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

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

Gaines County had the highest uninsured rate, under 65 (US model-based estimate) of 3132 counties in 2018, at 32.2%. Norfolk County had the lowest, at 2.4%. The median was 10.6%. Source: the U.S. Census Bureau.

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Highest32.2Gaines County
Lowest2.4Norfolk County
Median10.63132 counties

Map of counties, 2018

%, 2018. Hatched areas have no value for this period. 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. Boundaries: U.S. Census Bureau cartographic boundary files.

Top 40 counties, 2018

Gaines County: 32.2 %Gaines County32.2Hidalgo County: 32.1 %Hidalgo County32.1Presidio County: 32 %Presidio County32Cameron County: 30.2 %Cameron County30.2Dallam County: 30.2 %Dallam County30.2Collingsworth County: 30 %Collingsworth County30Starr County: 29.9 %Starr County29.9Webb County: 29.8 %Webb County29.8Jeff Davis County: 29.6 %Jeff Davis County29.6Bailey County: 29.1 %Bailey County29.1Castro County: 29.1 %Castro County29.1Hall County: 28.4 %Hall County28.4Zapata County: 28.4 %Zapata County28.4Hudspeth County: 28.3 %Hudspeth County28.3Menard County: 28.3 %Menard County28.3Sherman County: 28.3 %Sherman County28.3Parmer County: 28.2 %Parmer County28.2San Saba County: 28 %San Saba County28Hansford County: 27.8 %Hansford County27.8Lipscomb County: 27.8 %Lipscomb County27.8Maverick County: 27.7 %Maverick County27.7Mason County: 27.6 %Mason County27.6Clark County: 27.2 %Clark County27.2Hendry County: 27.2 %Hendry County27.2Ochiltree County: 27.2 %Ochiltree County27.2Cochran County: 27 %Cochran County27Mills County: 26.9 %Mills County26.9Kenedy County: 26.8 %Kenedy County26.8Briscoe County: 26.7 %Briscoe County26.7Deaf Smith County: 26 %Deaf Smith County26Glades County: 25.9 %Glades County25.9Haskell County: 25.8 %Haskell County25.8Leon County: 25.8 %Leon County25.8Wheeler County: 25.7 %Wheeler County25.7Aleutians East Borough: 25.6 %Aleutians East Borough25.6Hardeman County: 25.6 %Hardeman County25.6Gonzales County: 25.5 %Gonzales County25.5Knox County: 25.5 %Knox County25.5LaGrange County: 25.5 %LaGrange County25.5Lamb County: 25.5 %Lamb County25.5Gaines County: 32.2 %Gaines County32.2Hidalgo County: 32.1 %Hidalgo County32.1Presidio County: 32 %Presidio County32Cameron County: 30.2 %Cameron County30.2Dallam County: 30.2 %Dallam County30.2Collingsworth County: 30 %Collingsworth County30Starr County: 29.9 %Starr County29.9Webb County: 29.8 %Webb County29.8Jeff Davis County: 29.6 %Jeff Davis County29.6Bailey County: 29.1 %Bailey County29.1Castro County: 29.1 %Castro County29.1Hall County: 28.4 %Hall County28.4Zapata County: 28.4 %Zapata County28.4Hudspeth County: 28.3 %Hudspeth County28.3Menard County: 28.3 %Menard County28.3Sherman County: 28.3 %Sherman County28.3Parmer County: 28.2 %Parmer County28.2San Saba County: 28 %San Saba County28Hansford County: 27.8 %Hansford County27.8Lipscomb County: 27.8 %Lipscomb County27.8Maverick County: 27.7 %Maverick County27.7Mason County: 27.6 %Mason County27.6Clark County: 27.2 %Clark County27.2Hendry County: 27.2 %Hendry County27.2Ochiltree County: 27.2 %Ochiltree County27.2Cochran County: 27 %Cochran County27Mills County: 26.9 %Mills County26.9Kenedy County: 26.8 %Kenedy County26.8Briscoe County: 26.7 %Briscoe County26.7Deaf Smith County: 26 %Deaf Smith County26Glades County: 25.9 %Glades County25.9Haskell County: 25.8 %Haskell County25.8Leon County: 25.8 %Leon County25.8Wheeler County: 25.7 %Wheeler County25.7Aleutians East Borough: 25.6 %Aleutians East Borough25.6Hardeman County: 25.6 %Hardeman County25.6Gonzales County: 25.5 %Gonzales County25.5Knox County: 25.5 %Knox County25.5LaGrange County: 25.5 %LaGrange County25.5Lamb County: 25.5 %Lamb County25.5
%. 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

