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 through the ACA 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 U.S. Census Bureau reports that 8% of people nationwide did not have health insurance at any point in 2022, the latest year for which data is available, but the following states all had much 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
Share of state’s population without health insurance coverage in:
- 2022: 16.6%
- 2021: 18.0%
- 2019: 18.4%
- 2010: 23.7%
State’s Medicaid expansion status as of Jan. 1, 2022: Not expanded
2. Georgia (tie)
Share of state’s population without health insurance coverage in:
- 2022: 11.7%
- 2021: 12.6%
- 2019: 13.4%
- 2010: 19.7%
State’s Medicaid expansion status as of Jan. 1, 2022: Not expanded
2. Oklahoma (tie)
Share of state’s population without health insurance coverage in:
- 2022: 11.7%
- 2021: 13.8%
- 2019: 14.3%
- 2010: 18.9%
State’s Medicaid expansion status as of Jan. 1, 2022: Expanded
4. Wyoming
Share of state’s population without health insurance coverage in:
- 2022: 11.5%
- 2021: 12.2%
- 2019: 12.3%
- 2010: 14.9%
State’s Medicaid expansion status as of Jan. 1, 2022: Not expanded
5. Florida
Share of state’s population without health insurance coverage in:
- 2022: 11.2%
- 2021: 12.1%
- 2019: 13.2%
- 2010: 21.3%
State’s Medicaid expansion status as of Jan. 1, 2022: Not expanded
6. Nevada
Share of state’s population without health insurance coverage in:
- 2022: 11.1%
- 2021: 11.6%
- 2019: 11.4%
- 2010: 22.6%
State’s Medicaid expansion status as of Jan. 1, 2022: Expanded
7. Alaska
Share of state’s population without health insurance coverage in:
- 2022: 11.0%
- 2021: 11.4%
- 2019: 12.2%
- 2010: 19.9%
State’s Medicaid expansion status as of Jan. 1, 2022: Expanded
8. Mississippi
Share of state’s population without health insurance coverage in:
- 2022: 10.8%
- 2021: 11.9%
- 2019: 13.0%
- 2010: 18.2%
State’s Medicaid expansion status as of Jan. 1, 2022: Not expanded
9. Arizona
Share of state’s population without health insurance coverage in:
- 2022: 10.3%
- 2021: 10.7%
- 2019: 11.3%
- 2010: 16.9%
State’s Medicaid expansion status as of Jan. 1, 2022: Expanded
10. North Carolina (tie)
Share of state’s population without health insurance coverage in:
- 2022: 9.3%
- 2021: 10.4%
- 2019: 11.3%
- 2010: 16.8%
State’s Medicaid expansion status as of Jan. 1, 2022: Not expanded
10. Tennessee (tie)
Share of state’s population without health insurance coverage in:
- 2022: 9.3%
- 2021: 10.0%
- 2019: 10.1%
- 2010: 14.4%
State’s Medicaid expansion status as of Jan. 1, 2022: Not expanded
12. South Carolina
Share of state’s population without health insurance coverage in:
- 2022: 9.1%
- 2021: 10.0%
- 2019: 10.8%
- 2010: 17.5%
State’s Medicaid expansion status as of Jan. 1, 2022: Not expanded
13. Alabama
Share of state’s population without health insurance coverage in:
- 2022: 8.8%
- 2021: 9.9%
- 2019: 9.7%
- 2010: 14.6%
State’s Medicaid expansion status as of Jan. 1, 2022: Not expanded
14. Missouri (tie)
Share of state’s population without health insurance coverage in:
- 2022: 8.6%
- 2021: 9.4%
- 2019: 10.0%
- 2010: 13.2%
State’s Medicaid expansion status as of Jan. 1, 2022: Expanded
14. Kansas (tie)
Share of state’s population without health insurance coverage in:
- 2022: 8.6%
- 2021: 9.2%
- 2019: 9.2%
- 2010: 13.9%
State’s Medicaid expansion status as of Jan. 1, 2022: Not expanded
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