Having health insurance is vital to the well-being of your family and your wallet. It not only ensures that you have access to the care you need, but it also can significantly reduce your out-of-pocket medical expenses. Plus, with the COVID-19 pandemic continuing to rage across the U.S., 2020 is a year that you don’t want to be without health insurance. That’s especially true if you belong to one of the demographics that are more susceptible to serious symptoms. One study found the average cost of a COVID-19 hospitalization without health insurance was $73,000.
After the passage of the Affordable Care Act — dubbed “Obamacare” — the uninsured rate for all adult Americans dipped to a historic low. But the uninsured rate is back on the rise. According to data from the U.S. Census Bureau, the national uninsured rate reached 9.2 percent in 2019, compared to 8.9 percent in 2018.
With the ACA still in place but uninsured rates rising, WalletHub measured the post-Obamacare uninsured rates in each of the 50 states. For an even broader perspective of those rates, we broke the national figures down to categories such as race and income level. In addition, we conducted the same analysis at the city level. Read on for our findings, expert insight from a panel of experts and a full description of our methodology.
Main Findings
Uninsured Rates by State
| Overall Rank* (1 = Lowest) |
State | Change in Uninsured Rate Between 2010 & 2019 | 2019 Children’s Uninsured Rate (Rank) |
2019 Adults’ Uninsured Rate (Rank) |
2019 Whites’ Uninsured Rate (Rank) |
2019 Blacks’ Uninsured Rate (Rank) |
2019 Hispanics’ Uninsured Rate (Rank) |
2019 Low-Income Households’ Uninsured Rate (Rank) |
2019 High-Income Households’ Uninsured Rate (Rank) |
|||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1 | Massachusetts | -1.42% | Info | 1.52% (1) | 3.39% (1) | Info | 2.33% (1) | 4.89% (2) | 5.81% (2) | Info | 4.49% (1) | 1.87% (1) |
| 2 | Rhode Island | -8.08% | Info | 1.90% (2) | 4.68% (3) | Info | 2.57% (2) | 9.24% (26) | 9.47% (5) | Info | 6.15% (4) | 2.42% (3) |
| 3 | Hawaii | -3.73% | Info | 2.80% (5) | 4.57% (2) | Info | 4.51% (13) | 1.66% (1) | 4.68% (1) | Info | 5.71% (2) | 3.28% (9) |
| 4 | Vermont | -3.56% | Info | 2.09% (3) | 5.09% (4) | Info | 4.16% (10) | 17.07% (47) | 11.26% (7) | Info | 5.78% (3) | 2.35% (2) |
| 5 | Minnesota | -4.18% | Info | 3.08% (7) | 5.48% (5) | Info | 3.54% (5) | 9.38% (27) | 16.65% (23) | Info | 8.30% (9) | 2.46% (4) |
| 6 | Iowa | -4.30% | Info | 2.92% (6) | 5.70% (6) | Info | 3.92% (8) | 11.27% (34) | 13.91% (15) | Info | 7.62% (6) | 3.04% (7) |
| 7 | New York | -6.66% | Info | 2.36% (4) | 6.06% (7) | Info | 3.15% (4) | 5.59% (3) | 10.07% (6) | Info | 6.66% (5) | 3.70% (15) |
| 8 | Wisconsin | -3.71% | Info | 3.77% (16) | 6.31% (9) | Info | 4.18% (11) | 8.39% (20) | 19.26% (29) | Info | 8.90% (13) | 2.86% (6) |
| 9 | Pennsylvania | -4.40% | Info | 4.56% (22) | 6.11% (8) | Info | 4.92% (17) | 6.90% (9) | 12.47% (9) | Info | 8.19% (8) | 3.69% (14) |
