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 3143 counties in 2023, at 33.5%. Norfolk County had the lowest, at 2.1%. The median was 9.3%. Source: the U.S. Census Bureau.

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Highest33.5Gaines County
Lowest2.1Norfolk County
Median9.33143 counties

Map of counties, 2023

%, 2023. 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, 2023

Gaines County: 33.5 %Gaines County33.5Holmes County: 31.5 %Holmes County31.5LaGrange County: 31.3 %LaGrange County31.3Presidio County: 29.6 %Presidio County29.6Kenedy County: 29.2 %Kenedy County29.2Hansford County: 29.1 %Hansford County29.1Edwards County: 28.8 %Edwards County28.8Webb County: 28.7 %Webb County28.7Hidalgo County: 27.5 %Hidalgo County27.5Cochran County: 27.3 %Cochran County27.3Ochiltree County: 27.1 %Ochiltree County27.1Dallam County: 26.8 %Dallam County26.8Sherman County: 26.7 %Sherman County26.7Parmer County: 26.6 %Parmer County26.6Bailey County: 26.3 %Bailey County26.3Zapata County: 26.1 %Zapata County26.1Cameron County: 26 %Cameron County26Moore County: 25.8 %Moore County25.8Hudspeth County: 25.7 %Hudspeth County25.7San Saba County: 25.6 %San Saba County25.6Hall County: 25.3 %Hall County25.3Wheeler County: 25.3 %Wheeler County25.3Starr County: 25.1 %Starr County25.1Yoakum County: 25 %Yoakum County25Crockett County: 24.5 %Crockett County24.5Terry County: 24.5 %Terry County24.5Aleutians East Borough: 24.4 %Aleutians East Borough24.4Gonzales County: 24.1 %Gonzales County24.1Knox County: 24 %Knox County24Titus County: 23.9 %Titus County23.9Dawson County: 23.8 %Dawson County23.8Hale County: 23.8 %Hale County23.8Liberty County: 23.8 %Liberty County23.8Maverick County: 23.7 %Maverick County23.7Menard County: 23.7 %Menard County23.7Potter County: 23.7 %Potter County23.7King County: 23.6 %King County23.6Deaf Smith County: 23.5 %Deaf Smith County23.5Glades County: 23.5 %Glades County23.5La Salle County: 23.5 %La Salle County23.5Gaines County: 33.5 %Gaines County33.5Holmes County: 31.5 %Holmes County31.5LaGrange County: 31.3 %LaGrange County31.3Presidio County: 29.6 %Presidio County29.6Kenedy County: 29.2 %Kenedy County29.2Hansford County: 29.1 %Hansford County29.1Edwards County: 28.8 %Edwards County28.8Webb County: 28.7 %Webb County28.7Hidalgo County: 27.5 %Hidalgo County27.5Cochran County: 27.3 %Cochran County27.3Ochiltree County: 27.1 %Ochiltree County27.1Dallam County: 26.8 %Dallam County26.8Sherman County: 26.7 %Sherman County26.7Parmer County: 26.6 %Parmer County26.6Bailey County: 26.3 %Bailey County26.3Zapata County: 26.1 %Zapata County26.1Cameron County: 26 %Cameron County26Moore County: 25.8 %Moore County25.8Hudspeth County: 25.7 %Hudspeth County25.7San Saba County: 25.6 %San Saba County25.6Hall County: 25.3 %Hall County25.3Wheeler County: 25.3 %Wheeler County25.3Starr County: 25.1 %Starr County25.1Yoakum County: 25 %Yoakum County25Crockett County: 24.5 %Crockett County24.5Terry County: 24.5 %Terry County24.5Aleutians East Borough: 24.4 %Aleutians East Borough24.4Gonzales County: 24.1 %Gonzales County24.1Knox County: 24 %Knox County24Titus County: 23.9 %Titus County23.9Dawson County: 23.8 %Dawson County23.8Hale County: 23.8 %Hale County23.8Liberty County: 23.8 %Liberty County23.8Maverick County: 23.7 %Maverick County23.7Menard County: 23.7 %Menard County23.7Potter County: 23.7 %Potter County23.7King County: 23.6 %King County23.6Deaf Smith County: 23.5 %Deaf Smith County23.5Glades County: 23.5 %Glades County23.5La Salle County: 23.5 %La Salle County23.5
%. 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

