Counties in Virginia by uninsured rate, ages 18 to 64 (US model-based estimate)

Accomack County had the highest uninsured rate, ages 18 to 64 (US model-based estimate) of 133 counties in 2018, at 20.1%. Falls Church city had the lowest, at 4.9%. The median was 13.2% and the figure for Virginia was 12%. Source: the U.S. Census Bureau.

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Highest20.1Accomack County
Median13.2133 counties
Virginia12History

Map of counties, 2018

Accomack County: 20.1 %Albemarle County: 11.3 %Alleghany County: 12.2 %Amelia County: 15.5 %Amherst County: 14.3 %Appomattox County: 13.8 %Arlington County: 7.5 %Augusta County: 12.2 %Bath County: 14.2 %Bedford County: 12 %Bland County: 10.5 %Botetourt County: 9.2 %Brunswick County: 14.9 %Buchanan County: 14.8 %Buckingham County: 16.4 %Campbell County: 13.7 %Caroline County: 13.5 %Carroll County: 15.3 %Charles City County: 16.9 %Charlotte County: 17.5 %Chesterfield County: 11.8 %Clarke County: 11.9 %Craig County: 10.2 %Culpeper County: 15.1 %Cumberland County: 14.5 %Dickenson County: 13.7 %Dinwiddie County: 13 %Essex County: 13.9 %Fairfax County: 10.5 %Fauquier County: 11.9 %Floyd County: 15.8 %Fluvanna County: 12.4 %Franklin County: 13.7 %Frederick County: 12.4 %Giles County: 11.8 %Gloucester County: 12.1 %Goochland County: 8.1 %Grayson County: 14.9 %Greene County: 15 %Greensville County: 13.2 %Halifax County: 13.6 %Hanover County: 8.6 %Henrico County: 12.1 %Henry County: 17.2 %Highland County: 18.5 %Isle of Wight County: 10.2 %James City County: 9.2 %King and Queen County: 16.2 %King George County: 8.8 %King William County: 11.4 %Lancaster County: 14.7 %Lee County: 14.4 %Loudoun County: 8.6 %Louisa County: 14.8 %Lunenburg County: 18.4 %Madison County: 14.3 %Mathews County: 10.8 %Mecklenburg County: 13.6 %Middlesex County: 12.5 %Montgomery County: 11.8 %Nelson County: 14.8 %New Kent County: 10 %Northampton County: 16.9 %Northumberland County: 14.1 %Nottoway County: 17.1 %Orange County: 13.2 %Page County: 14.7 %Patrick County: 15.4 %Pittsylvania County: 14.8 %Powhatan County: 10.7 %Prince Edward County: 14.9 %Prince George County: 10.3 %Prince William County: 14.5 %Pulaski County: 11.1 %Rappahannock County: 14.9 %Richmond County: 15 %Roanoke County: 9.8 %Rockbridge County: 13.2 %Rockingham County: 14.5 %Russell County: 12.3 %Scott County: 12.7 %Shenandoah County: 14.2 %Smyth County: 13.5 %Southampton County: 12.2 %Spotsylvania County: 12.3 %Stafford County: 9.1 %Surry County: 11.4 %Sussex County: 15.5 %Tazewell County: 13.7 %Warren County: 13.8 %Washington County: 13.6 %Westmoreland County: 14.7 %Wise County: 14.5 %Wythe County: 13.6 %York County: 8.9 %Alexandria city: 12.8 %Bristol city: 12.6 %Buena Vista city: 11.8 %Charlottesville city: 11.4 %Chesapeake city: 9.7 %Colonial Heights city: 12.5 %Covington city: 12.7 %Danville city: 13.9 %Emporia city: 12.6 %Fairfax city: 11.2 %Falls Church city: 4.9 %Franklin city: 11.1 %Fredericksburg city: 13.6 %Galax city: 18.3 %Hampton city: 10.9 %Harrisonburg city: 17.1 %Hopewell city: 15.1 %Lexington city: 9.6 %Lynchburg city: 13 %Manassas city: 19.5 %Manassas Park city: 19.1 %Martinsville city: 13.2 %Newport News city: 13.2 %Norfolk city: 15 %Norton city: 11.5 %Petersburg city: 14.4 %Poquoson city: 6.8 %Portsmouth city: 12.8 %Radford city: 9.5 %Richmond city: 15.3 %Roanoke city: 16 %Salem city: 9.2 %Staunton city: 11.5 %Suffolk city: 10.3 %Virginia Beach city: 11.1 %Waynesboro city: 14.9 %Williamsburg city: 11.4 %Winchester city: 17.4 %
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%, 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.