| 10 | Michigan | -6.59% | Info | 3.42% (10) | 6.49% (10) | Info | 5.07% (18) | 6.44% (7) | 13.58% (14) | Info | 8.46% (11) | 2.82% (5) |
| 11 | Connecticut | -3.20% | Info | 3.48% (12) | 6.58% (11) | Info | 3.74% (6) | 6.62% (8) | 13.52% (13) | Info | 8.87% (12) | 3.27% (8) |
| 12 | Maryland | -5.27% | Info | 3.39% (9) | 6.81% (13) | Info | 2.99% (3) | 5.83% (5) | 21.44% (35) | Info | 9.02% (14) | 3.98% (20) |
| 13 | New Hampshire | -4.88% | Info | 3.68% (15) | 6.92% (14) | Info | 5.66% (23) | 11.60% (36) | 15.38% (17) | Info | 10.20% (18) | 3.62% (13) |
| 14 | Kentucky | -8.81% | Info | 4.26% (19) | 7.14% (17) | Info | 5.71% (25) | 7.44% (11) | 19.95% (30) | Info | 8.39% (10) | 3.71% (16) |
| 15 | Delaware | -3.13% | Info | 4.82% (24) | 7.07% (15) | Info | 4.87% (15) | 7.63% (12) | 15.42% (18) | Info | 9.33% (16) | 4.26% (26) |
| 16 | Ohio | -5.74% | Info | 4.79% (23) | 7.14% (16) | Info | 5.82% (26) | 8.14% (15) | 16.00% (21) | Info | 9.19% (15) | 3.52% (11) |
| 17 | Washington | -7.63% | Info | 3.08% (8) | 7.70% (19) | Info | 4.48% (12) | 8.29% (16) | 18.24% (25) | Info | 10.56% (21) | 3.83% (18) |
| 18 | West Virginia | -7.92% | Info | 3.52% (13) | 7.55% (18) | Info | 6.58% (29) | 7.41% (10) | 12.70% (11) | Info | 7.94% (7) | 3.85% (19) |
| 19 | North Dakota | -2.87% | Info | 7.77% (42) | 6.60% (12) | Info | 4.91% (16) | 24.70% (50) | 13.08% (12) | Info | 10.43% (20) | 5.35% (37) |
| 20 | Oregon | -9.98% | Info | 4.10% (18) | 8.03% (20) | Info | 5.61% (20) | 7.81% (13) | 16.55% (22) | Info | 9.69% (17) | 4.29% (27) |
| 21 | Illinois | -6.38% | Info | 4.03% (17) | 8.45% (21) | Info | 4.70% (14) | 8.89% (23) | 15.93% (20) | Info | 11.25% (24) | 3.77% (17) |
| 22 | California | -10.84% | Info | 3.55% (14) | 9.02% (27) | Info | 4.05% (9) | 5.67% (4) | 12.66% (10) | Info | 10.75% (22) | 4.71% (32) |
| 23 | New Jersey | -5.35% | Info | 4.32% (20) | 8.97% (26) | Info | 3.85% (7) | 9.42% (28) | 18.63% (27) | Info | 13.32% (31) | 4.23% (25) |
| 24 | Virginia | -5.14% | Info | 4.89% (25) | 8.88% (24) | Info | 5.33% (19) | 8.37% (19) | 24.70% (39) | Info | 12.72% (30) | 4.05% (21) |
| 25 | Colorado | -7.91% | Info | 5.45% (28) | 8.79% (23) | Info | 5.70% (24) | 9.15% (25) | 14.89% (16) | Info | 12.28% (28) | 4.32% (28) |
| 26 | Maine | -2.11% | Info | 5.60% (29) | 8.62% (22) | Info | 7.80% (37) | 8.36% (17) | 9.28% (4) | Info | 10.83% (23) | 4.46% (29) |
| 27 | Montana | -9.05% | Info | 6.22% (37) | 8.88% (25) | Info | 6.87% (32) | 8.37% (18) | 7.72% (3) | Info | 10.42% (19) | 5.66% (39) |
| 28 | Nebraska | -3.23% | Info | 5.66% (30) | 9.24% (28) | Info | 5.64% (22) | 16.86% (46) | 21.04% (34) | Info | 14.65% (34) | 3.52% (12) |
| 29 | Indiana | -6.11% | Info | 7.14% (39) | 9.25% (29) | Info | 7.71% (36) | 10.33% (30) | 17.46% (24) | Info | 12.20% (27) | 5.18% (36) |
| 30 | Louisiana | -8.91% | Info | 4.36% (21) | 10.45% (33) | Info | 6.94% (33) | 8.91% (24) | 27.47% (44) | Info | 11.27% (25) | 5.14% (35) |
