Data / Rankings / Uninsured rate, under 65 (US model-based estimate) / US counties

US counties by uninsured rate, under 65 (US model-based estimate), 2024

Gaines County had the highest uninsured rate, under 65 (US model-based estimate) of 3143 counties in 2024, at 38.5%. Norfolk County had the lowest, at 2.4%. The median was 9.8%. Source: the U.S. Census Bureau.

Highest38.5Gaines County
Lowest2.4Norfolk County
Median9.83143 counties

Top 40 counties, 2024

Gaines County: 38.5 %Gaines County38.5Holmes County: 33.4 %Holmes County33.4LaGrange County: 31.3 %LaGrange County31.3Presidio County: 29.6 %Presidio County29.6Moore County: 28.5 %Moore County28.5Ochiltree County: 27.6 %Ochiltree County27.6Edwards County: 27.2 %Edwards County27.2Parmer County: 27.2 %Parmer County27.2Starr County: 27.1 %Starr County27.1Crockett County: 26.8 %Crockett County26.8San Saba County: 26.8 %San Saba County26.8Zapata County: 26.8 %Zapata County26.8Hidalgo County: 26.7 %Hidalgo County26.7Cameron County: 26.6 %Cameron County26.6Dallam County: 26.4 %Dallam County26.4Webb County: 26.2 %Webb County26.2Bailey County: 25.9 %Bailey County25.9King County: 25.9 %King County25.9Collingsworth County: 25.7 %Collingsworth County25.7Hansford County: 25.7 %Hansford County25.7Mason County: 25.6 %Mason County25.6Terry County: 25.6 %Terry County25.6Gonzales County: 25.5 %Gonzales County25.5Deaf Smith County: 25.4 %Deaf Smith County25.4Titus County: 25.1 %Titus County25.1Wheeler County: 25.1 %Wheeler County25.1Comanche County: 25 %Comanche County25Cochran County: 24.9 %Cochran County24.9Hudspeth County: 24.6 %Hudspeth County24.6Kimble County: 24.5 %Kimble County24.5Madison County: 24.5 %Madison County24.5Ector County: 24.4 %Ector County24.4Glades County: 24.3 %Glades County24.3Dallas County: 24.2 %Dallas County24.2Maverick County: 24.2 %Maverick County24.2Menard County: 24.2 %Menard County24.2Floyd County: 24.1 %Floyd County24.1Hall County: 24.1 %Hall County24.1Lee County: 24.1 %Lee County24.1Liberty County: 24.1 %Liberty County24.1
%. Source: U.S. Census Bureau, Small Area Health Insurance Estimates (SAHIE): percent uninsured, under 65, all races, both sexes, all income levels, states and counties. Retrieved 2026-10-12.

