Methodology

To determine the states with the best and worst health insurance coverage, 24/7 Wall St. reviewed one-year estimates of the percentage of the noninstitutionalized civilian population under 65 without health insurance from the U.S. Census Bureau’s 2019 American Community Survey. 

We selected the under 65 age group because Americans become eligible for Medicare at age 65, and the uninsured rate for the population above this age is less than 1% nationwide. However, because the census does not publish insurance coverage estimates specifically for the under 65 age group, we aggregated the data from more granular age breakdowns. 

Each state was ranked based on its under 65 uninsured rate. The share of the population covered by each type of insurance — Medicare, Medicaid, VA, employer, direct-purchase, and Tricare/military — are for the same cohort and are also aggregated from one-year ACS estimates. The estimates reflect people who are covered by that type of insurance alone or in combination with other types on the list. So, when a person is covered by more than one type of insurance, they are included in each group.