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)

Presidio County had the highest uninsured rate, ages 18 to 64 (US model-based estimate) of 3134 counties in 2020, at 44.5%. Norfolk County had the lowest, at 2.6%. The median was 12.5%. Source: the U.S. Census Bureau.

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Highest44.5Presidio County
Lowest2.6Norfolk County
Median12.53134 counties

Map of counties, 2020

%, 2020. 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, 2020

Presidio County: 44.5 %Presidio County44.5Hidalgo County: 43.3 %Hidalgo County43.3Webb County: 41.8 %Webb County41.8Kenedy County: 41.7 %Kenedy County41.7Gaines County: 39.4 %Gaines County39.4Maverick County: 38.7 %Maverick County38.7Cameron County: 38.5 %Cameron County38.5Zapata County: 38.2 %Zapata County38.2Starr County: 37.4 %Starr County37.4Dallam County: 37 %Dallam County37Moore County: 35.7 %Moore County35.7Swisher County: 34.9 %Swisher County34.9Ochiltree County: 34.8 %Ochiltree County34.8Hansford County: 34.5 %Hansford County34.5Collingsworth County: 34.4 %Collingsworth County34.4Deaf Smith County: 34.3 %Deaf Smith County34.3Yoakum County: 33.9 %Yoakum County33.9Hendry County: 33.8 %Hendry County33.8Bailey County: 33.3 %Bailey County33.3Castro County: 33.1 %Castro County33.1Cochran County: 33.1 %Cochran County33.1Floyd County: 33.1 %Floyd County33.1Culberson County: 32.9 %Culberson County32.9Jeff Davis County: 32.9 %Jeff Davis County32.9Hudspeth County: 32.5 %Hudspeth County32.5San Saba County: 32.5 %San Saba County32.5Terry County: 31.7 %Terry County31.7Menard County: 31.5 %Menard County31.5Edwards County: 31.4 %Edwards County31.4Clark County: 31.3 %Clark County31.3Hardeman County: 31.1 %Hardeman County31.1Potter County: 31.1 %Potter County31.1Titus County: 31.1 %Titus County31.1Sherman County: 30.9 %Sherman County30.9Atkinson County: 30.8 %Atkinson County30.8DeSoto County: 30.7 %DeSoto County30.7Lamb County: 30.6 %Lamb County30.6Texas County: 30.6 %Texas County30.6Wheeler County: 30.6 %Wheeler County30.6Gray County: 30.5 %Gray County30.5Presidio County: 44.5 %Presidio County44.5Hidalgo County: 43.3 %Hidalgo County43.3Webb County: 41.8 %Webb County41.8Kenedy County: 41.7 %Kenedy County41.7Gaines County: 39.4 %Gaines County39.4Maverick County: 38.7 %Maverick County38.7Cameron County: 38.5 %Cameron County38.5Zapata County: 38.2 %Zapata County38.2Starr County: 37.4 %Starr County37.4Dallam County: 37 %Dallam County37Moore County: 35.7 %Moore County35.7Swisher County: 34.9 %Swisher County34.9Ochiltree County: 34.8 %Ochiltree County34.8Hansford County: 34.5 %Hansford County34.5Collingsworth County: 34.4 %Collingsworth County34.4Deaf Smith County: 34.3 %Deaf Smith County34.3Yoakum County: 33.9 %Yoakum County33.9Hendry County: 33.8 %Hendry County33.8Bailey County: 33.3 %Bailey County33.3Castro County: 33.1 %Castro County33.1Cochran County: 33.1 %Cochran County33.1Floyd County: 33.1 %Floyd County33.1Culberson County: 32.9 %Culberson County32.9Jeff Davis County: 32.9 %Jeff Davis County32.9Hudspeth County: 32.5 %Hudspeth County32.5San Saba County: 32.5 %San Saba