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)

Gaines County had the highest uninsured rate, ages 18 to 64 (US model-based estimate) of 3143 counties in 2023, at 38.6%. Norfolk County had the lowest, at 2.5%. The median was 10.7%. Source: the U.S. Census Bureau.

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Highest38.6Gaines County
Lowest2.5Norfolk County
Median10.73143 counties

Map of counties, 2023

%, 2023. 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, 2023

Gaines County: 38.6 %Gaines County38.6Hidalgo County: 35.7 %Hidalgo County35.7Webb County: 35.5 %Webb County35.5Presidio County: 35 %Presidio County35Edwards County: 33.4 %Edwards County33.4Zapata County: 33.2 %Zapata County33.2Starr County: 32.6 %Starr County32.6Cameron County: 32.5 %Cameron County32.5Dallam County: 31.6 %Dallam County31.6Kenedy County: 31.5 %Kenedy County31.5Hansford County: 31.1 %Hansford County31.1Bailey County: 31 %Bailey County31Cochran County: 30.9 %Cochran County30.9Moore County: 30.6 %Moore County30.6Ochiltree County: 30.3 %Ochiltree County30.3Parmer County: 30.3 %Parmer County30.3Terry County: 30 %Terry County30Maverick County: 29.9 %Maverick County29.9Sherman County: 29.5 %Sherman County29.5Liberty County: 29.4 %Liberty County29.4Hall County: 29.3 %Hall County29.3Atkinson County: 29 %Atkinson County29Hudspeth County: 28.8 %Hudspeth County28.8Titus County: 28.6 %Titus County28.6Wheeler County: 28.6 %Wheeler County28.6Deaf Smith County: 28.5 %Deaf Smith County28.5Holmes County: 28.5 %Holmes County28.5San Saba County: 28.4 %San Saba County28.4Hale County: 28.3 %Hale County28.3Yoakum County: 28.3 %Yoakum County28.3El Paso County: 28.1 %El Paso County28.1Hendry County: 28.1 %Hendry County28.1Potter County: 28 %Potter County28Gonzales County: 27.9 %Gonzales County27.9Crockett County: 27.4 %Crockett County27.4Knox County: 27.3 %Knox County27.3Lamb County: 27.2 %Lamb County27.2Castro County: 26.9 %Castro County26.9Dawson County: 26.9 %Dawson County26.9DeSoto County: 26.9 %DeSoto County26.9Gaines County: 38.6 %Gaines County38.6Hidalgo County: 35.7 %Hidalgo County35.7Webb County: 35.5 %Webb County35.5Presidio County: 35 %Presidio County35Edwards County: 33.4 %Edwards County33.4Zapata County: 33.2 %Zapata County33.2Starr County: 32.6 %Starr County32.6Cameron County: 32.5 %Cameron County32.5Dallam County: 31.6 %Dallam County31.6Kenedy County: 31.5 %Kenedy County31.5Hansford County: 31.1 %Hansford County31.1Bailey County: 31 %Bailey County31Cochran County: 30.9 %Cochran County30.9Moore County: 30.6 %Moore County30.6Ochiltree County: 30.3 %Ochiltree County30.3Parmer County: 30.3 %Parmer County30.3Terry County: 30 %Terry County30Maverick County: 29.9 %Maverick County29.9Sherman County: 29.5 %Sherman County29.5Liberty County: 29.4 %Liberty County29.4Hall County: 29.3 %Hall County29.3Atkinson County: 29 %Atkinson County29Hudspeth County: 28.8 %Hudspeth County28.8Titus County: 28.6 %Titus County28.6Wheeler County: 28.6 %Wheeler County28.6Deaf Smith County: 28.5 %Deaf Smith County28.5Holmes County: 28.5 %Holmes County28.5San Saba County: 28.4 %San Saba County28.4Hale County: 28.3 %Hale County28.3Yoakum County: 28.3 %Yoakum County28.3El Paso County: 28.1 %El Paso County28.1Hendry County: 28.1 %Hendry County28.1Potter County: 28 %Potter County28Gonzales County: 27.9 %Gonzales County27.9Crockett County: 27.4 %Crockett County27.4Knox County: 27.3 %Knox County27.3Lamb County: 27.2 %Lamb County27.2Castro County: 26.9 %Castro County26.9Dawson County: 26.9 %Dawson County26.9DeSoto County: 26.9 %DeSoto County26.9
%. 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

