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 2020, at 23.6%. Massachusetts had the lowest, at 3.6%. The median was 10.4%. Source: the U.S. Census Bureau.

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Highest23.6Texas
Lowest3.6Massachusetts
Median10.451 states

Map of states, 2020

Alabama: 14.9 %Alaska: 14.8 %Arizona: 15.2 %Arkansas: 12.6 %California: 10 %Colorado: 11.5 %Connecticut: 6.4 %Delaware: 9.1 %District of Columbia: 4.3 %Florida: 18.4 %Georgia: 18.4 %Hawaii: 5.4 %Idaho: 13.4 %Illinois: 10.4 %Indiana: 10.2 %Iowa: 7 %Kansas: 12.5 %Kentucky: 8 %Louisiana: 11.8 %Maine: 10.4 %Maryland: 7.9 %Massachusetts: 3.6 %Michigan: 7.8 %Minnesota: 6.9 %Mississippi: 17.5 %Missouri: 14.3 %Montana: 12.1 %Nebraska: 11.4 %Nevada: 16.1 %New Hampshire: 9.3 %New Jersey: 10.5 %New Mexico: 14.3 %New York: 7.3 %North Carolina: 15.5 %North Dakota: 9.1 %Ohio: 9.4 %Oklahoma: 21.7 %Oregon: 9.5 %Pennsylvania: 8.4 %Rhode Island: 5.1 %South Carolina: 15.4 %South Dakota: 13.9 %Tennessee: 14.5 %Texas: 23.6 %Utah: 11.1 %Vermont: 6.1 %Virginia: 10.1 %Washington: 9 %West Virginia: 10.3 %Wisconsin: 7.8 %Wyoming: 16.6 %
  • Under 7.5
  • 7.5 to 9.2
  • 9.2 to 10
  • 10 to 13
  • 13 to 15
  • 15 and over
%, 2020. 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, 2020

Texas: 23.6 %Texas23.6Oklahoma: 21.7 %Oklahoma21.7Florida: 18.4 %Florida18.4Georgia: 18.4 %Georgia18.4Mississippi: 17.5 %Mississippi17.5Wyoming: 16.6 %Wyoming16.6Nevada: 16.1 %Nevada16.1North Carolina: 15.5 %North Carolina15.5South Carolina: 15.4 %South Carolina15.4Arizona: 15.2 %Arizona15.2Alabama: 14.9 %Alabama14.9Alaska: 14.8 %Alaska14.8Tennessee: 14.5 %Tennessee14.5Missouri: 14.3 %Missouri14.3New Mexico: 14.3 %New Mexico14.3South Dakota: 13.9 %South Dakota13.9Idaho: 13.4 %Idaho13.4Arkansas: 12.6 %Arkansas12.6Kansas: 12.5 %Kansas12.5Montana: 12.1 %Montana12.1Louisiana: 11.8 %Louisiana11.8Colorado: 11.5 %Colorado11.5Nebraska: 11.4 %Nebraska11.4Utah: 11.1 %Utah11.1New Jersey: 10.5 %New Jersey10.5Illinois: 10.4 %Illinois10.4Maine: 10.4 %Maine10.4West Virginia: 10.3 %West Virginia10.3Indiana: 10.2 %Indiana10.2Virginia: 10.1 %Virginia10.1California: 10 %California10Oregon: 9.5 %Oregon9.5Ohio: 9.4 %Ohio9.4New Hampshire: 9.3 %New Hampshire9.3Delaware: 9.1 %Delaware9.1North Dakota: 9.1 %North Dakota9.1Washington: 9 %Washington9Pennsylvania: 8.4 %Pennsylvania8.4Kentucky: 8 %Kentucky8Maryland: 7.9 %Maryland7.9Michigan: 7.8 %Michigan7.8Wisconsin: 7.8 %Wisconsin7.8New York: 7.3 %New York7.3Iowa: 7 %Iowa7Minnesota: 6.9 %Minnesota6.9Connecticut: 6.4 %Connecticut6.4Vermont: 6.1 %Vermont6.1Hawaii: 5.4 %Hawaii5.4Rhode Island: 5.1 %Rhode Island5.1District of Columbia: 4.3 %District of Columbia4.3Massachusetts: 3.6 %Massachusetts3.6Texas: 23.6 %Texas23.6Oklahoma: 21.7 %Oklahoma21.7Florida: 18.4 %Florida18.4Georgia: 18.4 %Georgia18.4Mississippi: 17.5 %Mississippi17.5Wyoming: 16.6 %Wyoming16.6Nevada: 16.1 %Nevada16.1North Carolina: 15.5 %North Carolina15.5South Carolina: 15.4 %South Carolina15.4Arizona: 15.2 %Arizona15.2Alabama: 14.9 %Alabama14.9Alaska: 14.8 %Alaska14.8Tennessee: 14.5 %Tennessee14.5Missouri: 14.3 %Missouri14.3New Mexico: 14.3 %New Mexico14.3South Dakota: 13.9 %South Dakota13.9Idaho: 13.4 %Idaho13.4Arkansas: 12.6 %Arkansas12.6Kansas: 12.5 %Kansas12.5Montana: 12.1 %Montana12.1Louisiana: 11.8 %Louisiana11.8Colorado: 11.5 %Colorado11.5Nebraska: 11.4 %Nebraska11.4Utah: 11.1 %Utah11.1New Jersey: 10.5 %New Jersey10.5Illinois: 10.4 %Illinois10.4Maine: 10.4 %Maine10.4West Virginia: 10.3 %West Virginia10.3Indiana: 10.2 %Indiana10.2Virginia: 10.1 %Virginia10.1California: 10 %California10Oregon: 9.5 %Oregon9.5Ohio: 9.4 %Ohio9.4New Hampshire: 9.3 %New Hampshire9.3Delaware: 9.1 %Delaware9.1North Dakota: 9.1 %North Dakota9.1Washington: 9 %Washington9Pennsylvania: 8.4 %Pennsylvania8.4Kentucky: 8 %Kentucky8Maryland: 7.9 %Maryland7.9Michigan: 7.8 %Michigan7.8Wisconsin: 7.8 %Wisconsin7.8New York: 7.3 %New York7.3Iowa: 7 %Iowa7Minnesota: 6.9 %Minnesota6.9Connecticut: 6.4 %Connecticut6.4Vermont: 6.1 %Vermont6.1Hawaii: 5.4 %Hawaii5.4Rhode Island: 5.1 %Rhode Island5.1District of Columbia: 4.3 %District of Columbia4.3Massachusetts: 3.6 %Massachusetts3.6
%. 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

