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)

Kenedy County had the highest uninsured rate, ages 18 to 64 (US model-based estimate) of 3134 counties in 2021, at 47.1%. Loving County had the lowest, at 2.8%. The median was 12.1%. Source: the U.S. Census Bureau.

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Highest47.1Kenedy County
Lowest2.8Loving County
Median12.13134 counties

Map of counties, 2021

%, 2021. 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, 2021

Kenedy County: 47.1 %Kenedy County47.1Presidio County: 46.4 %Presidio County46.4Hidalgo County: 42.8 %Hidalgo County42.8Webb County: 39.3 %Webb County39.3Gaines County: 38.7 %Gaines County38.7Cameron County: 38.6 %Cameron County38.6Starr County: 38.4 %Starr County38.4Ochiltree County: 36.7 %Ochiltree County36.7Dallam County: 36.6 %Dallam County36.6Moore County: 36.6 %Moore County36.6Maverick County: 36.4 %Maverick County36.4Zapata County: 35.7 %Zapata County35.7Collingsworth County: 34.9 %Collingsworth County34.9Culberson County: 34.8 %Culberson County34.8Terry County: 34.3 %Terry County34.3Swisher County: 34.2 %Swisher County34.2Hudspeth County: 34 %Hudspeth County34Hall County: 33.9 %Hall County33.9Cochran County: 33.7 %Cochran County33.7Edwards County: 33.6 %Edwards County33.6Sherman County: 33.6 %Sherman County33.6Yoakum County: 33.5 %Yoakum County33.5Bailey County: 33.1 %Bailey County33.1Deaf Smith County: 33 %Deaf Smith County33Hansford County: 32.7 %Hansford County32.7Menard County: 32.6 %Menard County32.6Atkinson County: 32.2 %Atkinson County32.2San Saba County: 32.2 %San Saba County32.2Schleicher County: 31.8 %Schleicher County31.8Shelby County: 31.8 %Shelby County31.8Wheeler County: 31.8 %Wheeler County31.8Gonzales County: 31.7 %Gonzales County31.7Parmer County: 31.6 %Parmer County31.6Castro County: 31.4 %Castro County31.4Titus County: 31.3 %Titus County31.3Lamb County: 31.2 %Lamb County31.2Mason County: 31.2 %Mason County31.2Mills County: 31 %Mills County31Hardeman County: 30.9 %Hardeman County30.9Hendry County: 30.9 %Hendry County30.9Kenedy County: 47.1 %Kenedy County47.1Presidio County: 46.4 %Presidio County46.4Hidalgo County: 42.8 %Hidalgo County42.8Webb County: 39.3 %Webb County39.3Gaines County: 38.7 %Gaines County38.7Cameron County: 38.6 %Cameron County38.6Starr County: 38.4 %Starr County38.4Ochiltree County: 36.7 %Ochiltree County36.7Dallam County: 36.6 %Dallam County36.6Moore County: 36.6 %Moore County36.6Maverick County: 36.4 %Maverick County36.4Zapata County: 35.7 %Zapata County35.7Collingsworth County: 34.9 %Collingsworth County34.9Culberson County: 34.8 %Culberson County34.8Terry County: 34.3 %Terry County34.3Swisher County: 34.2 %Swisher County34.2Hudspeth County: 34 %Hudspeth County34Hall County: 33.9 %Hall County33.9Cochran County: 33.7 %Cochran County33.7Edwards County: 33.6 %Edwards County33.6Sherman County: 33.6 %Sherman County33.6Yoakum County: 33.5 %Yoakum County33.5Bailey County: 33.1 %Bailey County33.1Deaf Smith County: 33 %Deaf Smith County33Hansford County: 32.7 %Hansford County32.7Menard County: 32.6 %Menard County32.6Atkinson County: 32.2 %Atkinson County32.2San Saba County: 32.2 %San Saba County32.2Schleicher County: 31.8 %Schleicher County31.8Shelby County: 31.8 %Shelby County31.8Wheeler County: 31.8 %Wheeler County31.8Gonzales County: 31.7 %Gonzales County31.7Parmer County: 31.6 %Parmer County31.6Castro County: 31.4 %Castro County31.4Titus County: 31.3 %Titus County31.3Lamb County: 31.2 %Lamb County31.2Mason County: 31.2 %Mason County31.2Mills County: 31 %Mills County31Hardeman County: 30.9 %Hardeman County30.9Hendry County: 30.9 %Hendry County30.9
%. 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