RankCounties2023 (%)Change on 2022
1Gaines County38.6+0.5 pts
2Hidalgo County35.7-4.1 pts
3Webb County35.5-0.2 pts
4Presidio County35-5.7 pts
5Edwards County33.4-2.5 pts
6Zapata County33.2+1.4 pts
7Starr County32.6-0.4 pts
8Cameron County32.5-0.3 pts
9Dallam County31.6-3.4 pts
10Kenedy County31.5-7.6 pts
11Hansford County31.1-0.3 pts
12Bailey County31-2.1 pts
13Cochran County30.9+0.6 pts
14Moore County30.6-0.1 pts
15Ochiltree County30.3-2 pts
15Parmer County30.3+1.7 pts
17Terry County30+0.9 pts
18Maverick County29.9-4.5 pts
19Sherman County29.5-1.9 pts
20Liberty County29.4+1 pts
21Hall County29.3-1.1 pts
22Atkinson County29+2.8 pts
23Hudspeth County28.8-2.4 pts
24Titus County28.6+0.2 pts
24Wheeler County28.6-1.8 pts
26Deaf Smith County28.5+1.2 pts
26Holmes County28.5-2.6 pts
28San Saba County28.4-3.7 pts
29Hale County28.3+0.9 pts
29Yoakum County28.3-2.9 pts
31El Paso County28.1-0.9 pts
31Hendry County28.1-2.4 pts
33Potter County28-0.6 pts
34Gonzales County27.9+0.5 pts
35Crockett County27.4-3.7 pts
36Knox County27.3+1.7 pts
37Lamb County27.2-0.8 pts
38Castro County26.9-3.7 pts
38Dawson County26.9-0.5 pts
38DeSoto County26.9-0.1 pts
38La Salle County26.9+0.4 pts
38Navarro County26.9+4 pts
43Swisher County26.8-6 pts
43Willacy County26.8-0.9 pts
45Dallas County26.7-0.7 pts
45Uvalde County26.7-1.7 pts
47Comanche County26.4+0.6 pts
48Floyd County26.3-3.7 pts
49LaGrange County26.2-2.2 pts
50Caldwell County26.1-0.7 pts
50Collingsworth County26.1-4.5 pts
50Ector County26.1-0.1 pts
50Glades County26.1-2.4 pts
50Gray County26.1-0.1 pts
50Madison County26.1-2.8 pts
56Jefferson County25.9+1.2 pts
56Menard County25.9-4.4 pts
56Shelby County25.9-1.8 pts
59Harris County25.8-0.7 pts
60Frio County25.6-1.3 pts
61Aleutians East Borough25.5+5.1 pts
61Cherokee County25.5+1.5 pts
61Texas County25.5+3.1 pts
64Jack County25.3-0.6 pts
64Whitfield County25.3-1.1 pts
66Clark County25.2-0.7 pts
66Nacogdoches County25.2+2.4 pts
68Bastrop County25.1+0.5 pts
68Hopkins County25.1+1.1 pts
70Palo Pinto County25+0.6 pts
71Camp County24.8+0.6 pts
71Haskell County24.8-2.1 pts
73Matagorda County24.7-1 pts
73McCulloch County24.7-1.3 pts
73Reeves County24.7-1.4 pts
76Lipscomb County24.50 pts
76Pecos County24.5-2.3 pts
76Yakutat City and Borough24.5+2.8 pts
79Andrews County24.4-2.9 pts
80Colorado County24.3-1.5 pts
80King County24.3+2.3 pts
80Macon County24.3+1.3 pts
83Hamilton County24.2-1.1 pts
83Leon County24.2-1.2 pts
85Sutton County24.10 pts
85Wharton County24.1-0.8 pts
87Henderson County24-2.2 pts
87Hockley County24-2.7 pts
87Waller County24+2.4 pts
90Crosby County23.9-2.6 pts
91Erath County23.8+0.5 pts
91San Jacinto County23.8-0.3 pts
91Van Zandt County23.8+1.5 pts
94Lee County23.6+0.2 pts
94Red River County23.6+2.4 pts
94Young County23.6-1.2 pts
97Briscoe County23.5-1.8 pts
97Franklin County23.5+2.5 pts
97Freestone County23.5+1 pts
97Gillespie County23.5-4.4 pts
101Gregg County23.4-0.2 pts
102Crane County23.3-4 pts
102Grimes County23.3+0.2 pts
102Hill County23.3+0.3 pts
102Live Oak County23.3-1.2 pts
102San Augustine County23.3+0.3 pts
107Cooke County23.2+1.9 pts
107Eastland County23.2-0.4 pts
107Wood County23.2+0.8 pts
110Candler County23.1-2.1 pts
110Hardeman County23.1-0.2 pts
110Kerr County23.1+1.7 pts
110Montague County23.1-1.4 pts
110Wilbarger County23.1-1.1 pts
115Donley County23-1.8 pts
116Coleman County22.9-3.2 pts
116Colquitt County22.9-1.8 pts
116Runnels County22.9-0.6 pts
116Schleicher County22.9-3.3 pts
120Houston County22.8-0.7 pts
120Mason County22.8-4.2 pts
122Anderson County22.7+1 pts
122Hunt County22.7-0.3 pts
122Jim Hogg County22.7-4.2 pts
122Jim Wells County22.7-0.8 pts
122Stephens County22.7-2.2 pts
122Ward County22.7-4.9 pts
