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

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

Texas had the highest uninsured rate, ages 18 to 64 (US model-based estimate) of 51 states in 2018, at 23.8%. Massachusetts had the lowest, at 4%. The median was 11%. Source: the U.S. Census Bureau.

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Highest23.8Texas
Lowest4Massachusetts
Median1151 states

Map of states, 2018

Alabama: 15.1 %Alaska: 16 %Arizona: 14.7 %Arkansas: 11.8 %California: 10.3 %Colorado: 10.3 %Connecticut: 7.5 %Delaware: 8 %District of Columbia: 4.1 %Florida: 19.2 %Georgia: 19.1 %Hawaii: 5.5 %Idaho: 16.3 %Illinois: 9.9 %Indiana: 11 %Iowa: 6.8 %Kansas: 12.3 %Kentucky: 7.8 %Louisiana: 11.7 %Maine: 11.7 %Maryland: 8.3 %Massachusetts: 4 %Michigan: 7.7 %Minnesota: 5.9 %Mississippi: 18.5 %Missouri: 13.6 %Montana: 11.8 %Nebraska: 11.4 %Nevada: 14.9 %New Hampshire: 8.6 %New Jersey: 10.6 %New Mexico: 14 %New York: 7.7 %North Carolina: 15.5 %North Dakota: 8.8 %Ohio: 8.9 %Oklahoma: 20.2 %Oregon: 10.2 %Pennsylvania: 7.5 %Rhode Island: 5.7 %South Carolina: 15.7 %South Dakota: 13.6 %Tennessee: 14.6 %Texas: 23.8 %Utah: 12.2 %Vermont: 5.9 %Virginia: 12 %Washington: 9.2 %West Virginia: 9.3 %Wisconsin: 7.5 %Wyoming: 14.7 %
  • Under 7.5
  • 7.5 to 8.9
  • 8.9 to 11
  • 11 to 13
  • 13 to 15
  • 15 and over
%, 2018. 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.

All states, 2018

Texas: 23.8 %Texas23.8Oklahoma: 20.2 %Oklahoma20.2Florida: 19.2 %Florida19.2Georgia: 19.1 %Georgia19.1Mississippi: 18.5 %Mississippi18.5Idaho: 16.3 %Idaho16.3Alaska: 16 %Alaska16South Carolina: 15.7 %South Carolina15.7North Carolina: 15.5 %North Carolina15.5Alabama: 15.1 %Alabama15.1Nevada: 14.9 %Nevada14.9Arizona: 14.7 %Arizona14.7Wyoming: 14.7 %Wyoming14.7Tennessee: 14.6 %Tennessee14.6New Mexico: 14 %New Mexico14Missouri: 13.6 %Missouri13.6South Dakota: 13.6 %South Dakota13.6Kansas: 12.3 %Kansas12.3Utah: 12.2 %Utah12.2Virginia: 12 %Virginia12Arkansas: 11.8 %Arkansas11.8Montana: 11.8 %Montana11.8Louisiana: 11.7 %Louisiana11.7Maine: 11.7 %Maine11.7Nebraska: 11.4 %Nebraska11.4Indiana: 11 %Indiana11New Jersey: 10.6 %New Jersey10.6California: 10.3 %California10.3Colorado: 10.3 %Colorado10.3Oregon: 10.2 %Oregon10.2Illinois: 9.9 %Illinois9.9West Virginia: 9.3 %West Virginia9.3Washington: 9.2 %Washington9.2Ohio: 8.9 %Ohio8.9North Dakota: 8.8 %North Dakota8.8New Hampshire: 8.6 %New Hampshire8.6Maryland: 8.3 %Maryland8.3Delaware: 8 %Delaware8Kentucky: 7.8 %Kentucky7.8Michigan: 7.7 %Michigan7.7New York: 7.7 %New York7.7Connecticut: 7.5 %Connecticut7.5Pennsylvania: 7.5 %Pennsylvania7.5Wisconsin: 7.5 %Wisconsin7.5Iowa: 6.8 %Iowa6.8Minnesota: 5.9 %Minnesota5.9Vermont: 5.9 %Vermont5.9Rhode Island: 5.7 %Rhode Island5.7Hawaii: 5.5 %Hawaii5.5District of Columbia: 4.1 %District of Columbia4.1Massachusetts: 4 %Massachusetts4Texas: 23.8 %Texas23.8Oklahoma: 20.2 %Oklahoma20.2Florida: 19.2 %Florida19.2Georgia: 19.1 %Georgia19.1Mississippi: 18.5 %Mississippi18.5Idaho: 16.3 %Idaho16.3Alaska: 16 %Alaska16South Carolina: 15.7 %South Carolina15.7North Carolina: 15.5 %North Carolina15.5Alabama: 15.1 %Alabama15.1Nevada: 14.9 %Nevada14.9Arizona: 14.7 %Arizona14.7Wyoming: 14.7 %Wyoming14.7Tennessee: 14.6 %Tennessee14.6New Mexico: 14 %New Mexico14Missouri: 13.6 %Missouri13.6South Dakota: 13.6 %South Dakota13.6Kansas: 12.3 %Kansas12.3Utah: 12.2 %Utah12.2Virginia: 12 %Virginia12Arkansas: 11.8 %Arkansas11.8Montana: 11.8 %Montana11.8Louisiana: 11.7 %Louisiana11.7Maine: 11.7 %Maine11.7Nebraska: 11.4 %Nebraska11.4Indiana: 11 %Indiana11New Jersey: 10.6 %New Jersey10.6California: 10.3 %California10.3Colorado: 10.3 %Colorado10.3Oregon: 10.2 %Oregon10.2Illinois: 9.9 %Illinois9.9West Virginia: 9.3 %West Virginia9.3Washington: 9.2 %Washington9.2Ohio: 8.9 %Ohio8.9North Dakota: 8.8 %North Dakota8.8New Hampshire: 8.6 %New Hampshire8.6Maryland: 8.3 %Maryland8.3Delaware: 8 %Delaware8Kentucky: 7.8 %Kentucky7.8Michigan: 7.7 %Michigan7.7New York: 7.7 %New York7.7Connecticut: 7.5 %Connecticut7.5Pennsylvania: 7.5 %Pennsylvania7.5Wisconsin: 7.5 %Wisconsin7.5Iowa: 6.8 %Iowa6.8Minnesota: 5.9 %Minnesota5.9Vermont: 5.9 %Vermont5.9Rhode Island: 5.7 %Rhode Island5.7Hawaii: 5.5 %Hawaii5.5District of Columbia: 4.1 %District of Columbia4.1Massachusetts: 4 %Massachusetts4
%. 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