Top 40 counties, 2018

Accomack County: 20.1 %Accomack County20.1Manassas city: 19.5 %Manassas city19.5Manassas Park city: 19.1 %Manassas Park city19.1Highland County: 18.5 %Highland County18.5Lunenburg County: 18.4 %Lunenburg County18.4Galax city: 18.3 %Galax city18.3Charlotte County: 17.5 %Charlotte County17.5Winchester city: 17.4 %Winchester city17.4Henry County: 17.2 %Henry County17.2Harrisonburg city: 17.1 %Harrisonburg city17.1Nottoway County: 17.1 %Nottoway County17.1Charles City County: 16.9 %Charles City County16.9Northampton County: 16.9 %Northampton County16.9Buckingham County: 16.4 %Buckingham County16.4King and Queen County: 16.2 %King and Queen County16.2Roanoke city: 16 %Roanoke city16Floyd County: 15.8 %Floyd County15.8Amelia County: 15.5 %Amelia County15.5Sussex County: 15.5 %Sussex County15.5Patrick County: 15.4 %Patrick County15.4Carroll County: 15.3 %Carroll County15.3Richmond city: 15.3 %Richmond city15.3Culpeper County: 15.1 %Culpeper County15.1Hopewell city: 15.1 %Hopewell city15.1Greene County: 15 %Greene County15Norfolk city: 15 %Norfolk city15Richmond County: 15 %Richmond County15Brunswick County: 14.9 %Brunswick County14.9Grayson County: 14.9 %Grayson County14.9Prince Edward County: 14.9 %Prince Edward County14.9Rappahannock County: 14.9 %Rappahannock County14.9Waynesboro city: 14.9 %Waynesboro city14.9Buchanan County: 14.8 %Buchanan County14.8Louisa County: 14.8 %Louisa County14.8Nelson County: 14.8 %Nelson County14.8Pittsylvania County: 14.8 %Pittsylvania County14.8Lancaster County: 14.7 %Lancaster County14.7Page County: 14.7 %Page County14.7Westmoreland County: 14.7 %Westmoreland County14.7Cumberland County: 14.5 %Cumberland County14.5Accomack County: 20.1 %Accomack County20.1Manassas city: 19.5 %Manassas city19.5Manassas Park city: 19.1 %Manassas Park city19.1Highland County: 18.5 %Highland County18.5Lunenburg County: 18.4 %Lunenburg County18.4Galax city: 18.3 %Galax city18.3Charlotte County: 17.5 %Charlotte County17.5Winchester city: 17.4 %Winchester city17.4Henry County: 17.2 %Henry County17.2Harrisonburg city: 17.1 %Harrisonburg city17.1Nottoway County: 17.1 %Nottoway County17.1Charles City County: 16.9 %Charles City County16.9Northampton County: 16.9 %Northampton County16.9Buckingham County: 16.4 %Buckingham County16.4King and Queen County: 16.2 %King and Queen County16.2Roanoke city: 16 %Roanoke city16Floyd County: 15.8 %Floyd County15.8Amelia County: 15.5 %Amelia County15.5Sussex County: 15.5 %Sussex County15.5Patrick County: 15.4 %Patrick County15.4Carroll County: 15.3 %Carroll County15.3Richmond city: 15.3 %Richmond city15.3Culpeper County: 15.1 %Culpeper County15.1Hopewell city: 15.1 %Hopewell city15.1Greene County: 15 %Greene County15Norfolk city: 15 %Norfolk city15Richmond County: 15 %Richmond County15Brunswick County: 14.9 %Brunswick County14.9Grayson County: 14.9 %Grayson County14.9Prince Edward County: 14.9 %Prince Edward County14.9Rappahannock County: 14.9 %Rappahannock County14.9Waynesboro city: 14.9 %Waynesboro city14.9Buchanan County: 14.8 %Buchanan County14.8Louisa County: 14.8 %Louisa County14.8Nelson County: 14.8 %Nelson County14.8Pittsylvania County: 14.8 %Pittsylvania County14.8Lancaster County: 14.7 %Lancaster County14.7Page County: 14.7 %Page County14.7Westmoreland County: 14.7 %Westmoreland County14.7Cumberland County: 14.5 %Cumberland County14.5
%. 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