| 31 | Arkansas | -8.31% | Info | 5.86% (35) | 10.24% (30) | Info | 7.21% (34) | 8.67% (21) | 26.10% (41) | Info | 12.43% (29) | 3.46% (10) |
| 32 | Kansas | -4.69% | Info | 5.82% (33) | 10.39% (32) | Info | 6.50% (28) | 13.19% (39) | 23.34% (36) | Info | 15.99% (40) | 4.13% (23) |
| 33 | Utah | -5.69% | Info | 8.31% (45) | 10.26% (31) | Info | 6.70% (31) | 18.71% (48) | 23.38% (37) | Info | 17.14% (44) | 5.43% (38) |
| 34 | Alabama | -4.88% | Info | 3.48% (11) | 11.69% (37) | Info | 8.17% (40) | 11.03% (32) | 25.02% (40) | Info | 14.36% (32) | 4.07% (22) |
| 35 | New Mexico | -9.64% | Info | 5.75% (31) | 11.32% (36) | Info | 5.63% (21) | 8.85% (22) | 11.32% (8) | Info | 12.14% (26) | 6.00% (40) |
| 36 | Missouri | -3.13% | Info | 6.55% (38) | 11.13% (35) | Info | 9.16% (44) | 11.97% (38) | 20.86% (33) | Info | 16.13% (41) | 4.17% (24) |
| 37 | Tennessee | -4.21% | Info | 5.03% (27) | 11.74% (38) | Info | 8.13% (38) | 10.84% (31) | 34.22% (49) | Info | 15.30% (36) | 4.63% (31) |
| 38 | South Dakota | -2.20% | Info | 7.80% (43) | 11.03% (34) | Info | 6.61% (30) | 19.12% (49) | 24.27% (38) | Info | 16.26% (42) | 4.51% (30) |
| 39 | Idaho | -6.92% | Info | 4.96% (26) | 12.99% (44) | Info | 9.15% (43) | 10.04% (29) | 20.53% (31) | Info | 15.54% (38) | 6.22% (43) |
| 40 | South Carolina | -6.68% | Info | 5.82% (34) | 12.38% (40) | Info | 8.68% (41) | 11.88% (37) | 30.54% (46) | Info | 15.56% (39) | 4.82% (33) |
| 41 | North Carolina | -5.51% | Info | 5.77% (32) | 12.98% (43) | Info | 8.16% (39) | 11.53% (35) | 31.30% (47) | Info | 16.61% (43) | 5.03% (34) |
| 42 | Arizona | -5.60% | Info | 9.25% (47) | 11.94% (39) | Info | 6.43% (27) | 11.05% (33) | 18.57% (26) | Info | 15.47% (37) | 6.14% (41) |
| 43 | Nevada | -11.20% | Info | 8.00% (44) | 12.49% (41) | Info | 7.22% (35) | 7.93% (14) | 20.62% (32) | Info | 15.29% (35) | 7.12% (45) |
| 44 | Alaska | -7.64% | Info | 9.40% (48) | 13.25% (45) | Info | 8.81% (42) | 6.10% (6) | 15.74% (19) | Info | 14.60% (33) | 10.15% (50) |
| 45 | Wyoming | -2.61% | Info | 10.64% (49) | 12.88% (42) | Info | 10.01% (46) | 15.32% (44) | 26.19% (42) | Info | 18.63% (47) | 7.45% (47) |
| 46 | Mississippi | -5.22% | Info | 6.14% (36) | 15.33% (47) | Info | 10.96% (50) | 13.95% (42) | 35.47% (50) | Info | 17.55% (45) | 6.17% (42) |
| 47 | Florida | -8.10% | Info | 7.65% (41) | 14.64% (46) | Info | 9.63% (45) | 15.66% (45) | 18.95% (28) | Info | 17.68% (46) | 7.47% (48) |
| 48 | Georgia | -6.29% | Info | 7.41% (40) | 15.48% (48) | Info | 10.23% (47) | 13.32% (40) | 32.35% (48) | Info | 20.43% (49) | 6.44% (44) |
| 49 | Oklahoma | -4.58% | Info | 8.58% (46) | 16.28% (49) | Info | 10.71% (49) | 13.36% (41) | 26.76% (43) | Info | 19.94% (48) | 7.17% (46) |
| 50 | Texas | -5.36% | Info | 12.75% (50) | 20.47% (50) | Info | 10.57% (48) | 15.03% (43) | 28.64% (45) | Info | 27.18% (50) | 9.26% (49) |
| Info | National | -6.25% | Info | 5.66% | 10.28% | Info | 6.25% | 10.13% | 18.66% | Info | 13.71% | 4.82% |
*Note: Overall rank based on 2019 uninsured rates