Full ranking

RankCounties2024 (%)Change on 2023
1Gaines County38.5+5 pts
2Holmes County33.4+1.9 pts
3LaGrange County31.30 pts
4Presidio County29.60 pts
5Moore County28.5+2.7 pts
6Ochiltree County27.6+0.5 pts
7Edwards County27.2-1.6 pts
7Parmer County27.2+0.6 pts
9Starr County27.1+2 pts
10Crockett County26.8+2.3 pts
10San Saba County26.8+1.2 pts
10Zapata County26.8+0.7 pts
13Hidalgo County26.7-0.8 pts
14Cameron County26.6+0.6 pts
15Dallam County26.4-0.4 pts
16Webb County26.2-2.5 pts
17Bailey County25.9-0.4 pts
17King County25.9+2.3 pts
19Collingsworth County25.7+3 pts
19Hansford County25.7-3.4 pts
21Mason County25.6+4.3 pts
21Terry County25.6+1.1 pts
23Gonzales County25.5+1.4 pts
24Deaf Smith County25.4+1.9 pts
25Titus County25.1+1.2 pts
25Wheeler County25.1-0.2 pts
27Comanche County25+1.7 pts
28Cochran County24.9-2.4 pts
29Hudspeth County24.6-1.1 pts
30Kimble County24.5+4.3 pts
30Madison County24.5+2 pts
32Ector County24.4+1.8 pts
33Glades County24.3+0.8 pts
34Dallas County24.2+0.9 pts
34Maverick County24.2+0.5 pts
34Menard County24.2+0.5 pts
37Floyd County24.1+1.2 pts
37Hall County24.1-1.2 pts
37Lee County24.1+3.3 pts
37Liberty County24.1+0.3 pts
41Lamb County24+0.7 pts
41Shelby County24+2.1 pts
41Wood County24+3.4 pts
44Sherman County23.9-2.8 pts
45Lipscomb County23.8+1.8 pts
46Castro County23.7+0.8 pts
46DeSoto County23.7+0.8 pts
46El Paso County23.7+0.3 pts
49Jack County23.6+1 pts
50Caldwell County23.5+1 pts
50Swisher County23.5+0.3 pts
52Atkinson County23.4+0.1 pts
53Hamilton County23.3+1.4 pts
53Yakutat City and Borough23.3+1.5 pts
55Bastrop County23.2+2 pts
55Kenedy County23.2-6 pts
57Aleutians East Borough23.1-1.3 pts
57Haskell County23.1+1.1 pts
59Eastland County23+2.8 pts
59Hopkins County23+1.7 pts
59Potter County23-0.7 pts
62Texas County22.9+1.1 pts
63Harris County22.8+0.6 pts
63Yoakum County22.8-2.2 pts
65Burnet County22.7+2.1 pts
65Hendry County22.70 pts
67Camp County22.6+1.8 pts
67Hale County22.6-1.2 pts
69Live Oak County22.5+1.6 pts
69Real County22.5+3.1 pts
71Scotland County22.4+3.3 pts
72Frio County22.3+1.1 pts
72Navarro County22.3-0.6 pts
72Uvalde County22.3-0.7 pts
72Willacy County22.3+0.7 pts
76Crosby County22.2+1.9 pts
76Dawson County22.2-1.6 pts
76Nacogdoches County22.2+1.3 pts
79San Jacinto County22.1+1.6 pts
80Donley County22+1.2 pts
80Montague County22+1.8 pts
80Van Zandt County22+0.7 pts
83Gillespie County21.9+0.4 pts
83McCulloch County21.9+0.3 pts
85Leon County21.8+0.5 pts
86Beaver County21.6+2.4 pts
87Gray County21.5-0.4 pts
87Palo Pinto County21.50 pts
87Whitfield County21.5+1 pts
90Bosque County21.4+1.9 pts
90Burleson County21.4+1.2 pts
90Cherokee County21.40 pts
90Newton County21.4+1.4 pts
90Reeves County21.4+0.1 pts
95Andrews County21.3-0.2 pts
95Erath County21.30 pts
95Limestone County21.3+2.1 pts
95Rains County21.3+0.8 pts
99La Salle County21.2-2.3 pts
99Red River County21.2+0.2 pts
101Knox County21.1-2.9 pts
102Austin County21+1.6 pts
102Briscoe County21+0.3 pts
102Polk County21+2 pts
102San Augustine County21+0.6 pts
102Smith County21+2 pts
107Angelina County20.9+1.5 pts
107Waller County20.9+0.6 pts
107Wilbarger County20.9+0.7 pts
110Clark County20.8+2 pts
110Hardeman County20.8+0.4 pts
110Wharton County20.8-0.1 pts
113Colorado County20.7-0.8 pts
113Robertson County20.7+2.4 pts
113Stephens County20.7+1.1 pts
113Val Verde County20.7+1.7 pts
117Cimarron County20.5+2.4 pts
117Grimes County20.5+0.5 pts
119Crane County20.3+0.3 pts
119Freestone County20.3-0.6 pts
119Jefferson County20.3-1.2 pts
119Macon County20.3-0.2 pts
119Matagorda County20.3-0.7 pts
119Union County20.3+3.1 pts
125Cooke County20.2+0.4 pts
125Hill County20.2+0.2 pts