RankCounties2018 (%)Change on 2017
1Gaines County32.2-1.5 pts
2Hidalgo County32.1+0.9 pts
3Presidio County32+3 pts
4Cameron County30.2+1.2 pts
4Dallam County30.2-0.3 pts
6Collingsworth County30-2.7 pts
7Starr County29.9+1 pts
8Webb County29.8+1.2 pts
9Jeff Davis County29.6+0.2 pts
10Bailey County29.1+1.8 pts
10Castro County29.1+0.2 pts
12Hall County28.4+1.4 pts
12Zapata County28.4-0.8 pts
14Hudspeth County28.3-0.2 pts
14Menard County28.3+2.7 pts
14Sherman County28.3-1.3 pts
17Parmer County28.2-0.5 pts
18San Saba County28-0.9 pts
19Hansford County27.8+1.4 pts
19Lipscomb County27.8-1.7 pts
21Maverick County27.7+0.7 pts
22Mason County27.6-0.5 pts
23Clark County27.2+1 pts
23Hendry County27.2+0.3 pts
23Ochiltree County27.2-1.4 pts
26Cochran County27-1.5 pts
27Mills County26.9+1.1 pts
28Kenedy County26.8+4 pts
29Briscoe County26.7-4.7 pts
30Deaf Smith County26+0.8 pts
31Glades County25.90 pts
32Haskell County25.8+0.5 pts
32Leon County25.8+1.1 pts
34Wheeler County25.7+0.9 pts
35Aleutians East Borough25.6-2.3 pts
35Hardeman County25.6-1.1 pts
37Gonzales County25.5+0.5 pts
37Knox County25.5+0.5 pts
37LaGrange County25.5+0.6 pts
37Lamb County25.5+0.4 pts
41Shelby County25.3+0.7 pts
42Moore County25.2-2.5 pts
43Cottle County25.1-2.3 pts
43Echols County25.1-2.5 pts
45Comanche County25-0.2 pts
46Atkinson County24.9+2.5 pts
46Schleicher County24.9-0.7 pts
48Culberson County24.7-1.4 pts
48Gilmer County24.7+2.2 pts
48Terry County24.7+0.2 pts
51DeSoto County24.6+1.5 pts
52Hemphill County24.5+0.5 pts
52Potter County24.5+1 pts
52Throckmorton County24.5-2.8 pts
55Edwards County24.2-0.4 pts
55Stephens County24.2-1.9 pts
57Aransas County24.1+1.8 pts
57Coleman County24.1+1.1 pts
57Harper County24.1-1.8 pts
57Holmes County24.1+0.2 pts
61Dallas County24+1 pts
62Texas County23.9+2.3 pts
63Colquitt County23.8+0.2 pts
63El Paso County23.8+1.2 pts
63Real County23.8+1.3 pts
63Uvalde County23.8+1.3 pts
67Owyhee County23.7+0.5 pts
68Dawson County23.6+2.4 pts
69Hartley County23.5+2.6 pts
69Pecos County23.5+0.6 pts
71Bosque County23.4+1.1 pts
71Swisher County23.4+0.9 pts
73Gray County23.3-0.6 pts
73Jack County23.3-1.1 pts
73Waller County23.3-0.8 pts
73Wharton County23.3+1.6 pts
77Delaware County23.2-0.7 pts
78Burnet County23.1+1.8 pts
78Garza County23.1-1.8 pts
80Marshall County22.90 pts
80Montague County22.9-0.7 pts
82Adair County22.8-1.7 pts
82Cherokee County22.8-1.6 pts
82Floyd County22.8-0.8 pts
82Hamilton County22.8-1.5 pts
82Hill County22.8+1.7 pts
82Hopkins County22.8+0.8 pts
82San Jacinto County22.8-0.3 pts
89Cimarron County22.7-2.4 pts
89Foard County22.7-1.8 pts
91Collier County22.6-0.2 pts
91Harris County22.6+0.5 pts
91Palo Pinto County22.6+0.6 pts
91Willacy County22.6+0.3 pts
95Cherokee County22.4+0.8 pts
95Hockley County22.4+1.8 pts
95Titus County22.4-2.8 pts
95Yoakum County22.4-1.8 pts
99Grimes County22.3-0.5 pts
99Henderson County22.3+1.1 pts
99Okeechobee County22.3-0.2 pts
102Frio County22.20 pts
103Gillespie County22.1-1.7 pts
103Rains County22.1-0.5 pts
103Whitfield County22.1-0.9 pts
106Blanco County22+0.5 pts
106Candler County22+1.2 pts
106Hale County22-1.1 pts
106Harmon County22-2.2 pts
