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

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

Texas had the highest uninsured rate, under 65 (US model-based estimate) of 51 states in 2021, at 20.3%. Massachusetts had the lowest, at 2.9%. The median was 8.5%. Source: the U.S. Census Bureau.

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Highest20.3Texas
Lowest2.9Massachusetts
Median8.551 states

Map of states, 2021

Alabama: 11.7 %Alaska: 13.2 %Arizona: 13.1 %Arkansas: 11.1 %California: 8.1 %Colorado: 9.3 %Connecticut: 6 %Delaware: 6.9 %District of Columbia: 3.7 %Florida: 15.1 %Georgia: 14.8 %Hawaii: 4.4 %Idaho: 10.5 %Illinois: 8.2 %Indiana: 8.9 %Iowa: 5.8 %Kansas: 10.9 %Kentucky: 6.8 %Louisiana: 9.2 %Maine: 7.3 %Maryland: 7 %Massachusetts: 2.9 %Michigan: 6 %Minnesota: 5.3 %Mississippi: 14.3 %Missouri: 11.4 %Montana: 10.5 %Nebraska: 8.5 %Nevada: 13.8 %New Hampshire: 6.3 %New Jersey: 8.3 %New Mexico: 12.6 %New York: 6.1 %North Carolina: 12.5 %North Dakota: 9.2 %Ohio: 7.8 %Oklahoma: 16.9 %Oregon: 7.4 %Pennsylvania: 6.7 %Rhode Island: 4.9 %South Carolina: 12.3 %South Dakota: 11.5 %Tennessee: 11.9 %Texas: 20.3 %Utah: 10.1 %Vermont: 4.5 %Virginia: 8 %Washington: 7.6 %West Virginia: 7.7 %Wisconsin: 6.5 %Wyoming: 15.3 %
  • Under 6
  • 6 to 7.4
  • 7.4 to 8.5
  • 8.5 to 11
  • 11 to 13
  • 13 and over
%, 2021. 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.

All states, 2021

Texas: 20.3 %Texas20.3Oklahoma: 16.9 %Oklahoma16.9Wyoming: 15.3 %Wyoming15.3Florida: 15.1 %Florida15.1Georgia: 14.8 %Georgia14.8Mississippi: 14.3 %Mississippi14.3Nevada: 13.8 %Nevada13.8Alaska: 13.2 %Alaska13.2Arizona: 13.1 %Arizona13.1New Mexico: 12.6 %New Mexico12.6North Carolina: 12.5 %North Carolina12.5South Carolina: 12.3 %South Carolina12.3Tennessee: 11.9 %Tennessee11.9Alabama: 11.7 %Alabama11.7South Dakota: 11.5 %South Dakota11.5Missouri: 11.4 %Missouri11.4Arkansas: 11.1 %Arkansas11.1Kansas: 10.9 %Kansas10.9Idaho: 10.5 %Idaho10.5Montana: 10.5 %Montana10.5Utah: 10.1 %Utah10.1Colorado: 9.3 %Colorado9.3Louisiana: 9.2 %Louisiana9.2North Dakota: 9.2 %North Dakota9.2Indiana: 8.9 %Indiana8.9Nebraska: 8.5 %Nebraska8.5New Jersey: 8.3 %New Jersey8.3Illinois: 8.2 %Illinois8.2California: 8.1 %California8.1Virginia: 8 %Virginia8Ohio: 7.8 %Ohio7.8West Virginia: 7.7 %West Virginia7.7Washington: 7.6 %Washington7.6Oregon: 7.4 %Oregon7.4Maine: 7.3 %Maine7.3Maryland: 7 %Maryland7Delaware: 6.9 %Delaware6.9Kentucky: 6.8 %Kentucky6.8Pennsylvania: 6.7 %Pennsylvania6.7Wisconsin: 6.5 %Wisconsin6.5New Hampshire: 6.3 %New Hampshire6.3New York: 6.1 %New York6.1Connecticut: 6 %Connecticut6Michigan: 6 %Michigan6Iowa: 5.8 %Iowa5.8Minnesota: 5.3 %Minnesota5.3Rhode Island: 4.9 %Rhode Island4.9Vermont: 4.5 %Vermont4.5Hawaii: 4.4 %Hawaii4.4District of Columbia: 3.7 %District of Columbia3.7Massachusetts: 2.9 %Massachusetts2.9Texas: 20.3 %Texas20.3Oklahoma: 16.9 %Oklahoma16.9Wyoming: 15.3 %Wyoming15.3Florida: 15.1 %Florida15.1Georgia: 14.8 %Georgia14.8Mississippi: 14.3 %Mississippi14.3Nevada: 13.8 %Nevada13.8Alaska: 13.2 %Alaska13.2Arizona: 13.1 %Arizona13.1New Mexico: 12.6 %New Mexico12.6North Carolina: 12.5 %North Carolina12.5South Carolina: 12.3 %South Carolina12.3Tennessee: 11.9 %Tennessee11.9Alabama: 11.7 %Alabama11.7South Dakota: 11.5 %South Dakota11.5Missouri: 11.4 %Missouri11.4Arkansas: 11.1 %Arkansas11.1Kansas: 10.9 %Kansas10.9Idaho: 10.5 %Idaho10.5Montana: 10.5 %Montana10.5Utah: 10.1 %Utah10.1Colorado: 9.3 %Colorado9.3Louisiana: 9.2 %Louisiana9.2North Dakota: 9.2 %North Dakota9.2Indiana: 8.9 %Indiana8.9Nebraska: 8.5 %Nebraska8.5New Jersey: 8.3 %New Jersey8.3Illinois: 8.2 %Illinois8.2California: 8.1 %California8.1Virginia: 8 %Virginia8Ohio: 7.8 %Ohio7.8West Virginia: 7.7 %West Virginia7.7Washington: 7.6 %Washington7.6Oregon: 7.4 %Oregon7.4Maine: 7.3 %Maine7.3Maryland: 7 %Maryland7Delaware: 6.9 %Delaware6.9Kentucky: 6.8 %Kentucky6.8Pennsylvania: 6.7 %Pennsylvania6.7Wisconsin: 6.5 %Wisconsin6.5New Hampshire: 6.3 %New Hampshire6.3New York: 6.1 %New York6.1Connecticut: 6 %Connecticut6Michigan: 6 %Michigan6Iowa: 5.8 %Iowa5.8Minnesota: 5.3 %Minnesota5.3Rhode Island: 4.9 %Rhode Island4.9Vermont: 4.5 %Vermont4.5Hawaii: 4.4 %Hawaii4.4District of Columbia: 3.7 %District of Columbia3.7Massachusetts: 2.9 %Massachusetts2.9
%. 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

