15 States Where Many People Go Without Any Health Insurance

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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

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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)

Columbus, Georgia skyline
Sean Pavone / Shutterstock.com

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)

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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

Snowmobilers pass a bison in Wyoming
Carolina K. Smith MD / Shutterstock.com

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

Orlando, Florida
ESB Professional / Shutterstock.com

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

Lake Tahoe
By Adonis Villanueva / Shutterstock.com

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

Mountain range and railroad track in Denali National Park, Alaska
Martina Birnbaum / Shutterstock.com

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

Mississippi road sign
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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

Sedona, Arizona
DBSOCAL / Shutterstock.com

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)

Margaret.W / Shutterstock.com

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)

Tennessee
CrackerClips Stock Media / Shutterstock.com

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

Charleston, South Carolina
Bf11photo / Shutterstock.com

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

City scene from Mobile, Alabama
Fotoluminate LLC / Shutterstock.com

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)

Kansas City, MISSOURI
Real Window Creative / Shutterstock.com

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)

Kansas Road
barteverett / Shutterstock.com

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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