Since passage of the Affordable Care Act in 2010, the number of uninsured Americans has gone down nationwide. However, some states are doing better than others when it comes to helping their residents obtain health insurance.
While the federal government gave states the option to expand eligibility for Medicaid — a joint federal and state health insurance program primarily for people with low incomes — not all states took Uncle Sam up on the offer.
By and large, those states with the largest share of residents without health insurance are those that chose not to expand their Medicaid programs.
The Census Bureau reports that 8.3% of people nationwide (27.2 million) did not have health insurance at any point in 2021, but the following states all had higher rates. Here’s a look at the states with the largest percentage of uninsured residents.
If you don’t see your state here, see if it lands among the “15 States Where the Most People Have Health Insurance.”
1. Texas
State’s population without health insurance coverage in:
- 2021: 18.0%
- 2019: 18.4%
- 2010: 23.7%
State’s Medicaid expansion status as of Jan. 1, 2021: Not expanded
2. Oklahoma
State’s population without health insurance coverage in:
- 2021: 13.8%
- 2019: 14.3%
- 2010: 18.9%
State’s Medicaid expansion status as of Jan. 1, 2021: Not expanded
3. Georgia
State’s population without health insurance coverage in:
- 2021: 12.6%
- 2019: 13.4%
- 2010: 19.7%
State’s Medicaid expansion status as of Jan. 1, 2021: Not expanded
4. Wyoming
State’s population without health insurance coverage in:
- 2021: 12.2%
- 2019: 12.3%
- 2010: 14.9%
State’s Medicaid expansion status as of Jan. 1, 2021: Not expanded
5. Florida
State’s population without health insurance coverage in:
- 2021: 12.1%
- 2019: 13.2%
- 2010: 21.3%
State’s Medicaid expansion status as of Jan. 1, 2021: Not expanded
6. Mississippi
State’s population without health insurance coverage in:
- 2021: 11.9%
- 2019: 13.0%
- 2010: 18.2%
State’s Medicaid expansion status as of Jan. 1, 2021: Not expanded
7. Nevada
State’s population without health insurance coverage in:
- 2021: 11.6%
- 2019: 11.4%
- 2010: 22.6%
State’s Medicaid expansion status as of Jan. 1, 2021: Expanded
8. Alaska
State’s population without health insurance coverage in:
- 2021: 11.4%
- 2019: 12.2%
- 2010: 19.9%
State’s Medicaid expansion status as of Jan. 1, 2021: Expanded
9. Arizona
State’s population without health insurance coverage in:
- 2021: 10.7%
- 2019: 11.3%
- 2010: 16.9%
State’s Medicaid expansion status as of Jan. 1, 2021: Expanded
10. North Carolina
State’s population without health insurance coverage in:
- 2021: 10.4%
- 2019: 11.3%
- 2010: 16.8%
State’s Medicaid expansion status as of Jan. 1, 2021: Not expanded
11. South Carolina (three-way tie)
State’s population without health insurance coverage in:
- 2021: 10.0%
- 2019: 10.8%
- 2010: 17.5%
State’s Medicaid expansion status as of Jan. 1, 2021: Not expanded
11. Tennessee (three-way tie)
State’s population without health insurance coverage in:
- 2021: 10.0%
- 2019: 10.1%
- 2010: 14.4%
State’s Medicaid expansion status as of Jan. 1, 2021: Not expanded
11. New Mexico (three-way tie)
State’s population without health insurance coverage in:
- 2021: 10.0%
- 2019: 10.0%
- 2010: 19.6%
State’s Medicaid expansion status as of Jan. 1, 2021: Expanded
14. Alabama
State’s population without health insurance coverage in:
- 2021: 9.9%
- 2019: 9.7%
- 2010: 14.6%
State’s Medicaid expansion status as of Jan. 1, 2021: Not expanded
15. South Dakota
State’s population without health insurance coverage in:
- 2021: 9.5%
- 2019: 10.2%
- 2010: 12.4%
State’s Medicaid expansion status as of Jan. 1, 2021: Not expanded
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