County32.5Terry County: 31.7 %Terry County31.7Menard County: 31.5 %Menard County31.5Edwards County: 31.4 %Edwards County31.4Clark County: 31.3 %Clark County31.3Hardeman County: 31.1 %Hardeman County31.1Potter County: 31.1 %Potter County31.1Titus County: 31.1 %Titus County31.1Sherman County: 30.9 %Sherman County30.9Atkinson County: 30.8 %Atkinson County30.8DeSoto County: 30.7 %DeSoto County30.7Lamb County: 30.6 %Lamb County30.6Texas County: 30.6 %Texas County30.6Wheeler County: 30.6 %Wheeler County30.6Gray County: 30.5 %Gray County30.5
%. 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
1Presidio County44.5+4.7 pts
2Hidalgo County43.3-0.1 pts
3Webb County41.8+2.8 pts
4Kenedy County41.7+12.6 pts
5Gaines County39.4-1 pts
6Maverick County38.7+2.5 pts
7Cameron County38.5-1.3 pts
8Zapata County38.2-0.7 pts
9Starr County37.4-3.6 pts
10Dallam County37-0.8 pts
11Moore County35.7+3.5 pts
12Swisher County34.9+3.5 pts
13Ochiltree County34.8+3.3 pts
14Hansford County34.5+1.8 pts
15Collingsworth County34.4-2 pts
16Deaf Smith County34.3+1.4 pts
17Yoakum County33.9+4.6 pts
18Hendry County33.80 pts
19Bailey County33.3-0.1 pts
20Castro County33.1-1.1 pts
20Cochran County33.1+0.3 pts
20Floyd County33.1+2.2 pts
23Culberson County32.9+5.7 pts
23Jeff Davis County32.9+5.5 pts
25Hudspeth County32.5-2.5 pts
25San Saba County32.5-2.2 pts
27Terry County31.7-0.5 pts
28Menard County31.5+0.7 pts
29Edwards County31.4+2.4 pts
30Clark County31.3-4 pts
31Hardeman County31.1+1.4 pts
31Potter County31.1+0.9 pts
31Titus County31.1+0.6 pts
34Sherman County30.9+1.4 pts
35Atkinson County30.8+1.3 pts
36DeSoto County30.7-1.6 pts
37Lamb County30.6-1.4 pts
37Texas County30.6+0.9 pts
37Wheeler County30.6+1.8 pts
40Gray County30.5+1.8 pts
40Parmer County30.5-1.1 pts
40Willacy County30.5+0.9 pts
43Hall County30.4-5.6 pts
43Holmes County30.4+6.7 pts
43Val Verde County30.4+0.6 pts
46Mason County30.2-0.4 pts
47Pecos County30.1+1.5 pts
47Shelby County30.1-0.5 pts
49Uvalde County30-0.1 pts
50Hale County29.8+0.6 pts
51Glades County29.60 pts
51Marshall County29.6+2.1 pts
53Le Flore County29.5+2.3 pts
53Whitfield County29.5+1 pts
55Mills County29.4-0.5 pts
56Andrews County29.3+5.6 pts
56Hockley County29.3+3.2 pts
58Zavala County29.2+0.8 pts
59El Paso County29.1-1 pts
59McCurtain County29.1+1.1 pts
61Echols County28.9-0.2 pts
62Cherokee County28.7+0.1 pts
62Gonzales County28.7-1.2 pts
62Real County28.7+4.1 pts
62Swain County28.7+2.2 pts
62Wharton County28.7-1.1 pts
67Dawson County28.6+0.2 pts
67Liberty County28.6+1.9 pts
69Adair County28.5-0.2 pts
69Stephens County28.5+0.6 pts
71Colquitt County28.4-1.2 pts
72Crockett County28.3+4.8 pts
73Cherokee County28.2+1.5 pts
73Garza County28.2+1.2 pts
75Delaware County28.1+1.1 pts
75Jefferson County28.1+2.2 pts
77Haskell County28-2.2 pts
78McCulloch County27.9+3.5 pts
78Waller County27.9+0.2 pts
80Buffalo County27.8+1.7 pts
80Dimmit County27.8+2.3 pts
80Schleicher County27.8+1.4 pts
83Aransas County27.7-0.2 pts
83Choctaw County27.7+4 pts
83Knox County27.7-0.2 pts
86Brooks County27.6+3.9 pts
86Caldwell County27.6-2.4 pts
88Atoka County27.5+2.8 pts
88Crosby County27.5+2.1 pts