106King County22-2.1 pts
106Rabun County22+0.7 pts
106Young County22-1.1 pts
113Bandera County21.9+3.2 pts
113Jackson County21.9-3 pts
113Polk County21.9-0.6 pts
113Yukon-Koyukuk Census Area21.9-2.2 pts
117Bastrop County21.80 pts
117Limestone County21.8+0.7 pts
117Navarro County21.8-0.6 pts
117Reeves County21.8-0.5 pts
121Colorado County21.7-0.5 pts
121Kerr County21.7-0.8 pts
121Rusk County21.7+1.2 pts
121Scotland County21.7-1.1 pts
121Smith County21.7+1.9 pts
126Dickens County21.6-2.9 pts
126Liberty County21.6-0.1 pts
126Val Verde County21.6-1.3 pts
129Banks County21.5+2.2 pts
129Caldwell County21.5-0.2 pts
129Childress County21.5+1.1 pts
129Crockett County21.5-0.7 pts
129Wilbarger County21.5-0.4 pts
134Eastland County21.4-0.7 pts
134Ector County21.4+0.3 pts
134McCurtain County21.4+0.1 pts
134McIntosh County21.4+0.7 pts
134Van Zandt County21.4+0.1 pts
139Angelina County21.3-0.4 pts
139Beaver County21.3+0.9 pts
139Haskell County21.3+0.3 pts
139Hoonah-Angoon Census Area21.3-1.6 pts
139Matagorda County21.3-0.5 pts
139Murray County21.3+0.8 pts
139Trinity County21.3+0.9 pts
146Apache County21.2+2 pts
146Houston County21.2+1.1 pts
146Ziebach County21.2-1.9 pts
149Gregg County21.1-0.2 pts
149La Paz County21.1+1.3 pts
149Live Oak County21.1+0.3 pts
149Mitchell County21.1-0.1 pts
149Shackelford County21.1+0.4 pts
154Andrews County21-1.1 pts
154Pushmataha County210 pts
154Reagan County21-2.4 pts
157Gooding County20.9+1.2 pts
157Hall County20.9-0.8 pts
157Kimble County20.9-0.7 pts
157Nacogdoches County20.9-2 pts
157Winkler County20.9-0.8 pts
162Corson County20.8-0.9 pts
162Erath County20.8-2.6 pts
162Grady County20.80 pts
162Robertson County20.8+2.2 pts
162Upshur County20.8+2.6 pts
162Wise County20.8-1.9 pts
168Dimmit County20.7+1.4 pts
168Duplin County20.7+1.1 pts
168Falls County20.7-1.4 pts
168Freestone County20.7+0.8 pts
168Lake and Peninsula Borough20.7-4.6 pts
168Le Flore County20.7+0.5 pts
168Llano County20.70 pts
175Camp County20.6-0.6 pts
175Gordon County20.6-0.8 pts
175Lamar County20.6+1.1 pts
175Lee County20.6-1.4 pts
175Madison County20.6-1.2 pts
175Sequoyah County20.6+0.3 pts
181Concho County20.5-0.6 pts
181Grayson County20.5+1 pts
181Haskell County20.5-1.4 pts
181Jasper County20.5+0.1 pts
181Jefferson County20.5+0.5 pts
181Jefferson County20.5+0.3 pts
187Berrien County20.4+1.5 pts
187Burleson County20.4+0.6 pts
187Coal County20.4-0.9 pts
187Cooke County20.4-0.3 pts
187Hamilton County20.4-3 pts
187Roosevelt County20.4+0.8 pts
193Atascosa County20.3+1.3 pts
193Duval County20.3+0.3 pts
193McDonald County20.30 pts
193Nueces County20.3+1.3 pts
193Oglethorpe County20.3+1.4 pts
198Atoka County20.2-0.5 pts
198Lincoln County20.2+2.6 pts
198Prince of Wales-Hyder Census Area20.2-3 pts
198Southeast Fairbanks Census Area20.2-0.9 pts
202Bennett County20.1-1.7 pts
202Fannin County20.1-1.8 pts
202Garvin County20.1+1.4 pts
202Hayes County20.1-6.8 pts
202Jim Wells County20.1-0.1 pts
207Brooks County20+0.6 pts
207Crane County20-0.2 pts
207Habersham County20+0.7 pts
207Hutchinson County20-0.3 pts
207Lynn County20+1 pts
207Wood County20-0.5 pts
213Anderson County19.9+0.3 pts
