Health insurance isn’t a guarantee that you won’t end up stuck with big medical bills, but it can help reduce the chances that a major illness or injury could push you into bankruptcy court.

In 2018, the latest data show that 91.1% of U.S. residents had health insurance of some type, whether private or public, according to a recent report from the U.S. Census Bureau.

Public insurance programs include Medicare, Medicaid and VA health care, while private coverage includes insurance obtained by employees through their workplace or by individuals purchasing it from a federal or state marketplace.

Not every state has the same share of residents with insurance, however. Coverage rates in each state range from a high of 97.2% to a low of 82.3%.

Here is a look at the 18 states with the largest shares of residents without health insurance. The state with the lowest rate of insured residents is shown last.