Special Report

Metros With the Worst Health Insurance Coverage in the Nation

The share of Americans under the age of 65 without health insurance fell every year between 2010, when the Affordable Care Act was signed into law, and 2016, when President Barack Obama left office. Though the U.S. uninsured rate among Americans younger than 65 has inched up over the years since, it remains well below the reported 17%+ figures in the years leading up to the ACA. 

Without a universal health care program, most Americans under age 65 receive employer-based health insurance coverage. Under this system, 10.8% of Americans younger than 65, approximately 29 million people, lacked health insurance in 2019 — and that was before the COVID-19 pandemic put over 22 million Americans out of work.

While most of those jobs have since been restored, the official uninsured rate for Americans younger than 65 for 2020 will likely be higher than the 2019 rate. And in some parts of the country, the 2019 rate is already close to or above the higher national uninsured rates of the era before the passing of the ACA. 

Using data from the U.S. Census Bureau, 24/7 Wall St. identified the 50 metropolitan areas with the worst health insurance coverage. Metro areas are ranked on the share of residents under age 65 — the age of eligibility for Medicare — who are uninsured. 

Well over half of the metro areas on this list are in Southern states — including 19 in Texas and another 13 in Florida.

Click here to see the metros with the worst health insurance coverage in the nation.
Click here to see our detailed methodology.