Special Report

The County With the Worst Health Insurance Coverage in Every State

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 uninsured rate among Americans younger than 65 has inched up over the years since, it remains well below the 17%+ figures in the years leading up to the ACA. 

Without a universal health care program, employer-based health insurance covers most Americans under age 65. Under this system, 10.3% of Americans younger than 65, approximately 25 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 2020 uninsured rate for Americans under 65 will likely be higher than the 2019 rate, which, in some parts of the country, was already well above the national uninsured rate levels from before the passing of the ACA. 

Using data from the U.S. Census Bureau, 24/7 Wall St. identified the county or county equivalent, with the worst health insurance coverage in every state. Counties were ranked based on the share of residents under age 65 — the age of eligibility for Medicare — who are uninsured. 

Uninsured rates vary considerably across the country, and as a result, a county’s ranking on this list does not necessarily mean the uninsured rate is high relative to the nation as a whole. In several states, particularly in New England and parts of the Midwest, the highest uninsured rate among counties is in the single digits. Uninsured rates in the counties on this list range from 3.9% all the way up to 38.3%. (These are the cities with the worst health insurance coverage in every state.)

Click here to see the county with the worst health insurance coverage in every state.
Click here to read our detailed methodology.