128Burleson County22.6-1.8 pts
128Jackson County22.6-0.8 pts
128Kimble County22.6-2.1 pts
128Rains County22.6-2.2 pts
132Val Verde County22.5-4.3 pts
133Angelina County22.4-1.5 pts
133Limestone County22.4-1.1 pts
133Newton County22.4-1.4 pts
133Petersburg Borough22.4+1.5 pts
137Brantley County22.3+0.6 pts
137Clinch County22.3-0.3 pts
137Lake and Peninsula Borough22.3-1.8 pts
140Burnet County22.2+0.2 pts
141Brooks County22.1-1.2 pts
141Grady County22.1-0.3 pts
141Harper County22.1+0.7 pts
141Seward County22.1-1.5 pts
141Winkler County22.1-1.3 pts
146Appling County22-1.7 pts
146Austin County22-0.2 pts
146Evans County22-0.3 pts
146Jerome County22+2.3 pts
146Mills County22-2.4 pts
146Owyhee County22+1.9 pts
146Real County22-2.1 pts
146Smith County22-0.3 pts
154Big Horn County21.9-0.7 pts
154Marshall County21.9-0.3 pts
154Nueces County21.9-1.9 pts
154Sampson County21.9+0.8 pts
158Beaver County21.8-0.9 pts
158Santa Cruz County21.8-1 pts
160Brewster County21.7-3.9 pts
160Kleberg County21.7-0.7 pts
160Marion County21.7-0.3 pts
160Prince of Wales-Hyder Census Area21.7-0.6 pts
160Rabun County21.7-1.1 pts
165Atoka County21.6+0.5 pts
165Foard County21.6+0.6 pts
165Grayson County21.6+0.2 pts
165Lamar County21.60 pts
165Polk County21.6-0.5 pts
165Victoria County21.6-1.3 pts
171Coffee County21.5-2.8 pts
171Duplin County21.5+2.3 pts
171Jeff Davis County21.5-0.7 pts
174Atascosa County21.4-3 pts
174Bosque County21.4-2 pts
174Echols County21.4-2.5 pts
174Habersham County21.4-1.5 pts
174McDonald County21.4-0.9 pts
174Zavala County21.4-0.5 pts
180Aleutians West Census Area21.3+3.7 pts
180Dimmit County21.3-3.9 pts
180Scurry County21.3-3.2 pts
180Tyler County21.3-1.3 pts
180Wheeler County21.3-1.2 pts
185Harmon County21.2-0.3 pts
185Lampasas County21.2+1.6 pts
185Wrangell City and Borough21.2-2.3 pts
188Gooding County21.1-0.8 pts
188Hardee County21.1-1.7 pts
188Johnson County21.1-0.8 pts
188Lanier County21.1+3.9 pts
188Sevier County21.1+1.3 pts
193Bledsoe County21+2.2 pts
193Falls County21-0.5 pts
193Robertson County21+0.8 pts
193Rusk County21-1.4 pts
193San Patricio County21-2.1 pts
193Tattnall County21+1.6 pts
193Throckmorton County21-0.9 pts
200Ford County20.90 pts
200Gordon County20.9-3.5 pts
200Greene County20.9-1 pts
200Jones County20.9-0.2 pts
200Tift County20.9-0.1 pts
200Tom Green County20.9+0.7 pts
200Wise County20.9-0.2 pts
207Hyde County20.8-1.8 pts
207Scott County20.8+0.9 pts
209Hemphill County20.7-3.6 pts
209Upton County20.7-2.5 pts
209Wilcox County20.7+3.1 pts
212Bacon County20.6-1.1 pts
212Collier County20.6-0.6 pts
212Kodiak Island Borough20.6+0.5 pts
212Milam County20.6-2.1 pts
212Morris County20.6+0.4 pts
212Tarrant County20.6-0.7 pts
212Toombs County20.6+0.1 pts
212Walker County20.6-0.4 pts
220Cherokee County20.5+0.3 pts
220Garza County20.5-5.3 pts
220Gray County20.5-0.3 pts
220Hall County20.5-2.8 pts
220Kaufman County20.5+1.6 pts
220McLennan County20.5-1.2 pts
220Sabine County20.5-1 pts
227Childress County20.4-1.9 pts
227Fayette County20.4-1.1 pts
227Llano County20.4-1.5 pts
227Yukon-Koyukuk Census Area20.4-2.9 pts
231Gilmer County20.3-0.4 pts
231Gwinnett County20.3+1.6 pts
231Haskell County20.3-4.4 pts
231Jefferson County20.3-2.2 pts
231Karnes County20.3-1.2 pts
231Montgomery County20.3+1.8 pts
231Nome Census Area20.3+1.5 pts
231Okeechobee County20.3-0.9 pts
239Alleghany County20.2-0.3 pts
239Blanco County20.20 pts
239Fannin County20.2+0.5 pts
239Finney County20.2-1.8 pts
239Marion County20.2+0.9 pts
239Nolan County20.2-1.9 pts
239Reagan County20.2-4.1 pts
239Trinity County20.2-0.3 pts
247Bandera County20.1-2 pts
247Clayton County20.1+0.2 pts
247Le Flore County20.1-3.7 pts
247Mellette County20.1+0.9 pts