RankStates2018 (%)Change on 2017
1Texas23.8+0.4 pts
2Oklahoma20.2+0.1 pts
3Florida19.2+0.2 pts
4Georgia19.1+0.2 pts
5Mississippi18.5+0.2 pts
6Idaho16.3+1.1 pts
7Alaska16-1.1 pts
8South Carolina15.7-0.4 pts
9North Carolina15.5-0.1 pts
10Alabama15.1+1 pts
11Nevada14.9-0.3 pts
12Arizona14.7+0.7 pts
12Wyoming14.7-1.7 pts
14Tennessee14.6+0.7 pts
15New Mexico14+0.6 pts
16Missouri13.6+0.4 pts
16South Dakota13.6+0.9 pts
18Kansas12.30 pts
19Utah12.2+0.5 pts
20Virginia12-0.1 pts
21Arkansas11.8+0.4 pts
21Montana11.8-0.3 pts
23Louisiana11.7-0.6 pts
23Maine11.7-0.2 pts
25Nebraska11.4-0.2 pts
26Indiana110 pts
27New Jersey10.6-0.3 pts
28California10.3+0.2 pts
28Colorado10.3+0.1 pts
30Oregon10.2+0.4 pts
31Illinois9.9+0.1 pts
32West Virginia9.3+0.1 pts
33Washington9.2+0.5 pts
34Ohio8.9+0.8 pts
35North Dakota8.8-0.3 pts
36New Hampshire8.6+0.1 pts
37Maryland8.30 pts
38Delaware8+0.7 pts
39Kentucky7.8+0.4 pts
40Michigan7.7+0.4 pts
40New York7.7-0.3 pts
42Connecticut7.50 pts
42Pennsylvania7.5+0.1 pts
42Wisconsin7.5+0.1 pts
45Iowa6.8+0.3 pts
46Minnesota5.9+0.1 pts
46Vermont5.9-0.9 pts
48Rhode Island5.7-0.8 pts
49Hawaii5.50 pts
50District of Columbia4.1-1.1 pts
51Massachusetts4+0.1 pts

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 states 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-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 states 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 states 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-states?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 states 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-states?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 states 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-states?period=2018 (Accessed: 12 October 2026).

BibTeX
@misc{census_us_states_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 states 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-states?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 states 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-states?period=2018
Y2  - 2026/10/12
N1  - Accessed via Invokely, https://invokely.ai/rankings/uninsured-rate-ages-18-64/us-states?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 state has the highest uninsured rate, ages 18 to 64 (US model-based estimate)?

Texas, with 23.8% in 2018, according to the U.S. Census Bureau.

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

Massachusetts, with 4% 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.

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

US states: more rankings