RankCounties2018 (%)Change on 2017
1Accomack County20.1+0.7 pts
2Manassas city19.5-0.9 pts
3Manassas Park city19.1-0.7 pts
4Highland County18.5-0.5 pts
5Lunenburg County18.4+0.3 pts
6Galax city18.3-0.2 pts
7Charlotte County17.5+0.1 pts
8Winchester city17.4-1.1 pts
9Henry County17.2+1.8 pts
10Harrisonburg city17.1-1.3 pts
10Nottoway County17.1+0.9 pts
12Charles City County16.9-1.1 pts
12Northampton County16.9-0.2 pts
14Buckingham County16.4+0.6 pts
15King and Queen County16.20 pts
16Roanoke city16+0.5 pts
17Floyd County15.8+0.4 pts
18Amelia County15.50 pts
18Sussex County15.5+0.2 pts
20Patrick County15.4-0.5 pts
21Carroll County15.3+0.6 pts
21Richmond city15.3-1.1 pts
23Culpeper County15.1-1.1 pts
23Hopewell city15.10 pts
25Greene County15-1.1 pts
25Norfolk city15+0.8 pts
25Richmond County15+0.2 pts
28Brunswick County14.90 pts
28Grayson County14.9-0.7 pts
28Prince Edward County14.9+0.8 pts
28Rappahannock County14.9-0.6 pts
28Waynesboro city14.9+0.3 pts
33Buchanan County14.8+0.4 pts
33Louisa County14.8+0.5 pts
33Nelson County14.80 pts
33Pittsylvania County14.8-0.5 pts
37Lancaster County14.7+1.1 pts
37Page County14.7-0.7 pts
37Westmoreland County14.7-0.9 pts
40Cumberland County14.5-0.1 pts
40Prince William County14.5+0.6 pts
40Rockingham County14.5-3 pts
40Wise County14.5+0.4 pts
44Lee County14.4-0.1 pts
44Petersburg city14.4+0.8 pts
46Amherst County14.3-0.2 pts
46Madison County14.3-0.5 pts
48Bath County14.2+2 pts
48Shenandoah County14.2-0.5 pts
50Northumberland County14.1+0.2 pts
51Danville city13.9+0.7 pts
51Essex County13.9-0.9 pts
53Appomattox County13.8+0.1 pts
53Warren County13.8+0.4 pts
55Campbell County13.7+0.3 pts
55Dickenson County13.7-0.1 pts
55Franklin County13.7-1.2 pts
55Tazewell County13.7-0.1 pts
59Fredericksburg city13.6+0.6 pts
59Halifax County13.6+0.3 pts
59Mecklenburg County13.6-0.5 pts
59Washington County13.6+0.8 pts
59Wythe County13.6-0.5 pts
64Caroline County13.5-0.1 pts
64Smyth County13.5+0.8 pts
66Greensville County13.2+0.7 pts
66Martinsville city13.2+0.2 pts
66Newport News city13.2-0.3 pts
66Orange County13.2-0.6 pts
66Rockbridge County13.2-0.5 pts
71Dinwiddie County13-0.8 pts
71Lynchburg city13+0.8 pts
73Alexandria city12.8+0.4 pts
73Portsmouth city12.8-1.2 pts
75Covington city12.7+0.2 pts
75Scott County12.7-0.3 pts
77Bristol city12.6+1.2 pts
77Emporia city12.6-2.1 pts
79Colonial Heights city12.5-0.3 pts
79Middlesex County12.5-0.4 pts
81Fluvanna County12.40 pts
81Frederick County12.4-0.3 pts
83Russell County12.3-0.7 pts
83Spotsylvania County12.3+0.6 pts
85Alleghany County12.2+0.6 pts
85Augusta County12.2-0.9 pts
85Southampton County12.2-0.6 pts
88Gloucester County12.1+0.9 pts
88Henrico County12.1+0.6 pts
90Bedford County12+0.4 pts
91Clarke County11.9-0.8 pts
91Fauquier County11.9+0.6 pts
93Buena Vista city11.8-0.8 pts
93Chesterfield County11.8+0.9 pts
93Giles County11.8-1.6 pts
93Montgomery County11.8-0.6 pts
97Norton city11.5-2.3 pts
97Staunton city11.5-0.5 pts
99Charlottesville city11.4-1.8 pts
99King William County11.4-0.1 pts
99Surry County11.4+0.3 pts
99Williamsburg city11.4-1.7 pts
103Albemarle County11.3-0.3 pts
104Fairfax city11.20 pts
105Franklin city11.1-1.1 pts
105Pulaski County11.1-0.2 pts
105Virginia Beach city11.1+0.2 pts
108Hampton city10.9-0.9 pts
109Mathews County10.8-0.1 pts
110Powhatan County10.7+0.3 pts
111Bland County10.5+0.4 pts
111Fairfax County10.5-0.3 pts
113Prince George County10.3-0.4 pts
113Suffolk city10.3-0.3 pts
115Craig County10.2-1.9 pts
115Isle of Wight County10.2-0.4 pts
117New Kent County10-0.6 pts
118Roanoke County9.8+0.1 pts
119Chesapeake city9.7+0.2 pts
120Lexington city9.6-0.4 pts
121Radford city9.5-0.7 pts
122Botetourt County9.2-0.4 pts
122James City County9.2-1.3 pts
122Salem city9.2-1.1 pts
125Stafford County9.1-0.1 pts
126York County8.9-0.3 pts
127King George County8.8+0.1 pts
128Hanover County8.6-0.5 pts
128Loudoun County8.6+0.9 pts
130Goochland County8.1+0.3 pts
131Arlington County7.5-1.1 pts
132Poquoson city6.8-0.5 pts
133Falls Church city4.9+0.5 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 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-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 (Counties in Virginia 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, Counties in Virginia 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/virginia-counties?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. Counties in Virginia 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/virginia-counties?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, Counties in Virginia 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/virginia-counties?period=2018 (Accessed: 12 October 2026).

BibTeX
@misc{census_counties_in_virginia_by_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: Counties in Virginia 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/virginia-counties?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: Counties in Virginia 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/virginia-counties?period=2018
Y2  - 2026/10/12
N1  - Accessed via Invokely, https://invokely.ai/rankings/uninsured-rate-ages-18-64/virginia-counties?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 county has the highest uninsured rate, ages 18 to 64 (US model-based estimate)?

Accomack County, with 20.1% in 2018, according to the U.S. Census Bureau.

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

Falls Church city, with 4.9% 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

Counties in Virginia: more rankings