Showing the top 250 of 3143. 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. 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-2023-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), 2023) [Data set]. Retrieved October 12, 2026, from https://www2.census.gov/programs-surveys/sahie/datasets/time-series/estimates-acs/sahie-2023-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), 2023. U.S. Census Bureau, 6 Aug. 2026, https://www2.census.gov/programs-surveys/sahie/datasets/time-series/estimates-acs/sahie-2023-csv.zip. Invokely, https://invokely.ai/rankings/uninsured-rate-ages-18-64/us-counties?period=2023. 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), 2023. Dataset. Accessed October 12, 2026. https://www2.census.gov/programs-surveys/sahie/datasets/time-series/estimates-acs/sahie-2023-csv.zip. Also distributed by Invokely, https://invokely.ai/rankings/uninsured-rate-ages-18-64/us-counties?period=2023.

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), 2023 [Dataset]. Available at: https://www2.census.gov/programs-surveys/sahie/datasets/time-series/estimates-acs/sahie-2023-csv.zip, via Invokely: https://invokely.ai/rankings/uninsured-rate-ages-18-64/us-counties?period=2023 (Accessed: 12 October 2026).

BibTeX
@misc{census_us_counties_by_uninsured_2023,
  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), 2023}},
  year = {2026},
  howpublished = {Data set},
  url = {https://www2.census.gov/programs-surveys/sahie/datasets/time-series/estimates-acs/sahie-2023-csv.zip},
  urldate = {2026-10-12},
  note = {Accessed via Invokely, https://invokely.ai/rankings/uninsured-rate-ages-18-64/us-counties?period=2023. 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-2023-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), 2023
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-2023-csv.zip
L2  - https://invokely.ai/rankings/uninsured-rate-ages-18-64/us-counties?period=2023
Y2  - 2026/10/12
N1  - Accessed via Invokely, https://invokely.ai/rankings/uninsured-rate-ages-18-64/us-counties?period=2023.
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-2023-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)?

Gaines County, with 38.6% in 2023, 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 2.5% in 2023.

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

US counties: more rankings