Where the most people lack health insurance
Share of the civilian noninstitutionalized population with no health insurance coverage, from the Census ACS 5-year estimates.
Top of the list: Texas at 17.1%. Bottom: Massachusetts at 2.6%.
| # | State | Uninsured | Median household income |
|---|---|---|---|
| 1 | Texas | 17.1% | $78,476 |
| 2 | Oklahoma | 12.9% | $65,039 |
| 3 | Georgia | 12.4% | $77,353 |
| 4 | Florida | 11.5% | $74,568 |
| 5 | Nevada | 11.4% | $78,260 |
| 6 | Wyoming | 11.3% | $76,176 |
| 7 | Alaska | 11.0% | $92,788 |
| 8 | Mississippi | 11.0% | $56,447 |
| 9 | Arizona | 10.5% | $79,964 |
| 10 | Tennessee | 10.0% | $69,595 |
| 11 | North Carolina | 9.9% | $72,388 |
| 12 | New Mexico | 9.6% | $64,059 |
| 13 | South Carolina | 9.6% | $69,324 |
| 14 | Alabama | 9.2% | $63,999 |
| 15 | Idaho | 9.1% | $77,800 |
| 16 | Arkansas | 9.0% | $60,773 |
| 17 | South Dakota | 9.0% | $75,081 |
| 18 | Kansas | 8.8% | $74,275 |
| 19 | Missouri | 8.8% | $70,702 |
| 20 | Montana | 8.6% | $72,509 |
| 21 | Utah | 8.4% | $95,166 |
| 22 | Louisiana | 7.8% | $60,756 |
| 23 | Colorado | 7.7% | $95,470 |
| 24 | New Jersey | 7.5% | $103,556 |
| 25 | Indiana | 7.4% | $71,957 |
| 26 | Nebraska | 7.2% | $76,475 |
| 27 | Illinois | 6.9% | $83,390 |
| 28 | Virginia | 6.9% | $93,170 |
| 29 | California | 6.6% | $99,122 |
| 30 | North Dakota | 6.5% | $76,657 |
| 31 | Ohio | 6.4% | $71,389 |
| 32 | Delaware | 6.3% | $84,954 |
| 33 | Maryland | 6.3% | $103,678 |
| 34 | Washington | 6.3% | $98,141 |
| 35 | Maine | 6.2% | $74,733 |
| 36 | Kentucky | 6.0% | $63,726 |
| 37 | West Virginia | 6.0% | $59,608 |
| 38 | Oregon | 5.9% | $83,011 |
| 39 | Pennsylvania | 5.6% | $77,971 |
| 40 | Connecticut | 5.4% | $95,781 |
| 41 | New Hampshire | 5.3% | $99,031 |
| 42 | Wisconsin | 5.2% | $77,485 |
| 43 | New York | 5.1% | $85,974 |
| 44 | Iowa | 5.0% | $75,059 |
| 45 | Michigan | 4.9% | $72,875 |
| 46 | Minnesota | 4.7% | $89,062 |
| 47 | Rhode Island | 4.4% | $87,796 |
| 48 | Vermont | 3.9% | $81,203 |
| 49 | District of Columbia | 3.6% | $109,870 |
| 50 | Hawaii | 3.6% | $100,389 |
| 51 | Massachusetts | 2.6% | $103,960 |
US Census ACS 5-Year Estimates (summary file) · B01003, B01002, B25031, B19301, B17001, B15003, B08013, B08303, B08301, B28002, B27010, B25040 · 2020–2024 · rel. December 2025 · Official data
Understanding where the most people lack health insurance
Across all 50 states and the District of Columbia, uninsured spans from 17.1% in Texas at the top of the list to 2.6% in Massachusetts at the bottom. The three at the top are Texas, Oklahoma, and Georgia; the three at the bottom are the District of Columbia, Hawaii, and Massachusetts.
Texas has the highest uninsured rate in the country by a wide margin: 17% of residents had no health coverage, about twice the national rate of 8.4%. Oklahoma, Georgia, Florida, Nevada, and Wyoming follow at 11% to 13%. Massachusetts has the lowest rate at under 3%, with DC, Hawaii, Vermont, and Rhode Island also below 4.5%.
Much of the gap follows state policy. Most of the states with the highest uninsured rates had not expanded Medicaid under the Affordable Care Act during the survey period, and Massachusetts had near-universal coverage rules before the federal law. Employment, income, and the share of residents who are not citizens also play a part.
For someone moving, the uninsured rate is a signal about the local health insurance market and safety net more than about personal cost. It does not measure premiums or out-of-pocket costs. The figures are five-year averages, so they smooth over year-to-year changes in enrollment.