125Jim Hogg County20.2+0.6 pts
128Candler County20.1+1.6 pts
128Houston County20.1+0.2 pts
128Jeff Davis County20.1+2.8 pts
131Bandera County20+2.1 pts
131Coffee County20+2.3 pts
131Hockley County20-0.4 pts
131Jim Wells County20+0.9 pts
131Schleicher County20-0.8 pts
136Sutton County19.9-1.9 pts
136Victoria County19.9+1.5 pts
138Colquitt County19.8+1.5 pts
138Daviess County19.8+3.6 pts
138Dickens County19.8+1.9 pts
138Grady County19.8+1.9 pts
138Owyhee County19.8+0.4 pts
138Pecos County19.8-1.5 pts
138Tyler County19.8+1.1 pts
138Wise County19.8+1.9 pts
146Coleman County19.7-0.1 pts
147Golden Valley County19.6+5.6 pts
147Johnson County19.6+1.5 pts
147Kerr County19.6-1.1 pts
147Walker County19.6+1 pts
151Harding County19.5+5.2 pts
151Harper County19.5+0.2 pts
151Haskell County19.5+2.3 pts
151Henderson County19.5-0.6 pts
151Runnels County19.5-0.8 pts
151Santa Cruz County19.5-0.5 pts
157Gooding County19.4+1.5 pts
157Hunt County19.4-0.3 pts
157Throckmorton County19.40 pts
160Fayette County19.3+0.9 pts
160Foard County19.3-0.8 pts
160Gray County19.3+1.1 pts
160Hamilton County19.3+3.3 pts
160Jones County19.3+0.7 pts
165Clark County19.2-2.6 pts
165Garza County19.2+0.8 pts
165Hemphill County19.2+0.8 pts
165Winkler County19.20 pts
169Chattooga County19.1+3 pts
169Hall County19.1+2.1 pts
169Jackson County19.1-1.2 pts
169Lamar County19.1+0.9 pts
169Nueces County19.1+0.7 pts
174Grayson County19+0.3 pts
174Lynn County19+3.5 pts
174Rabun County19+0.3 pts
177Fannin County18.9+1.1 pts
177Gregg County18.9-0.9 pts
177Jerome County18.9+0.5 pts
177Morgan County18.9+0.4 pts
177Tarrant County18.9+1.3 pts
182Brantley County18.80 pts
182Knox County18.8+1.7 pts
182Llano County18.8+0.1 pts
182Martin County18.8+2.1 pts
182McIntosh County18.8+3.2 pts
182Mills County18.8-1.1 pts
188Jefferson County18.7+1.6 pts
188Kaufman County18.7+1.2 pts
188Motley County18.7+2.6 pts
188Trinity County18.7+0.4 pts
192Atascosa County18.6-0.1 pts
192Gordon County18.6+1.3 pts
192Johnson County18.6+2.1 pts
192Le Flore County18.6+1.7 pts
192Madison County18.6+2.3 pts
192Marshall County18.6+0.3 pts
192Sabine County18.6+0.4 pts
192Sanders County18.6+1.6 pts
192Wrangell City and Borough18.6-0.4 pts
201Brewster County18.5-1.2 pts
201DeWitt County18.5+1.2 pts
201Habersham County18.5+0.7 pts
201Harmon County18.5+0.5 pts
201Lampasas County18.5-0.2 pts
201Milam County18.50 pts
201Stonewall County18.5+0.5 pts
201Ward County18.5-1.7 pts
201Wilcox County18.5+1.6 pts
201Yuma County18.5+3.6 pts
211Brooks County18.4+0.5 pts
211Franklin County18.4+2.2 pts
211Tom Green County18.4+0.4 pts
211Young County18.4-2.3 pts
215Calhoun County18.3+1.1 pts
215Lavaca County18.3+0.8 pts
215McLennan County18.3+1.1 pts
215Pulaski County18.3+1.4 pts
215Rusk County18.3+0.5 pts
215San Patricio County18.30 pts
215Sevier County18.3+1.3 pts
222Anderson County18.2-0.6 pts
222Brown County18.2+1 pts
222Morris County18.2+0.6 pts
225Bexar County18.1+1.2 pts
225Esmeralda County18.1+0.7 pts
225Issaquena County18.1+0.2 pts
225Wilkes County18.1+2.2 pts
229Falls County18-0.4 pts
229Hardee County18+0.8 pts
229Hartley County18+3.1 pts
229Marion County18-0.2 pts
229Okeechobee County18+0.7 pts
229Tattnall County18+0.8 pts
235Appling County17.9+0.2 pts
235Concho County17.9+3.1 pts
235Jasper County17.9+1.6 pts
235Kleberg County17.9-0.9 pts
235Kodiak Island Borough17.9+0.1 pts
235Marion County17.90 pts
241Bledsoe County17.8-0.7 pts
241Goliad County17.8+0.1 pts
241Howard County17.8+0.6 pts
241Major County17.8+2 pts
241Prairie County17.8+2.1 pts
241Scurry County17.8-0.7 pts
247Bacon County17.7+1.1 pts
247Baylor County17.7+2 pts
247Evans County17.7-0.1 pts
247Lake and Peninsula Borough17.7-0.8 pts