RankCounties2021 (%)Change on 2020
1Kenedy County47.1+5.4 pts
2Presidio County46.4+1.9 pts
3Hidalgo County42.8-0.5 pts
4Webb County39.3-2.5 pts
5Gaines County38.7-0.7 pts
6Cameron County38.6+0.1 pts
7Starr County38.4+1 pts
8Ochiltree County36.7+1.9 pts
9Dallam County36.6-0.4 pts
9Moore County36.6+0.9 pts
11Maverick County36.4-2.3 pts
12Zapata County35.7-2.5 pts
13Collingsworth County34.9+0.5 pts
14Culberson County34.8+1.9 pts
15Terry County34.3+2.6 pts
16Swisher County34.2-0.7 pts
17Hudspeth County34+1.5 pts
18Hall County33.9+3.5 pts
19Cochran County33.7+0.6 pts
20Edwards County33.6+2.2 pts
20Sherman County33.6+2.7 pts
22Yoakum County33.5-0.4 pts
23Bailey County33.1-0.2 pts
24Deaf Smith County33-1.3 pts
25Hansford County32.7-1.8 pts
26Menard County32.6+1.1 pts
27Atkinson County32.2+1.4 pts
27San Saba County32.2-0.3 pts
29Schleicher County31.8+4 pts
29Shelby County31.8+1.7 pts
29Wheeler County31.8+1.2 pts
32Gonzales County31.7+3 pts
33Parmer County31.6+1.1 pts
34Castro County31.4-1.7 pts
35Titus County31.3+0.2 pts
36Lamb County31.2+0.6 pts
36Mason County31.2+1 pts
38Mills County31+1.6 pts
39Hardeman County30.9-0.2 pts
39Hendry County30.9-2.9 pts
41Gray County30.8+0.3 pts
42Floyd County30.6-2.5 pts
42Lipscomb County30.6+3.6 pts
44Crockett County30.5+2.2 pts
44Val Verde County30.5+0.1 pts
46Texas County30.4-0.2 pts
47Navarro County30.3+3 pts
48Knox County30+2.3 pts
48Potter County30-1.1 pts
50Pecos County29.8-0.3 pts
50Willacy County29.8-0.7 pts
52Clark County29.7-1.6 pts
53Cherokee County29.6+1.4 pts
53El Paso County29.6+0.5 pts
55Briscoe County29.5+3.2 pts
55Caldwell County29.5+1.9 pts
55Hale County29.5-0.3 pts
58Frio County29.4+2.8 pts
58Hockley County29.4+0.1 pts
58San Augustine County29.4+6.6 pts
61Crane County29.3+3.8 pts
61Duval County29.3+2.9 pts
61Glades County29.3-0.3 pts
61Madison County29.3+3.5 pts
65Colquitt County29.2+0.8 pts
66Jack County29.1+4.6 pts
66Whitfield County29.1-0.4 pts
68Ector County29+3.3 pts
68Liberty County29+0.4 pts
68Uvalde County29-1 pts
71Crosby County28.9+1.4 pts
71DeSoto County28.9-1.8 pts
73Dawson County28.8+0.2 pts
74Dickens County28.6+5.1 pts
74Hamilton County28.6+3.5 pts
76McCulloch County28.5+0.6 pts
77Stephens County28.4-0.1 pts
78Andrews County28.3-1 pts
78Harper County28.3+0.9 pts
78Hemphill County28.3+1.7 pts
81King County28.2+2.3 pts
81Marshall County28.2-1.4 pts
81Real County28.2-0.5 pts
84Dallas County28.1+1 pts
84Harris County28.1+1.4 pts
84Haskell County28.1+0.1 pts
84Wharton County28.1-0.6 pts
88Matagorda County28+1 pts
89Coal County27.9+0.5 pts
90Kimble County27.8+1.6 pts
90Wilbarger County27.8+0.8 pts
92Brooks County27.60 pts
92Jefferson County27.6-0.5 pts
92Reeves County27.6+1.8 pts
95Coffee County27.5+1.7 pts
95Waller County27.5-0.4 pts
97Echols County27.4-1.5 pts
97Jim Hogg County27.4+0.7 pts
97Winkler County27.4+2 pts
100Brewster County27.3+1.1 pts
100Dimmit County27.3-0.5 pts
100Holmes County27.3-3.1 pts
103Eastland County27.2+3.4 pts
103Rains County27.2+1.8 pts
103Sutton County27.2+0.5 pts
106Yukon-Koyukuk Census Area27.1+1.3 pts
107Garza County27-1.2 pts
107Hardee County27+2.3 pts
109Angelina County26.9+0.4 pts
109Brantley County26.9+1.6 pts
109Comanche County26.9+2.4 pts
109Shackelford County26.9+3.5 pts
113Cherokee County26.8-1.9 pts
113Live Oak County26.8+2.8 pts
113San Jacinto County26.8+1.1 pts
113Ward County26.8+0.3 pts
117Atascosa County26.7-0.4 pts
118Beaver County26.6+0.8 pts
118Zavala County26.6-2.6 pts
120Atoka County26.5-1 pts
120Bastrop County26.5+0.6 pts
120Coleman County26.5+2.5 pts
120Gordon County26.5+1.3 pts
120Gregg County26.5+0.9 pts
120Haskell County26.5+2.8 pts
120Hopkins County26.5+2.2 pts
120Jim Wells County26.5+1.7 pts
120Nacogdoches County26.5-0.3 pts
129Colorado County26.4-0.5 pts
129Leon County26.4+0.6 pts
129Wood County26.4+1.3 pts
132Caddo County26.3+1.2 pts
132Childress County26.3-0.1 pts
132Glasscock County26.3+2.8 pts
132La Salle County26.3-0.1 pts
132Le Flore County26.3-3.2 pts
132Reagan County26.3+1.7 pts
138Hamilton County26.2-0.1 pts
138Lee County26.2+3.7 pts
138Seward County26.20 pts
138Throckmorton County26.2+1.5 pts
138Tyler County26.2+2.7 pts
