The share of Americans under the age of 65 without health insurance fell every year between 2010, when the Affordable Care Act was signed into law, and 2016, when President Barack Obama left office. Though the U.S. uninsured rate among Americans younger than 65 has inched up over the years since, it remains well below the 17%+ figures in the years leading up to the ACA.
Without a universal health care program, most Americans under age 65 receive employer-based health insurance coverage. Under this system, 10.3% of Americans younger than 65, approximately 29 million people, lacked health insurance in 2019 — and that was before the COVID-19 pandemic put over 22 million Americans out of work.
While most of those jobs have since been restored, the official uninsured rate for Americans younger than 65 for 2020 will likely be higher than the 2019 rate. And in some parts of the country, the 2019 rate was already close to or above the higher national uninsured rates of the era before the passing of the ACA.
Using data from the U.S. Census Bureau, 24/7 Tempo identified the ZIP code in every state with the worst health insurance coverage. Uninsured rates in some places on this list exceed 50%.
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Alabama: 36509
> Location: Bayou La Batre, Alabama > Residents under 65, no health insurance: 27.2% (Alabama: 11.3%) > Residents under 65, Medicare coverage (or multiple types): 3.8% (Alabama: 4.9%) > Residents under 65, Medicaid coverage (or multiple types): 24.8% (Alabama: 20.9%) > Residents under 65, VA coverage (or multiple types): 0.6% (Alabama: 1.7%) > Residents under 65, employer-based insurance (or multiple types): 32.3% (Alabama: 57.8%) > Residents under 65, direct-purchase insurance (or multiple types): 14.3% (Alabama: 10.5%) > Residents under 65, Tricare/military insurance (or many types): 2.7% (Alabama: 3.3%)
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Alaska: 99661
> Location: Sand Point, Alaska > Residents under 65, no health insurance: 55.4% (Alaska: 15.3%) > Residents under 65, Medicare coverage (or multiple types): 0.9% (Alaska: 1.9%) > Residents under 65, Medicaid coverage (or multiple types): 14.6% (Alaska: 21.1%) > Residents under 65, VA coverage (or multiple types): 0.8% (Alaska: 3.0%) > Residents under 65, employer-based insurance (or multiple types): 25.9% (Alaska: 54.4%) > Residents under 65, direct-purchase insurance (or multiple types): 3.6% (Alaska: 6.9%) > Residents under 65, Tricare/military insurance (or many types): 0.8% (Alaska: 9.6%)
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New Hampshire: 03816
> Location: Center Tuftonboro, New Hampshire > Residents under 65, no health insurance: 26.5% (New Hampshire: 7.1%) > Residents under 65, Medicare coverage (or multiple types): 4.1% (New Hampshire: 3.2%) > Residents under 65, Medicaid coverage (or multiple types): 19.3% (New Hampshire: 14.6%) > Residents under 65, VA coverage (or multiple types): 0.4% (New Hampshire: 1.3%) > Residents under 65, employer-based insurance (or multiple types): 46.5% (New Hampshire: 69.8%) > Residents under 65, direct-purchase insurance (or multiple types): 13.1% (New Hampshire: 9.3%) > Residents under 65, Tricare/military insurance (or many types): 0.4% (New Hampshire: 1.5%)
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New Jersey: 07105
> Location: Newark, New Jersey > Residents under 65, no health insurance: 36.8% (New Jersey: 9.0%) > Residents under 65, Medicare coverage (or multiple types): 2.2% (New Jersey: 2.4%) > Residents under 65, Medicaid coverage (or multiple types): 27.4% (New Jersey: 17.7%) > Residents under 65, VA coverage (or multiple types): 0.1% (New Jersey: 0.4%) > Residents under 65, employer-based insurance (or multiple types): 31.3% (New Jersey: 66.5%) > Residents under 65, direct-purchase insurance (or multiple types): 6.0% (New Jersey: 8.9%) > Residents under 65, Tricare/military insurance (or many types): 0.2% (New Jersey: 0.7%)