RankCounties2023 (%)Change on 2022
1Gaines County33.5+1.5 pts
2Holmes County31.5-3.3 pts
3LaGrange County31.3-2 pts
4Presidio County29.6-3.9 pts
5Kenedy County29.2-8.5 pts
6Hansford County29.1+2 pts
7Edwards County28.8-0.6 pts
8Webb County28.7+1.6 pts
9Hidalgo County27.5-2.7 pts
10Cochran County27.3+3.8 pts
11Ochiltree County27.1-1 pts
12Dallam County26.8-1.2 pts
13Sherman County26.7-0.6 pts
14Parmer County26.6+2.2 pts
15Bailey County26.3-0.3 pts
16Zapata County26.1+2.4 pts
17Cameron County26+0.8 pts
18Moore County25.8-0.3 pts
19Hudspeth County25.7+0.1 pts
20San Saba County25.6-1.6 pts
21Hall County25.3+0.2 pts
21Wheeler County25.3-0.4 pts
23Starr County25.1+0.1 pts
24Yoakum County25-1.6 pts
25Crockett County24.5-2.2 pts
25Terry County24.5+0.9 pts
27Aleutians East Borough24.4+4.8 pts
28Gonzales County24.1+1.5 pts
29Knox County24+3.1 pts
30Titus County23.9-0.3 pts
31Dawson County23.8+1.7 pts
31Hale County23.8+1.5 pts
31Liberty County23.8+1.2 pts
34Maverick County23.7-2.6 pts
34Menard County23.7-2.1 pts
34Potter County23.7+0.8 pts
37King County23.6+3.3 pts
38Deaf Smith County23.5+0.8 pts
38Glades County23.5-1.3 pts
38La Salle County23.5+1.2 pts
41El Paso County23.4-0.1 pts
42Atkinson County23.3+2.6 pts
42Comanche County23.3+1.4 pts
42Dallas County23.3-0.3 pts
42Lamb County23.3+0.3 pts
46Swisher County23.2-4.9 pts
47Uvalde County23+0.1 pts
48Castro County22.9-2.4 pts
48DeSoto County22.9+0.3 pts
48Floyd County22.9-2 pts
48Navarro County22.9+4.2 pts
52Collingsworth County22.7-3.3 pts
52Hendry County22.7-1.6 pts
54Ector County22.6+0.8 pts
54Jack County22.6+0.3 pts
56Caldwell County22.5-0.3 pts
56Madison County22.5-1.8 pts
58Harris County22.20 pts
59Haskell County22-1.6 pts
59Lipscomb County22+0.3 pts
61Gray County21.9+0.4 pts
61Hamilton County21.9-0.4 pts
61Shelby County21.9-0.5 pts
64Clark County21.8+0.2 pts
64Sutton County21.8+0.5 pts
64Texas County21.8+3 pts
64Yakutat City and Borough21.8+2.5 pts
68McCulloch County21.6-0.7 pts
68Willacy County21.60 pts
70Andrews County21.5-1.4 pts
70Colorado County21.5-1.1 pts
70Gillespie County21.5-3.2 pts
70Jefferson County21.5+1 pts
70Palo Pinto County21.5+0.8 pts
75Cherokee County21.4+1.8 pts
76Erath County21.3+0.7 pts
76Hopkins County21.3+1 pts
76Leon County21.3-0.5 pts
76Mason County21.3-2.7 pts
76Pecos County21.3-1.1 pts
76Reeves County21.3-0.7 pts
76Van Zandt County21.3+2.1 pts
83Bastrop County21.2+0.4 pts
83Frio County21.2-0.7 pts
85Matagorda County21-0.6 pts
85Red River County21+1.9 pts
87Freestone County20.9+2 pts
87Live Oak County20.9-0.4 pts
87Nacogdoches County20.9+1.7 pts
87Wharton County20.9+0.3 pts
91Camp County20.8+0.6 pts
91Donley County20.8-0.7 pts
91Lee County20.8+0.5 pts
91Schleicher County20.8-2.3 pts
95Briscoe County20.7-0.8 pts
95Kerr County20.7+1.7 pts
95Young County20.7-0.4 pts
98Burnet County20.6+1.1 pts
98Wood County20.6+0.8 pts
100Macon County20.5+1.2 pts
100Rains County20.5-1.2 pts
100San Jacinto County20.5+0.3 pts
100Whitfield County20.5-0.9 pts
104Hardeman County20.4+0.5 pts
104Hockley County20.4-2.1 pts
104San Augustine County20.4+0.8 pts
107Aleutians West Census Area20.3+3.6 pts
107Crosby County20.3-1.7 pts
107Jackson County20.3+0.5 pts
107Runnels County20.3-0.4 pts