Uninsured Rates Over Time
Medicaid States vs. Non-Medicaid States
Red vs. Blue States
Ask the Experts
For insight on the future of the ACA, we asked a panel of experts to share their thoughts on the following key questions:
- Do you think ACA had an overall positive effect on the U.S. health insurance marketplace? Are there states that had gained/ lost more than others?
- How can the almost flat insurance rate be explained?
- What do you think is the most common misconception people have about ACA?
- What can be done in terms of affordable coverage for people who lost their employer provided health insurance in the aftermath of the COVID-19 outbreak?
Ask the Experts
Ph.D. – Professor of Health Law, Policy, and Management; Director, Health Reform Program – Boston University School of Public Health
Read More
M.D., J.D. – Professor of Law – Georgetown University
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Ph.D. – Adjunct Faculty Gerontology and Political Science – Youngstown State University
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Ph.D. – Professor, Health Management & Policy – School of Public Health; Professor, Sociology – University of Michigan
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Ph.D. – Albert G. and Frances Lomas Feldman Professor of Social Policy and Health; Fellow, American Academy of Social Welfare and Social Work; Co-Lead, Social Work Grand Challenge to Create Social Responses to a Changing Environment; Suzanne Dworak-Peck School of Social Work – University of Southern California
Read More
Professor of Healthcare Studies – Baylor University School of Law
Read More
Methodology
In order to measure the rates of uninsured by state, WalletHub compared the overall insurance rates in the 50 states in 2019 using U.S. Census Bureau data. In addition to comparing overall insurance rates, we examined the state rates based on age, race and income.
An overall rank of No. 1 corresponds with the state with the lowest uninsured rate. When viewing our findings in the above tables, please note that the change in uninsured rate refers to the difference between the percentages of uninsured in 2019 and 2010. A small change in the absolute difference does not necessarily indicate a negative outcome, as the percentage of uninsured people pre-Obamacare may have already been low to start with.
Change in Uninsured Rate Between 2010 & 2019
Health Insurance Rate by Age Group
- Health Insurance Rate for Children (Aged 0 to 18 Years)
- Health Insurance Rate for Adults (Aged 19 Years & Older)
Health Insurance Rate by Race/Ethnicity
- Health Insurance Rate for Whites
- Health Insurance Rate for Blacks or African Americans
- Health Insurance Rate for Hispanics or Latinos
Health Insurance Rate by Household Income
- Health Insurance Rate for Lower-Income Households ($50,000 or less)
- Health Insurance Rate for Higher-Income Households ($100,000 or more)
Sources: Data used to create this ranking were collected from the U.S. Census Bureau.
