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, the leading cause of personal bankruptcy in the U.S.

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 recent data from the U.S. Census Bureau, the national uninsured rate for 2018 was 8.5%, compared to 7.9% in 2017.

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 & 2018 2018 Children’s Uninsured Rate

(Rank) 2018 Adults’ Uninsured Rate

(Rank) 2018 Whites’ Uninsured Rate

(Rank) 2018 Blacks’ Uninsured Rate

(Rank) 2018 Hispanics’ Uninsured Rate

(Rank) 2018 Low-Income Households’ Uninsured Rate

(Rank) 2018 High-Income Households’ Uninsured Rate

(Rank) 1 Massachusetts -1.65% 1.22%

(1) 3.19%

(1) 2.08%

(1) 4.26%

(2) 5.33%

(1) 4.22%

(1) 1.64%

(1) 2 Vermont -4.02% 1.97%

(2) 4.55%

(3) 3.71%

(9) 11.59%

(35) 11.04%

(6) 5.92%

(3) 2.41%

(7) 3 Hawaii -3.81% 2.61%

(7) 4.52%

(2) 3.21%

(6) 4.75%

(4) 7.21%

(2) 6.83%

(4) 2.36%

(6) 4 Rhode Island -8.09% 2.18%

(3) 4.59%

(4) 2.95%

(3) 3.92%

(1) 8.92%

(3) 5.80%

(2) 1.94%

(2) 5 Minnesota -4.67% 3.28%

(11) 4.77%

(5) 3.13%

(5) 6.46%

(9) 17.14%

(24) 7.26%

(8) 2.30%

(4) 6 Iowa -4.59% 2.69%

(8) 5.40%

(6) 3.70%

(8) 12.06%

(37) 13.00%

(12) 7.24%

(7) 2.30%

(5) 7 Connecticut -3.79% 2.58%

(5) 6.09%

(10) 3.05%

(4) 6.78%

(11) 13.10%

(13) 8.66%

(14) 2.84%

(10) 8 New York -6.51% 2.49%

(4) 6.23%

(11) 3.27%

(7) 5.85%

(5) 10.59%

(5) 6.89%

(5) 3.49%

(21) 9 Michigan -6.96% 3.39%

(16) 6.01%

(9) 4.75%

(18) 6.47%

(10) 11.79%

(10) 7.60%

(10) 2.84%

(9) 10 Wisconsin -3.97% 3.78%

(21) 5.97%

(8) 4.17%

(12) 7.81%

(13) 15.99%

(22) 8.39%

(13) 2.66%

(8) 11 Pennsylvania -4.62% 4.39%

(23) 5.88%

(7) 4.66%

(17) 7.10%

(12) 12.34%

(11) 7.77%

(11) 3.18%

(13) 12 Kentucky -9.61% 3.75%

(20) 6.25%

(12) 4.82%

(19) 6.00%

(7) 23.40%

(38) 7.54%

(9) 2.29%

(3) 13 Delaware -4.03% 3.64%

(19) 6.26%

(13) 4.19%

(13) 4.61%

(3) 17.72%

(27) 7.04%

(6) 4.84%

(38) 14 New Hampshire -5.38% 2.59%

(6) 6.58%

(14) 5.17%

(20) 10.03%

(27) 14.03%

(16) 9.51%

(16) 3.10%

(12) 15 Maryland -5.26% 3.29%

(12) 6.85%

(15) 2.83%

(2) 6.10%

(8) 22.29%

(36) 9.61%

(17) 3.52%

(23) 16 West Virginia -8.18% 3.38%

(13) 7.27%

(17) 6.25%

(29) 9.52%

(25) 11.41%

(7) 8.32%

(12) 2.91%

(11) 17 Washington -7.82% 2.71%

(9) 7.58%

(18) 4.40%

(15) 8.30%

(17) 17.91%

(28) 9.76%

(18) 3.60%

(25) 18 Ohio -5.86% 4.82%

(28) 6.97%

(16) 5.66%

(24) 8.48%

(19) 15.30%

(19) 9.40%

(15) 3.21%

(14) 19 Illinois -6.81% 3.38%

(15) 8.10%

(21) 4.32%

(14) 8.27%

(16) 15.42%

(20) 10.75%

(24) 3.42%

(18) 20 Oregon -10.09% 3.56%

(18) 8.06%

(20) 5.34%

(22) 8.47%

(18) 16.21%

(23) 10.25%

(20) 3.46%

(19) 21 California -11.30% 3.14%

(10) 8.55%

(24) 3.99%

(11) 5.96%

(6) 11.68%

(9) 10.34%

(22) 4.31%

(31) 22 North Dakota -2.52% 6.02%

(38) 7.66%

(19) 5.42%

(23) 19.37%

(49) 13.23%

(15) 11.59%

(26) 3.28%

(15) 23 New Jersey -5.80% 3.87%

(22) 8.53%

(23) 3.78%

(10) 8.73%

(22) 17.30%

(25) 13.40%

(30) 3.49%

(20) 24 Colorado -8.40% 4.63%

(25) 8.44%

(22) 5.25%

(21) 8.66%

(21) 14.91%

(17) 11.68%

(27) 4.29%

(30) 25 Louisiana -9.84% 3.38%

(14) 9.55%

(30) 6.22%

(28) 8.03%

(14) 27.69%

(45) 10.17%

(19) 4.19%

(26) 26 Maine -2.11% 5.49%

(35) 8.66%

(25) 7.69%

(37) 14.23%

(43) 13.17%