Showing the top 250 of 3143. The Excel download has every row.

Other periods

About this ranking

People under 65 without health insurance coverage of any kind, as a percentage of all people under 65. 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. People 65 and over are left out because nearly all of them have Medicare.

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, under 65, all races, both sexes, all income levels, states and counties. https://www2.census.gov/programs-surveys/sahie/datasets/time-series/estimates-acs/sahie-2024-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, under 65, all races, both sexes, all income levels, states and counties (US counties by uninsured rate, under 65 (US model-based estimate), 2024) [Data set]. Retrieved October 12, 2026, from https://www2.census.gov/programs-surveys/sahie/datasets/time-series/estimates-acs/sahie-2024-csv.zip

MLA 9

Small Area Health Insurance Estimates (SAHIE): percent uninsured, under 65, all races, both sexes, all income levels, states and counties, US counties by uninsured rate, under 65 (US model-based estimate), 2024. U.S. Census Bureau, 6 Aug. 2026, https://www2.census.gov/programs-surveys/sahie/datasets/time-series/estimates-acs/sahie-2024-csv.zip. Invokely, https://invokely.ai/rankings/uninsured-rate-under-65/us-counties. Accessed 12 Oct. 2026.

Chicago (author-date)

U.S. Census Bureau. 2026. Small Area Health Insurance Estimates (SAHIE): percent uninsured, under 65, all races, both sexes, all income levels, states and counties. US counties by uninsured rate, under 65 (US model-based estimate), 2024. Dataset. Accessed October 12, 2026. https://www2.census.gov/programs-surveys/sahie/datasets/time-series/estimates-acs/sahie-2024-csv.zip. Also distributed by Invokely, https://invokely.ai/rankings/uninsured-rate-under-65/us-counties.

Harvard

U.S. Census Bureau (2026) Small Area Health Insurance Estimates (SAHIE): percent uninsured, under 65, all races, both sexes, all income levels, states and counties, US counties by uninsured rate, under 65 (US model-based estimate), 2024 [Dataset]. Available at: https://www2.census.gov/programs-surveys/sahie/datasets/time-series/estimates-acs/sahie-2024-csv.zip, via Invokely: https://invokely.ai/rankings/uninsured-rate-under-65/us-counties (Accessed: 12 October 2026).

BibTeX
@misc{census_us_counties_by_uninsured_2024,
  author = {{U.S. Census Bureau}},
  title = {{Small Area Health Insurance Estimates (SAHIE): percent uninsured, under 65, all races, both sexes, all income levels, states and counties: US counties by uninsured rate, under 65 (US model-based estimate), 2024}},
  year = {2026},
  howpublished = {Data set},
  url = {https://www2.census.gov/programs-surveys/sahie/datasets/time-series/estimates-acs/sahie-2024-csv.zip},
  urldate = {2026-10-12},
  note = {Accessed via Invokely, https://invokely.ai/rankings/uninsured-rate-under-65/us-counties. Publisher attribution: U.S. Census Bureau. Small Area Health Insurance Estimates (SAHIE): percent uninsured, under 65, all races, both sexes, all income levels, states and counties. https://www2.census.gov/programs-surveys/sahie/datasets/time-series/estimates-acs/sahie-2024-csv.zip. Retrieved 2026-10-12.},
}
RIS
TY  - DATA
AU  - U.S. Census Bureau
TI  - Small Area Health Insurance Estimates (SAHIE): percent uninsured, under 65, all races, both sexes, all income levels, states and counties: US counties by uninsured rate, under 65 (US model-based estimate), 2024
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-2024-csv.zip
L2  - https://invokely.ai/rankings/uninsured-rate-under-65/us-counties
Y2  - 2026/10/12
N1  - Accessed via Invokely, https://invokely.ai/rankings/uninsured-rate-under-65/us-counties.
N1  - Publisher attribution: U.S. Census Bureau. Small Area Health Insurance Estimates (SAHIE): percent uninsured, under 65, all races, both sexes, all income levels, states and counties. https://www2.census.gov/programs-surveys/sahie/datasets/time-series/estimates-acs/sahie-2024-csv.zip. Retrieved 2026-10-12.
ER  -
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Questions

Which county has the highest uninsured rate, under 65 (US model-based estimate)?

Gaines County, with 38.5% in 2024, according to the U.S. Census Bureau.

Which county has the lowest uninsured rate, under 65 (US model-based estimate)?

Norfolk County, with 2.4% in 2024.

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, under 65, all races, both sexes, all income levels, states and counties. Retrieved 2026-10-12.

Uninsured rate, under 65 (US model-based estimate): other rankings

US counties: more rankings