88Sequoyah County27.5+1.5 pts
91Coal County27.4+2.6 pts
91Harper County27.4+1.6 pts
91Hill County27.4+0.8 pts
94Navarro County27.3-0.7 pts
95Atascosa County27.1+0.8 pts
95Dallas County27.1-2 pts
97Lipscomb County27-1.9 pts
97Matagorda County27+2.9 pts
97Wilbarger County27+1.4 pts
100Colorado County26.9-0.9 pts
101Candler County26.8-1.2 pts
101Nacogdoches County26.8+1.7 pts
101Quitman County26.8+3 pts
104Harmon County26.7-1.8 pts
104Harris County26.7-1.7 pts
104Jim Hogg County26.7+3 pts
104Sutton County26.7+3.3 pts
108Frio County26.6-1.3 pts
108Hemphill County26.6+1.8 pts
108Murray County26.6+1.7 pts
108Ottawa County26.6+1.8 pts
112Angelina County26.5+0.4 pts
112Gillespie County26.5+1 pts
112McDonald County26.5-0.8 pts
112Ward County26.5+2.2 pts
116Childress County26.4-0.3 pts
116Duval County26.4-0.6 pts
116La Salle County26.4+4.3 pts
119Briscoe County26.3+0.9 pts
119Hamilton County26.3-0.9 pts
119Pushmataha County26.3+1.9 pts
122Brewster County26.2+2.7 pts
122Duplin County26.2-1 pts
122Kimble County26.2-0.5 pts
122Kleberg County26.2+2.6 pts
122LaGrange County26.20 pts
122Oglala Lakota County26.2+2.2 pts
122Seward County26.2+0.7 pts
129Bryan County26.1+1.6 pts
129Seminole County26.1+0.7 pts
131Cimarron County26+0.8 pts
131Grimes County26+0.5 pts
131Okeechobee County26-0.6 pts
134Bastrop County25.9-0.3 pts
134Custer County25.9+1.5 pts
134King County25.9+4.3 pts
137Beaver County25.8+0.8 pts
137Coffee County25.8-0.4 pts
137Jackson County25.8+1 pts
137Leon County25.8-2.5 pts
137Madison County25.8-1.6 pts
137Reeves County25.8+0.6 pts
137Yukon-Koyukuk Census Area25.8+0.8 pts
144Bennett County25.7-3.2 pts
144Dewey County25.7-2.4 pts
144Ector County25.7+0.1 pts
144Kusilvak Census Area25.7+2.6 pts
144San Jacinto County25.7+0.2 pts
149Clinch County25.6+3.1 pts
149Cooke County25.6+0.8 pts
149Gregg County25.6-0.8 pts
149Rabun County25.6+0.8 pts
149Robeson County25.6+1.8 pts
149Runnels County25.6+2.2 pts
149Tillman County25.6+1 pts
156Charlton County25.5+0.4 pts
156Crane County25.5+2.6 pts
156Smith County25.5+0.4 pts
159Burnet County25.4+1.7 pts
159Donley County25.4+2.2 pts
159Garvin County25.4+2.2 pts
159Rains County25.4+1.2 pts
159Rusk County25.4+1.3 pts
159Winkler County25.4+1.3 pts
165Brantley County25.3+2.6 pts
165Saluda County25.3+4.2 pts
165Scurry County25.3-1.2 pts
168Banks County25.2-0.2 pts
168Bosque County25.2-0.7 pts
168Gordon County25.2+1.5 pts
168Habersham County25.2+0.3 pts
168Jeff Davis County25.2+0.8 pts
168McIntosh County25.2-0.9 pts
174Caddo County25.1+0.3 pts
174Hamilton County25.10 pts
174Limestone County25.1-0.8 pts
174Mayes County25.1+2.7 pts
174Neshoba County25.1-2.7 pts
174Scotland County25.1-0.5 pts
174Toombs County25.1+0.7 pts
174Wise County25.1+0.6 pts
174Wood County25.1-0.1 pts
183Austin County25+0.6 pts
183Gilmer County25-0.4 pts
183Leake County25-2.1 pts
183Morgan County25+0.8 pts
187Bethel Census Area24.9+2.2 pts
187Hall County24.9-1.4 pts
187Kerr County24.9-1.8 pts
187Treutlen County24.9+1.1 pts
187Young County24.9-1.5 pts
192Haskell County24.8-0.1 pts
192Jim Wells County24.8-2.1 pts
192Kingfisher County24.8+3.6 pts