(14) 11.23%

(25) 3.52%

(24) 27 Montana -9.11% 6.11%

(39) 8.86%

(27) 7.17%

(36) N/A

(N/A) 9.25%

(4) 10.74%

(23) 4.59%

(36) 28 Arkansas -9.23% 4.51%

(24) 9.48%

(29) 6.32%

(31) 8.20%

(15) 24.19%

(40) 10.27%

(21) 4.54%

(34) 29 Indiana -6.56% 6.56%

(41) 8.84%

(26) 6.90%

(35) 10.41%

(29) 19.99%

(31) 11.85%

(28) 4.57%

(35) 30 Nebraska -3.23% 5.23%

(32) 9.39%

(28) 5.88%

(25) 14.24%

(44) 20.27%

(32) 14.11%

(31) 3.51%

(22) 31 Kansas -5.12% 5.11%

(30) 10.07%

(32) 6.46%

(32) 12.54%

(40) 22.07%

(35) 14.92%

(36) 3.33%

(16) 32 Virginia -4.25% 5.10%

(29) 9.98%

(31) 6.15%

(27) 10.80%

(31) 23.84%

(39) 14.99%

(38) 4.25%

(29) 33 Missouri -3.75% 5.68%

(36) 10.61%

(34) 8.46%

(42) 12.48%

(39) 20.83%

(33) 14.32%

(32) 4.19%

(27) 34 Utah -5.92% 7.35%

(43) 10.36%

(33) 6.29%

(30) 17.40%

(48) 25.44%

(42) 16.24%

(43) 5.16%

(41) 35 New Mexico -10.08% 5.25%

(33) 10.93%

(35) 4.52%

(16) 11.28%

(33) 11.49%

(8) 11.89%

(29) 4.43%

(32) 36 South Dakota -2.59% 5.91%

(37) 11.17%

(36) 6.48%

(33) 8.76%

(23) 21.87%

(34) 16.33%

(44) 3.39%

(17) 37 Alabama -4.59% 3.50%

(17) 12.08%

(40) 8.11%

(39) 11.49%

(34) 27.87%

(46) 14.98%

(37) 4.21%

(28) 38 Tennessee -4.23% 5.19%

(31) 11.68%

(39) 8.22%

(40) 12.21%

(38) 29.62%

(48) 14.81%

(33) 4.99%

(40) 39 Wyoming -4.46% 7.13%

(42) 11.58%

(38) 9.31%

(44) 9.96%

(26) 15.88%

(21) 15.49%

(41) 5.47%

(42) 40 South Carolina -7.06% 4.73%

(27) 12.24%

(42) 8.34%

(41) 11.60%

(36) 27.56%

(44) 14.83%

(35) 4.87%

(39) 41 Arizona -6.26% 8.38%

(48) 11.35%

(37) 6.11%

(26) 10.25%

(28) 17.72%

(26) 14.82%

(34) 5.55%

(43) 42 North Carolina -6.05% 5.32%

(34) 12.43%

(43) 7.98%

(38) 10.68%

(30) 29.65%

(49) 16.11%

(42) 4.47%

(33) 43 Idaho -6.64% 6.11%

(40) 12.98%

(44) 9.27%

(43) 8.59%

(20) 22.56%

(37) 15.20%

(39) 6.15%

(44) 44 Nevada -11.41% 7.97%

(45) 12.24%

(41) 6.79%

(34) 10.98%

(32) 19.72%

(30) 15.30%

(40) 6.89%

(46) 45 Mississippi -6.06% 4.69%

(26) 14.73%

(47) 10.05%

(47) 13.94%

(42) 28.79%

(47) 17.45%

(47) 4.72%

(37) 46 Alaska -7.21% 9.44%

(49) 13.83%

(45) 9.66%

(46) 8.84%

(24) 15.25%

(18) 16.70%

(45) 8.59%

(49) 47 Florida -8.27% 7.55%

(44) 14.47%

(46) 9.49%

(45) 15.13%

(46) 19.00%

(29) 17.04%

(46) 7.28%

(47) 48 Georgia -6.05% 8.14%

(46) 15.58%

(48) 10.40%

(49) 13.61%

(41) 33.20%

(50) 20.21%

(49) 6.44%

(45) 49 Oklahoma -4.66% 8.25%

(47) 16.31%

(49) 10.47%

(50) 14.87%

(45) 25.17%

(41) 19.38%

(48) 7.30%

(48) 50 Texas -6.00% 11.15%

(50) 20.23%

(50) 10.29%

(48) 15.21%

(47) 27.29%

(43) 25.50%

(50) 8.67%

(50) National -6.56% 5.21%

10.03%

6.03%

10.15%

17.94%

13.22%

4.46%



*Note: Overall rank based on 2018 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?

Methodology

In order to measure the rates of uninsured by state, WalletHub compared the overall insurance rates in the 50 states in 2018 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 2018 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 & 2018

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)





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Sources: Data used to create this ranking were collected from the U.S. Census Bureau.

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