213Crosby County19.9-2.2 pts
213Fisher County19.9-0.9 pts
213Scott County19.9-0.6 pts
213Walker County19.9+0.6 pts
218Hunt County19.8+1.1 pts
218Jefferson Davis County19.8+2.7 pts
218Kodiak Island Borough19.8+1.4 pts
218McCulloch County19.8-1.4 pts
218Stonewall County19.8-2.5 pts
218Sutton County19.8-2 pts
224Austin County19.7-0.5 pts
224Brewster County19.7-0.1 pts
224Carter County19.7+1.9 pts
224Donley County19.7-0.7 pts
224Greene County19.7-0.4 pts
224Runnels County19.7-1.3 pts
224San Augustine County19.7+0.8 pts
224Tattnall County19.7+0.7 pts
224Tift County19.7+1.9 pts
224Tillman County19.7-0.2 pts
234Greene County19.6+0.8 pts
234Jeff Davis County19.6+0.8 pts
234Macon County19.6+0.4 pts
234Monroe County19.6-0.7 pts
234Newton County19.6+2.1 pts
234Seminole County19.6-0.1 pts
234Wilkes County19.6+1.8 pts
234Zavala County19.6+0.4 pts
242Bryan County19.5-0.1 pts
242Coffee County19.5+0.1 pts
242Fayette County19.5-1.1 pts
242Glasscock County19.5-2.4 pts
242Hughes County19.5-0.9 pts
242Jasper County19.5+2 pts
242Miami-Dade County19.5-0.5 pts
242Ottawa County19.50 pts
242Roger Mills County19.5+1 pts

Showing the top 250 of 3132. 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. 11 counties with data in other periods have no value for 2018 and are left out rather than filled from another source. 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-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, under 65, all races, both sexes, all income levels, states and counties (US counties by uninsured rate, under 65 (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, under 65, all races, both sexes, all income levels, states and counties, US counties by uninsured rate, under 65 (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-under-65/us-counties?period=2018. 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), 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-under-65/us-counties?period=2018.

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), 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-under-65/us-counties?period=2018 (Accessed: 12 October 2026).

BibTeX
@misc{census_us_counties_by_uninsured_2018,
  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), 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-under-65/us-counties?period=2018. 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-2018-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), 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-under-65/us-counties?period=2018
Y2  - 2026/10/12
N1  - Accessed via Invokely, https://invokely.ai/rankings/uninsured-rate-under-65/us-counties?period=2018.
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-2018-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 32.2% in 2018, 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 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, under 65, all races, both sexes, all income levels, states and counties. Retrieved 2026-10-12. 11 counties have no value for 2018 and are not ranked.

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

US counties: more rankings