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New Mexico: 87001
> Location: San Felipe Pueblo, New Mexico > Residents under 65, no health insurance: 46.7% (New Mexico: 11.4%) > Residents under 65, Medicare coverage (or multiple types): 3.9% (New Mexico: 3.6%) > Residents under 65, Medicaid coverage (or multiple types): 30.4% (New Mexico: 35.6%) > Residents under 65, VA coverage (or multiple types): 0.2% (New Mexico: 1.7%) > Residents under 65, employer-based insurance (or multiple types): 24.4% (New Mexico: 46.4%) > Residents under 65, direct-purchase insurance (or multiple types): 2.5% (New Mexico: 8.0%) > Residents under 65, Tricare/military insurance (or many types): 0.0% reported (New Mexico: 3.3%)
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New York: 14726
> Location: Conewango Valley, New York > Residents under 65, no health insurance: 57.9% (New York: 6.7%) > Residents under 65, Medicare coverage (or multiple types): 1.2% (New York: 2.8%) > Residents under 65, Medicaid coverage (or multiple types): 17.8% (New York: 26.9%) > Residents under 65, VA coverage (or multiple types): 0.9% (New York: 0.6%) > Residents under 65, employer-based insurance (or multiple types): 21.1% (New York: 59.7%) > Residents under 65, direct-purchase insurance (or multiple types): 6.2% (New York: 10.8%) > Residents under 65, Tricare/military insurance (or many types): 0.2% (New York: 0.7%)
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North Carolina: 28747
> Location: Lake Toxaway, North Carolina > Residents under 65, no health insurance: 45.8% (North Carolina: 12.6%) > Residents under 65, Medicare coverage (or multiple types): 2.5% (North Carolina: 3.5%) > Residents under 65, Medicaid coverage (or multiple types): 19.3% (North Carolina: 19.4%) > Residents under 65, VA coverage (or multiple types): 0.3% (North Carolina: 1.7%) > Residents under 65, employer-based insurance (or multiple types): 28.6% (North Carolina: 55.9%) > Residents under 65, direct-purchase insurance (or multiple types): 9.2% (North Carolina: 11.7%) > Residents under 65, Tricare/military insurance (or many types): 1.2% (North Carolina: 3.8%)
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North Dakota: 58329
> Location: Dunseith, North Dakota > Residents under 65, no health insurance: 35.1% (North Dakota: 8.5%) > Residents under 65, Medicare coverage (or multiple types): 2.4% (North Dakota: 2.1%) > Residents under 65, Medicaid coverage (or multiple types): 38.6% (North Dakota: 11.4%) > Residents under 65, VA coverage (or multiple types): 0.0% reported (North Dakota: 1.4%) > Residents under 65, employer-based insurance (or multiple types): 21.5% (North Dakota: 67.6%) > Residents under 65, direct-purchase insurance (or multiple types): 4.6% (North Dakota: 14.3%) > Residents under 65, Tricare/military insurance (or many types): 0.7% (North Dakota: 3.4%)
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Rhode Island: 02863
> Location: Central Falls, Rhode Island > Residents under 65, no health insurance: 18.2% (Rhode Island: 5.3%) > Residents under 65, Medicare coverage (or multiple types): 5.5% (Rhode Island: 3.4%) > Residents under 65, Medicaid coverage (or multiple types): 51.7% (Rhode Island: 23.2%) > Residents under 65, VA coverage (or multiple types): 0.4% (Rhode Island: 1.0%) > Residents under 65, employer-based insurance (or multiple types): 26.8% (Rhode Island: 64.1%) > Residents under 65, direct-purchase insurance (or multiple types): 5.2% (Rhode Island: 10.8%) > Residents under 65, Tricare/military insurance (or many types): 0.4% (Rhode Island: 1.4%)