RankStates2021 (%)Change on 2020
1Texas20.3+0.4 pts
2Oklahoma16.9-1.2 pts
3Wyoming15.3+1.2 pts
4Florida15.1-0.4 pts
5Georgia14.8-0.5 pts
6Mississippi14.3+0.4 pts
7Nevada13.80 pts
8Alaska13.2+0.2 pts
9Arizona13.1-0.4 pts
10New Mexico12.6+0.8 pts
11North Carolina12.5-0.2 pts
12South Carolina12.3-0.5 pts
13Tennessee11.9-0.3 pts
14Alabama11.7-0.1 pts
15South Dakota11.5-0.1 pts
16Missouri11.4-0.8 pts
17Arkansas11.1+0.9 pts
18Kansas10.9+0.6 pts
19Idaho10.5-0.7 pts
19Montana10.5-0.3 pts
21Utah10.1+0.4 pts
22Colorado9.3-0.6 pts
23Louisiana9.2-0.4 pts
23North Dakota9.2+1 pts
25Indiana8.9-0.1 pts
26Nebraska8.5-1 pts
27New Jersey8.3-0.4 pts
28Illinois8.2-0.2 pts
29California8.1-0.1 pts
30Virginia8-0.6 pts
31Ohio7.8-0.3 pts
32West Virginia7.7-0.7 pts
33Washington7.6+0.2 pts
34Oregon7.4-0.6 pts
35Maine7.3-2 pts
36Maryland7+0.3 pts
37Delaware6.9-0.6 pts
38Kentucky6.8-0.1 pts
39Pennsylvania6.7-1 pts
40Wisconsin6.5-0.3 pts
41New Hampshire6.3-1.6 pts
42New York6.10 pts
43Connecticut6+0.6 pts
43Michigan6-0.4 pts
45Iowa5.8+0.1 pts
46Minnesota5.3-0.6 pts
47Rhode Island4.9+0.3 pts
48Vermont4.5-0.4 pts
49Hawaii4.4-0.3 pts
50District of Columbia3.70 pts
51Massachusetts2.9-0.3 pts

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 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, 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-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, under 65, all races, both sexes, all income levels, states and counties (US states by uninsured rate, under 65 (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, under 65, all races, both sexes, all income levels, states and counties, US states by uninsured rate, under 65 (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-under-65/us-states?period=2021. 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 states by uninsured rate, under 65 (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-under-65/us-states?period=2021.

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 states by uninsured rate, under 65 (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-under-65/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, under 65, all races, both sexes, all income levels, states and counties: US states by uninsured rate, under 65 (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-under-65/us-states?period=2021. 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-2021-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 states by uninsured rate, under 65 (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-under-65/us-states?period=2021
Y2  - 2026/10/12
N1  - Accessed via Invokely, https://invokely.ai/rankings/uninsured-rate-under-65/us-states?period=2021.
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-2021-csv.zip. Retrieved 2026-10-12.
ER  -
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Questions

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

Texas, with 20.3% in 2021, according to the U.S. Census Bureau.

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

Massachusetts, with 2.9% 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, 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 states: more rankings