107Waller County20.3+2 pts
112Burleson County20.2-0.9 pts
112Eastland County20.20 pts
112Kimble County20.2-1.4 pts
112Montague County20.2-0.7 pts
112Ward County20.2-3.1 pts
112Wilbarger County20.2-0.7 pts
118Foard County20.1+1.8 pts
118Henderson County20.1-2.3 pts
118Petersburg Borough20.1+1.7 pts
121Crane County20-3.2 pts
121Grimes County20+0.3 pts
121Hill County20+0.4 pts
121Newton County20-0.4 pts
121Santa Cruz County200 pts
126Houston County19.9+0.1 pts
126Mills County19.9-1.7 pts
128Coleman County19.8-1.8 pts
128Cooke County19.8+1.4 pts
128Gregg County19.8-0.1 pts
131Brewster County19.7-3 pts
131Hunt County19.7+0.8 pts
133Jim Hogg County19.6-1.8 pts
133Stephens County19.6-1.1 pts
135Bosque County19.5-0.8 pts
135Franklin County19.5+2.1 pts
137Angelina County19.4-0.2 pts
137Austin County19.4+0.3 pts
137Owyhee County19.4+2.8 pts
137Real County19.4-1.3 pts
137Throckmorton County19.40 pts
142Atoka County19.3+1.4 pts
142Harper County19.3+0.9 pts
144Beaver County19.2-0.8 pts
144Limestone County19.2-0.6 pts
144Winkler County19.2-0.5 pts
147Jim Wells County19.1+0.1 pts
147Scotland County19.1-3.9 pts
149Polk County190 pts
149Smith County19+0.4 pts
149Val Verde County19-2.4 pts
149Wrangell City and Borough19-2.1 pts
153Prince of Wales-Hyder Census Area18.9-0.2 pts
154Anderson County18.8+1.1 pts
154Blanco County18.8+0.6 pts
154Brantley County18.8+0.9 pts
154Clark County18.8-1.2 pts
154Kleberg County18.8-0.3 pts
159Atascosa County18.7-1.5 pts
159Grayson County18.7+0.2 pts
159Lampasas County18.7+1.2 pts
159Llano County18.7-0.9 pts
159Rabun County18.7-1 pts
159Tyler County18.7-0.4 pts
165Jones County18.6+0.7 pts
165Walker County18.60 pts
167Big Horn County18.5-0.3 pts
167Bledsoe County18.5+2.4 pts
167Candler County18.5-1.7 pts
167Lake and Peninsula Borough18.5-0.7 pts
167Milam County18.5-0.8 pts
167Morgan County18.5-2.9 pts
167Scurry County18.5-2.4 pts
174Falls County18.4+0.1 pts
174Fayette County18.4-0.6 pts
174Garza County18.4-3.8 pts
174Hemphill County18.4-2.4 pts
174Jerome County18.4+2.3 pts
174Nueces County18.4-1 pts
174Victoria County18.4-0.7 pts
181Colquitt County18.3-1.5 pts
181Marshall County18.3-0.3 pts
181Robertson County18.3+0.9 pts
181San Patricio County18.3-0.6 pts
181Trinity County18.3+0.7 pts
186Clinch County18.2-0.3 pts
186Gray County18.2+0.3 pts
186Lamar County18.20 pts
186Marion County18.2+0.3 pts
186Sabine County18.2-1.1 pts
191Cimarron County18.1+3.3 pts
191Collier County18.1-0.5 pts
191Franklin County18.1-1.6 pts
191Johnson County18.1-0.2 pts
191Upton County18.1-1.6 pts
196Harmon County18+0.4 pts
196Reagan County18-2.9 pts
196Stonewall County18+1.6 pts
196Tom Green County18-0.1 pts
200Bandera County17.9-1.6 pts
200Brooks County17.90 pts
200Dickens County17.9-1 pts
200Gooding County17.9-0.1 pts
200Grady County17.9+0.2 pts
200Issaquena County17.9-5.1 pts
200Marion County17.9+1.2 pts
200Wise County17.90 pts
208Evans County17.80 pts
208Fannin County17.8+1.2 pts
208Habersham County17.8-0.6 pts
208Karnes County17.8-0.5 pts
208Kodiak Island Borough17.80 pts
208Refugio County17.8-0.7 pts
208Rusk County17.8-1.2 pts
215Appling County17.7-1 pts
215Childress County17.7-0.7 pts
215Coffee County17.7-1.4 pts
215Goliad County17.7+1.2 pts
215Hyde County17.7-1.2 pts
