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 2021, at 24.1%. Massachusetts had the lowest, at 3.5%. The median was 10.1%. Source: the U.S. Census Bureau.

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Highest24.1Texas
Lowest3.5Massachusetts
Median10.151 states

Map of states, 2021

Alabama: 14.6 %Alaska: 15.2 %Arizona: 15 %Arkansas: 13.3 %California: 9.8 %Colorado: 10.9 %Connecticut: 7.3 %Delaware: 8.1 %District of Columbia: 4.1 %Florida: 17.8 %Georgia: 18 %Hawaii: 5.1 %Idaho: 12 %Illinois: 10.1 %Indiana: 10.2 %Iowa: 6.9 %Kansas: 13.4 %Kentucky: 7.9 %Louisiana: 11.2 %Maine: 8.3 %Maryland: 8.1 %Massachusetts: 3.5 %Michigan: 7.1 %Minnesota: 6.2 %Mississippi: 17.6 %Missouri: 13.5 %Montana: 11.7 %Nebraska: 10.1 %Nevada: 15.8 %New Hampshire: 7.1 %New Jersey: 10 %New Mexico: 14.9 %New York: 7.4 %North Carolina: 15.1 %North Dakota: 10 %Ohio: 8.9 %Oklahoma: 20.6 %Oregon: 8.7 %Pennsylvania: 7.5 %Rhode Island: 5.7 %South Carolina: 14.9 %South Dakota: 13.2 %Tennessee: 14.6 %Texas: 24.1 %Utah: 11.3 %Vermont: 5.4 %Virginia: 9.3 %Washington: 9.2 %West Virginia: 9.2 %Wisconsin: 7.4 %Wyoming: 17 %
  • Under 7.2
  • 7.2 to 8.6
  • 8.6 to 10
  • 10 to 13
  • 13 to 15
  • 15 and over
%, 2021. 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, 2021

Texas: 24.1 %Texas24.1Oklahoma: 20.6 %Oklahoma20.6Georgia: 18 %Georgia18Florida: 17.8 %Florida17.8Mississippi: 17.6 %Mississippi17.6Wyoming: 17 %Wyoming17Nevada: 15.8 %Nevada15.8Alaska: 15.2 %Alaska15.2North Carolina: 15.1 %North Carolina15.1Arizona: 15 %Arizona15New Mexico: 14.9 %New Mexico14.9South Carolina: 14.9 %South Carolina14.9Alabama: 14.6 %Alabama14.6Tennessee: 14.6 %Tennessee14.6Missouri: 13.5 %Missouri13.5Kansas: 13.4 %Kansas13.4Arkansas: 13.3 %Arkansas13.3South Dakota: 13.2 %South Dakota13.2Idaho: 12 %Idaho12Montana: 11.7 %Montana11.7Utah: 11.3 %Utah11.3Louisiana: 11.2 %Louisiana11.2Colorado: 10.9 %Colorado10.9Indiana: 10.2 %Indiana10.2Illinois: 10.1 %Illinois10.1Nebraska: 10.1 %Nebraska10.1New Jersey: 10 %New Jersey10North Dakota: 10 %North Dakota10California: 9.8 %California9.8Virginia: 9.3 %Virginia9.3Washington: 9.2 %Washington9.2West Virginia: 9.2 %West Virginia9.2Ohio: 8.9 %Ohio8.9Oregon: 8.7 %Oregon8.7Maine: 8.3 %Maine8.3Delaware: 8.1 %Delaware8.1Maryland: 8.1 %Maryland8.1Kentucky: 7.9 %Kentucky7.9Pennsylvania: 7.5 %Pennsylvania7.5New York: 7.4 %New York7.4Wisconsin: 7.4 %Wisconsin7.4Connecticut: 7.3 %Connecticut7.3Michigan: 7.1 %Michigan7.1New Hampshire: 7.1 %New Hampshire7.1Iowa: 6.9 %Iowa6.9Minnesota: 6.2 %Minnesota6.2Rhode Island: 5.7 %Rhode Island5.7Vermont: 5.4 %Vermont5.4Hawaii: 5.1 %Hawaii5.1District of Columbia: 4.1 %District of Columbia4.1Massachusetts: 3.5 %Massachusetts3.5Texas: 24.1 %Texas24.1Oklahoma: 20.6 %Oklahoma20.6Georgia: 18 %Georgia18Florida: 17.8 %Florida17.8Mississippi: 17.6 %Mississippi17.6Wyoming: 17 %Wyoming17Nevada: 15.8 %Nevada15.8Alaska: 15.2 %Alaska15.2North Carolina: 15.1 %North Carolina15.1Arizona: 15 %Arizona15New Mexico: 14.9 %New Mexico14.9South Carolina: 14.9 %South Carolina14.9Alabama: 14.6 %Alabama14.6Tennessee: 14.6 %Tennessee14.6Missouri: 13.5 %Missouri13.5Kansas: 13.4 %Kansas13.4Arkansas: 13.3 %Arkansas13.3South Dakota: 13.2 %South Dakota13.2Idaho: 12 %Idaho12Montana: 11.7 %Montana11.7Utah: 11.3 %Utah11.3Louisiana: 11.2 %Louisiana11.2Colorado: 10.9 %Colorado10.9Indiana: 10.2 %Indiana10.2Illinois: 10.1 %Illinois10.1Nebraska: 10.1 %Nebraska10.1New Jersey: 10 %New Jersey10North Dakota: 10 %North Dakota10California: 9.8 %California9.8Virginia: 9.3 %Virginia9.3Washington: 9.2 %Washington9.2West Virginia: 9.2 %West Virginia9.2Ohio: 8.9 %Ohio8.9Oregon: 8.7 %Oregon8.7Maine: 8.3 %Maine8.3Delaware: 8.1 %Delaware8.1Maryland: 8.1 %Maryland8.1Kentucky: 7.9 %Kentucky7.9Pennsylvania: 7.5 %Pennsylvania7.5New York: 7.4 %New York7.4Wisconsin: 7.4 %Wisconsin7.4Connecticut: 7.3 %Connecticut7.3Michigan: 7.1 %Michigan7.1New Hampshire: 7.1 %New Hampshire7.1Iowa: 6.9 %Iowa6.9Minnesota: 6.2 %Minnesota6.2Rhode Island: 5.7 %Rhode Island5.7Vermont: 5.4 %Vermont5.4Hawaii: 5.1 %Hawaii5.1District of Columbia: 4.1 %District of Columbia4.1Massachusetts: 3.5 %Massachusetts3.5
%. 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