143Newton County26.1+2.9 pts
143Scurry County26.1+0.8 pts
145Adair County26-2.5 pts
145Aransas County26-1.7 pts
145Grimes County260 pts
145Harmon County26-0.7 pts
149Gillespie County25.9-0.6 pts
149Limestone County25.9+0.8 pts
149Nueces County25.9+1.5 pts
152Martin County25.8+1.9 pts
153Buffalo County25.7-2.1 pts
153Candler County25.7-1.1 pts
153Donley County25.7+0.3 pts
153Palo Pinto County25.7+0.9 pts
157Ottawa County25.6-1 pts
158Henderson County25.5+0.9 pts
158Kerr County25.5+0.6 pts
158Kleberg County25.5-0.7 pts
158Lincoln County25.5+1.3 pts
158Nolan County25.5+1.2 pts
158Rabun County25.5-0.1 pts
158Upton County25.5+0.8 pts
165Cooke County25.4-0.2 pts
165Habersham County25.4+0.2 pts
165Smith County25.4-0.1 pts
165Young County25.4+0.5 pts
169Bryan County25.3-0.8 pts
169Lake and Peninsula Borough25.3+1.7 pts
169Montague County25.3+0.8 pts
172Hall County25.2+0.3 pts
172Lynn County25.2+0.7 pts
172McDonald County25.2-1.3 pts
172Stonewall County25.2+1.4 pts
176DeKalb County25.1+0.7 pts
176Fremont County25.1+1 pts
176Lamar County25.1+0.7 pts
176Llano County25.1+2.1 pts
176Love County25.1+0.9 pts
181Burleson County25+2.2 pts
181DeWitt County25+2.4 pts
181Ford County25+0.8 pts
181Runnels County25-0.6 pts
181San Patricio County25+0.2 pts
181Sequoyah County25-2.5 pts
187Appling County24.9+0.7 pts
187Banks County24.9-0.3 pts
187Greene County24.9+0.5 pts
187Hill County24.9-2.5 pts
187Jeff Davis County24.9-8 pts
187Quitman County24.9-1.9 pts
187Tillman County24.9-0.7 pts
194Freestone County24.8+0.7 pts
194Houston County24.8+2.3 pts
194Hunt County24.8+2.4 pts
194Terrell County24.8+3.2 pts
194Terrell County24.8+1.2 pts
194Victoria County24.8+0.5 pts
200Cimarron County24.7-1.3 pts
200Erath County24.7+2.7 pts
200Morgan County24.7-0.3 pts
200Okeechobee County24.7-1.3 pts
204Camp County24.6+1.2 pts
204Dewey County24.6-1.1 pts
204Jackson County24.6-1.2 pts
204McCurtain County24.6-4.5 pts
208Austin County24.5-0.5 pts
208Bosque County24.5-0.7 pts
208Burnet County24.5-0.9 pts
208Jeff Davis County24.5-0.7 pts
208Marion County24.5+3.3 pts
208Murray County24.5-2.1 pts
208Oglala Lakota County24.5-1.7 pts
208Rusk County24.5-0.9 pts
216Delaware County24.4-3.7 pts
216Duplin County24.4-1.8 pts
216McIntosh County24.4-0.8 pts
216Treutlen County24.4-0.5 pts
220Anderson County24.3+1.6 pts
220Falls County24.3+1.6 pts
220Jackson County24.3+1.2 pts
220Lafayette County24.3+2.7 pts
220LaGrange County24.3-1.9 pts
220Sabine County24.3+2.4 pts
220Swain County24.3-4.4 pts
220Wise County24.3-0.8 pts
228Howard County24.2+1.3 pts
228Pittsburg County24.2+0.2 pts
228Sevier County24.2+2.3 pts
231Beckham County24.1+1.4 pts
231Pushmataha County24.1-2.2 pts
231Seminole County24.1-2 pts
234Haskell County24-0.8 pts
234Yakutat City and Borough24+0.5 pts
236Gilmer County23.9-1.1 pts
236Grady County23.9-0.5 pts
236Graham County23.9+2.2 pts
236Kingfisher County23.9-0.9 pts
236Macon County23.9-0.3 pts
236Milam County23.9-0.7 pts
236Scotland County23.9-1.2 pts
236Taylor County23.9+4.3 pts
236Todd County23.9+0.5 pts
236Van Zandt County23.9+0.4 pts
236Wheeler County23.9+4.1 pts
247Bacon County23.8+0.8 pts
248Jefferson County23.7-0.9 pts
248Madison County23.7+1.4 pts
248Woodward County23.7-0.2 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 2021 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-2021-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), 2021) [Data set]. Retrieved October 12, 2026, from https://www2.census.gov/programs-surveys/sahie/datasets/time-series/estimates-acs/sahie-2021-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), 2021. U.S. Census Bureau, 6 Aug. 2026, https://www2.census.gov/programs-surveys/sahie/datasets/time-series/estimates-acs/sahie-2021-csv.zip. Invokely, https://invokely.ai/rankings/uninsured-rate-ages-18-64/us-counties?period=2021. 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), 2021. Dataset. Accessed October 12, 2026. https://www2.census.gov/programs-surveys/sahie/datasets/time-series/estimates-acs/sahie-2021-csv.zip. Also distributed by Invokely, https://invokely.ai/rankings/uninsured-rate-ages-18-64/us-counties?period=2021.