RankStates2020 (%)Change on 2019
1Texas23.6-0.7 pts
2Oklahoma21.7+1.4 pts
3Florida18.4-1 pts
3Georgia18.4-0.6 pts
5Mississippi17.5-1.7 pts
6Wyoming16.6+0.3 pts
7Nevada16.1+0.5 pts
8North Carolina15.5-0.8 pts
9South Carolina15.4-0.6 pts
10Arizona15.2-0.2 pts
11Alabama14.9+0.2 pts
12Alaska14.8+0.1 pts
13Tennessee14.5-0.3 pts
14Missouri14.3+0.3 pts
14New Mexico14.3-0.3 pts
16South Dakota13.9-0.1 pts
17Idaho13.4-2.7 pts
18Arkansas12.6-0.3 pts
19Kansas12.5-0.3 pts
20Montana12.1+0.4 pts
21Louisiana11.8-1.1 pts
22Colorado11.5+0.7 pts
23Nebraska11.40 pts
24Utah11.1-1 pts
25New Jersey10.5-0.7 pts
26Illinois10.4-0.1 pts
26Maine10.4-1.2 pts
28West Virginia10.3+0.5 pts
29Indiana10.2-1.5 pts
30Virginia10.1-0.7 pts
31California10-1 pts
32Oregon9.5-0.7 pts
33Ohio9.4+0.3 pts
34New Hampshire9.3+0.3 pts
35Delaware9.10 pts
35North Dakota9.1+1.4 pts
37Washington9-0.4 pts
38Pennsylvania8.4+0.6 pts
39Kentucky8-1 pts
40Maryland7.9-0.4 pts
41Michigan7.8-0.5 pts
41Wisconsin7.8-0.2 pts
43New York7.3-0.2 pts
44Iowa70 pts
45Minnesota6.90 pts
46Connecticut6.4-1.9 pts
47Vermont6.1-0.8 pts
48Hawaii5.4-0.2 pts
49Rhode Island5.1-0.9 pts
50District of Columbia4.3-0.3 pts
51Massachusetts3.6-0.6 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-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 states 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 states 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-states?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 states 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-states?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 states 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-states?period=2020 (Accessed: 12 October 2026).

BibTeX
@misc{census_us_states_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 states 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-states?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 states 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-states?period=2020
Y2  - 2026/10/12
N1  - Accessed via Invokely, https://invokely.ai/rankings/uninsured-rate-ages-18-64/us-states?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 state has the highest uninsured rate, ages 18 to 64 (US model-based estimate)?

Texas, with 23.6% in 2020, according to the U.S. Census Bureau.

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

Massachusetts, with 3.6% 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.

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

US states: more rankings