The United States is the only industrialized country in the world without universal health care — and as a result, most Americans under age 65 receive employer-based health insurance coverage. Under this system, an estimated 28.9 million Americans under age 65 were uninsured in 2019 — before over 22 million Americans lost their jobs in the early months of the COVID-19 pandemic.
While most of those jobs have since been restored, the official uninsured rate for Americans younger than 65 in 2020 will likely be higher than the 10.3% rate in 2019 — a continuation of the three-year trend of declining insurance coverage that began in 2017. Still, there are many parts of the country where nearly every American under 65 is insured, either through their employer, Medicaid, or directly purchased coverage.
Using data from the U.S. Census Bureau, 24/7 Wall St. identified the 50 counties with the best health insurance coverage. Counties are ranked on the share of residents under age 65 — the age of eligibility for Medicare — who are uninsured.
The counties on this list span 15 states, primarily in the Midwest and Northeast. Over half of the 14 counties in Massachusetts rank on this list largely because the state was a national leader in health care reform, enacting laws that led to near-universal coverage almost half a decade before the Affordable Care Act was signed into law under the Obama Administration.