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), 2021 [Dataset]. Available at: https://www2.census.gov/programs-surveys/sahie/datasets/time-series/estimates-acs/sahie-2021-csv.zip, via Invokely: https://invokely.ai/rankings/uninsured-rate-ages-18-64/us-counties?period=2021 (Accessed: 12 October 2026).

BibTeX
@misc{census_us_counties_by_uninsured_2021,
  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), 2021}},
  year = {2026},
  howpublished = {Data set},
  url = {https://www2.census.gov/programs-surveys/sahie/datasets/time-series/estimates-acs/sahie-2021-csv.zip},
  urldate = {2026-10-12},
  note = {Accessed via Invokely, https://invokely.ai/rankings/uninsured-rate-ages-18-64/us-counties?period=2021. 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-2021-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), 2021
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-2021-csv.zip
L2  - https://invokely.ai/rankings/uninsured-rate-ages-18-64/us-counties?period=2021
Y2  - 2026/10/12
N1  - Accessed via Invokely, https://invokely.ai/rankings/uninsured-rate-ages-18-64/us-counties?period=2021.
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-2021-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)?

Kenedy County, with 47.1% in 2021, according to the U.S. Census Bureau.

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

Loving County, with 2.8% in 2021.

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 2021 and are not ranked.

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

US counties: more rankings