215Nolan County17.7-1.2 pts
215Washington County17.7+1.4 pts
215Wheeler County17.7-0.3 pts
223Aransas County17.6-3 pts
223Montgomery County17.6+2.1 pts
223Morris County17.6+0.9 pts
223Panola County17.6-0.6 pts
223Seward County17.6-0.6 pts
223Tarrant County17.6-0.6 pts
223Zavala County17.6+0.5 pts
230Irion County17.5-3 pts
230Kaufman County17.5+0.7 pts
230Lavaca County17.5+2.5 pts
230Oldham County17.5+1.9 pts
234Boundary County17.4+3.8 pts
234Coke County17.4-0.8 pts
234Esmeralda County17.4-1.4 pts
234Greene County17.4-0.5 pts
238Cherokee County17.3+0.2 pts
238DeWitt County17.3-1.5 pts
238Dimmit County17.3-2.1 pts
238Gordon County17.3-2.6 pts
238Jeff Davis County17.3-0.3 pts
238Lanier County17.3+3.4 pts
238Okeechobee County17.3-0.2 pts
238Pushmataha County17.3+1.2 pts
246Alleghany County17.2-0.1 pts
246Brown County17.2-0.6 pts
246Calhoun County17.2+0.4 pts
246Duplin County17.2+1.5 pts
246Hardee County17.2-0.7 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-2023-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), 2023) [Data set]. Retrieved October 12, 2026, from https://www2.census.gov/programs-surveys/sahie/datasets/time-series/estimates-acs/sahie-2023-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), 2023. U.S. Census Bureau, 6 Aug. 2026, https://www2.census.gov/programs-surveys/sahie/datasets/time-series/estimates-acs/sahie-2023-csv.zip. Invokely, https://invokely.ai/rankings/uninsured-rate-under-65/us-counties?period=2023. 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), 2023. Dataset. Accessed October 12, 2026. https://www2.census.gov/programs-surveys/sahie/datasets/time-series/estimates-acs/sahie-2023-csv.zip. Also distributed by Invokely, https://invokely.ai/rankings/uninsured-rate-under-65/us-counties?period=2023.

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), 2023 [Dataset]. Available at: https://www2.census.gov/programs-surveys/sahie/datasets/time-series/estimates-acs/sahie-2023-csv.zip, via Invokely: https://invokely.ai/rankings/uninsured-rate-under-65/us-counties?period=2023 (Accessed: 12 October 2026).

BibTeX
@misc{census_us_counties_by_uninsured_2023,
  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), 2023}},
  year = {2026},
  howpublished = {Data set},
  url = {https://www2.census.gov/programs-surveys/sahie/datasets/time-series/estimates-acs/sahie-2023-csv.zip},
  urldate = {2026-10-12},
  note = {Accessed via Invokely, https://invokely.ai/rankings/uninsured-rate-under-65/us-counties?period=2023. 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-2023-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), 2023
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-2023-csv.zip
L2  - https://invokely.ai/rankings/uninsured-rate-under-65/us-counties?period=2023
Y2  - 2026/10/12
N1  - Accessed via Invokely, https://invokely.ai/rankings/uninsured-rate-under-65/us-counties?period=2023.
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-2023-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 33.5% in 2023, according to the U.S. Census Bureau.

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

Norfolk County, with 2.1% in 2023.

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