. Dataset. Accessed October 12, 2026. https://www2.census.gov/programs-surveys/sahie/datasets/time-series/estimates-acs/sahie-2019-csv.zip. Also distributed by Invokely, https://invokely.ai/rankings/uninsured-rate-ages-18-64/us-counties?period=2019.

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), 2019 [Dataset]. Available at: https://www2.census.gov/programs-surveys/sahie/datasets/time-series/estimates-acs/sahie-2019-csv.zip, via Invokely: https://invokely.ai/rankings/uninsured-rate-ages-18-64/us-counties?period=2019 (Accessed: 12 October 2026).

BibTeX
@misc{census_us_counties_by_uninsured_2019,
  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), 2019}},
  year = {2026},
  howpublished = {Data set},
  url = {https://www2.census.gov/programs-surveys/sahie/datasets/time-series/estimates-acs/sahie-2019-csv.zip},
  urldate = {2026-10-12},
  note = {Accessed via Invokely, https://invokely.ai/rankings/uninsured-rate-ages-18-64/us-counties?period=2019. 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-2019-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), 2019
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-2019-csv.zip
L2  - https://invokely.ai/rankings/uninsured-rate-ages-18-64/us-counties?period=2019
Y2  - 2026/10/12
N1  - Accessed via Invokely, https://invokely.ai/rankings/uninsured-rate-ages-18-64/us-counties?period=2019.
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-2019-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 43.4% in 2019, according to the U.S. Census Bureau.

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

Norfolk County, with 2.8% in 2019.

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 2019 and are not ranked.

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

US counties: more rankings