192Palo Pinto County24.8-1.8 pts
192San Patricio County24.8+2.5 pts
197Carter County24.7+1.4 pts
197Hardee County24.7-0.8 pts
197Taliaferro County24.7+3.9 pts
197Throckmorton County24.7-0.7 pts
197Upton County24.7+2.3 pts
202Cottle County24.6+0.5 pts
202Henderson County24.6-2.3 pts
202Jefferson County24.6+0.7 pts
202Milam County24.6+2.4 pts
202Reagan County24.6+2.7 pts
202Tift County24.6+0.9 pts
208Comanche County24.5-2.6 pts
208Jack County24.5-2.9 pts
208Lynn County24.50 pts
208Montague County24.5-0.4 pts
212DeKalb County24.4+0.1 pts
212Grady County24.4-0.8 pts
212Greene County24.4-1.1 pts
212Lamar County24.4-0.9 pts
212Murray County24.4+3.6 pts
212Nueces County24.4+0.4 pts
212Oglethorpe County24.4+1.5 pts
219Hopkins County24.3-3.1 pts
219Nolan County24.3+0.2 pts
219Victoria County24.3+0.7 pts
222Appling County24.2-1 pts
222Ford County24.2+1.1 pts
222Lincoln County24.2+3.8 pts
222Love County24.2+0.4 pts
222Macon County24.2+2.8 pts
222Pontotoc County24.2+1.7 pts
228Emanuel County24.1+1.8 pts
228Freestone County24.1+0.2 pts
228Fremont County24.1-0.1 pts
228Muskogee County24.1+1 pts
232Coleman County24-4.4 pts
232Live Oak County24-0.6 pts
232Okfuskee County24+0.5 pts
232Pittsburg County24+1.6 pts
236Jackson County23.9+1.5 pts
236Jerome County23.9-4.1 pts
236Kemper County23.9+0.7 pts
236Martin County23.9+1.5 pts
236Woodward County23.9+2 pts
241Eastland County23.8-3.8 pts
241Hartley County23.80 pts
241Stonewall County23.8+3.7 pts
244Barrow County23.7+1.7 pts
244Haskell County23.7-0.7 pts
244Wheatland County23.7+2.2 pts
247Fannin County23.6-0.9 pts
247Fayette County23.6+0.2 pts
247Lake and Peninsula Borough23.6+0.7 pts
247Major County23.6+2.5 pts

Showing the top 250 of 3134. 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. 9 counties with data in other periods have no value for 2020 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-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 (US counties 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, US counties 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/us-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. US counties 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/us-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, US counties 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/us-counties?period=2020 (Accessed: 12 October 2026).

BibTeX
@misc{census_us_counties_by_uninsured_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: US counties 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/us-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: US counties 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/us-counties?period=2020
Y2  - 2026/10/12
N1  - Accessed via Invokely, https://invokely.ai/rankings/uninsured-rate-ages-18-64/us-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)?

Presidio County, with 44.5% in 2020, 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 2.6% 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. 9 counties have no value for 2020 and are not ranked.

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

US counties: more rankings