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South Carolina: 29470
> Location: Ravenel, South Carolina > Residents under 65, no health insurance: 32.3% (South Carolina: 12.6%) > Residents under 65, Medicare coverage (or multiple types): 5.2% (South Carolina: 3.8%) > Residents under 65, Medicaid coverage (or multiple types): 21.3% (South Carolina: 20.7%) > Residents under 65, VA coverage (or multiple types): 0.5% (South Carolina: 1.8%) > Residents under 65, employer-based insurance (or multiple types): 41.0% (South Carolina: 56.5%) > Residents under 65, direct-purchase insurance (or multiple types): 8.5% (South Carolina: 10.4%) > Residents under 65, Tricare/military insurance (or many types): 1.6% (South Carolina: 3.7%)
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South Dakota: 57339
> Location: Fort Thompson, South Dakota > Residents under 65, no health insurance: 46.2% (South Dakota: 11.2%) > Residents under 65, Medicare coverage (or multiple types): 6.2% (South Dakota: 2.7%) > Residents under 65, Medicaid coverage (or multiple types): 39.4% (South Dakota: 15.3%) > Residents under 65, VA coverage (or multiple types): 1.2% (South Dakota: 1.9%) > Residents under 65, employer-based insurance (or multiple types): 9.4% (South Dakota: 61.1%) > Residents under 65, direct-purchase insurance (or multiple types): 1.5% (South Dakota: 13.7%) > Residents under 65, Tricare/military insurance (or many types): 0.7% (South Dakota: 3.4%)
Microsoft and partners may be compensated if you purchase something through recommended links in this article.
Tennessee: 37097
> Location: Lobelville, Tennessee > Residents under 65, no health insurance: 31.1% (Tennessee: 11.4%) > Residents under 65, Medicare coverage (or multiple types): 3.9% (Tennessee: 3.8%) > Residents under 65, Medicaid coverage (or multiple types): 33.7% (Tennessee: 21.6%) > Residents under 65, VA coverage (or multiple types): 0.3% (Tennessee: 1.6%) > Residents under 65, employer-based insurance (or multiple types): 31.3% (Tennessee: 57.8%) > Residents under 65, direct-purchase insurance (or multiple types): 5.4% (Tennessee: 10.1%) > Residents under 65, Tricare/military insurance (or many types): 0.4% (Tennessee: 2.7%)
Microsoft and partners may be compensated if you purchase something through recommended links in this article.
Washington: 99349
> Location: Mattawa, Washington > Residents under 65, no health insurance: 31.9% (Washington: 7.3%) > Residents under 65, Medicare coverage (or multiple types): 0.3% (Washington: 2.5%) > Residents under 65, Medicaid coverage (or multiple types): 44.1% (Washington: 22.0%) > Residents under 65, VA coverage (or multiple types): 0.1% (Washington: 1.6%) > Residents under 65, employer-based insurance (or multiple types): 20.9% (Washington: 62.3%) > Residents under 65, direct-purchase insurance (or multiple types): 3.4% (Washington: 9.7%) > Residents under 65, Tricare/military insurance (or many types): 0.5% (Washington: 3.6%)
Microsoft and partners may be compensated if you purchase something through recommended links in this article.
West Virginia: 25159
> Location: Poca, West Virginia > Residents under 65, no health insurance: 19.0% (West Virginia: 7.4%) > Residents under 65, Medicare coverage (or multiple types): 3.4% (West Virginia: 5.4%) > Residents under 65, Medicaid coverage (or multiple types): 28.5% (West Virginia: 30.3%) > Residents under 65, VA coverage (or multiple types): 1.7% (West Virginia: 1.8%) > Residents under 65, employer-based insurance (or multiple types): 50.0% (West Virginia: 57.1%) > Residents under 65, direct-purchase insurance (or multiple types): 2.3% (West Virginia: 6.4%) > Residents under 65, Tricare/military insurance (or many types): 1.3% (West Virginia: 1.6%)