RankStates2021 (%)Change on 2020
1Texas24.1+0.5 pts
2Oklahoma20.6-1.1 pts
3Georgia18-0.4 pts
4Florida17.8-0.6 pts
5Mississippi17.6+0.1 pts
6Wyoming17+0.4 pts
7Nevada15.8-0.3 pts
8Alaska15.2+0.4 pts
9North Carolina15.1-0.4 pts
10Arizona15-0.2 pts
11New Mexico14.9+0.6 pts
11South Carolina14.9-0.5 pts
13Alabama14.6-0.3 pts
13Tennessee14.6+0.1 pts
15Missouri13.5-0.8 pts
16Kansas13.4+0.9 pts
17Arkansas13.3+0.7 pts
18South Dakota13.2-0.7 pts
19Idaho12-1.4 pts
20Montana11.7-0.4 pts
21Utah11.3+0.2 pts
22Louisiana11.2-0.6 pts
23Colorado10.9-0.6 pts
24Indiana10.20 pts
25Illinois10.1-0.3 pts
25Nebraska10.1-1.3 pts
27New Jersey10-0.5 pts
27North Dakota10+0.9 pts
29California9.8-0.2 pts
30Virginia9.3-0.8 pts
31Washington9.2+0.2 pts
31West Virginia9.2-1.1 pts
33Ohio8.9-0.5 pts
34Oregon8.7-0.8 pts
35Maine8.3-2.1 pts
36Delaware8.1-1 pts
36Maryland8.1+0.2 pts
38Kentucky7.9-0.1 pts
39Pennsylvania7.5-0.9 pts
40New York7.4+0.1 pts
40Wisconsin7.4-0.4 pts
42Connecticut7.3+0.9 pts
43Michigan7.1-0.7 pts
43New Hampshire7.1-2.2 pts
45Iowa6.9-0.1 pts
46Minnesota6.2-0.7 pts
47Rhode Island5.7+0.6 pts
48Vermont5.4-0.7 pts
49Hawaii5.1-0.3 pts
50District of Columbia4.1-0.2 pts
51Massachusetts3.5-0.1 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-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 states 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 states 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-states?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 states 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-states?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 states 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-states?period=2021 (Accessed: 12 October 2026).

BibTeX
@misc{census_us_states_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 states 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-states?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 states 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-states?period=2021
Y2  - 2026/10/12
N1  - Accessed via Invokely, https://invokely.ai/rankings/uninsured-rate-ages-18-64/us-states?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 state has the highest uninsured rate, ages 18 to 64 (US model-based estimate)?

Texas, with 24.1% in 2021, according to the U.S. Census Bureau.

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

Massachusetts, with 3.5% 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.

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

US states: more rankings