Special Report

States With the Best and Worst Health Insurance Coverage

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. In some parts of the country, the 2019 rate was already close to or above those 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. ranked all 50 states based on the percentage of the population under 65 with health insurance coverage. The percentage of uninsured Americans under 65 ranges from 3.5% to more than 20%. Most of the states with the worst coverage are in the South. 

Click here to see the states with the best and worst health insurance coverage.
Click here to see our detailed methodology.