18 states with the highest rates of health insurance

More than 9 in 10 people in the U.S. — 91.1% of the population — had some type of health insurance coverage in 2018, according to a recent report by the U.S. Census Bureau. However, the rates and types of coverage can vary widely from state to state.

Following are the states with the smallest proportion of uninsured residents and therefore the biggest share of people covered by health insurance, whether by private plans (like employer-paid coverage and direct purchase plans) or public insurance programs (usually Medicaid and Medicare).`  

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States with the highest insurance
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States with the highest insurance

Ohio

Share of the population:

  • Without health insurance: 6.5%
  • With private insurance: 68.6%
  • With public insurance: 37.5%

Ohio’s share of residents without health insurance in 2018 was easily below the national average of 8.9%, but that wasn’t necessarily a reflection of affordability.

In fact, a November analysis by the nonprofit Commonwealth Fund found that Ohio had the nation’s sixth-highest average annual employee health insurance premium for individual coverage last year, at $1,632.

West Virginia

Share of the population:

  • Without health insurance: 6.4%
  • With private insurance: 62.8%
  • With public insurance: 47.1%

While only 6.4% of West Virginia’s population had no health insurance, those who bought coverage from a marketplace established under 2010’s Affordable Care Act (ACA) likely face relatively high premiums.

According to a Kaiser Family Foundation analysis of government data, a 40-year-old resident of West Virginia paid, on average, $596 in premiums for a silver-tier ACA health insurance plan in 2019, compared with a national average of $478.

Washington

Share of the population:

  • Without health insurance: 6.4%
  • With private insurance: 70.6%
  • With public insurance: 35.9%

U.S. News & World Report ranked the state of Washington No. 4 in the nation last year for how well it meets its citizens’ health care needs.

Among factors leading to that ranking, the publication ranked Washington particularly high, No. 3, in the category of health care quality.

Maryland

Share of the population:

  • Without health insurance: 6.0%
  • With private insurance: 74.0%
  • With public insurance: 33.3%

A study by the Urban Institute found that in Maryland, the lowest-cost premiums for ACA marketplace plans had gone down 9.9% for silver-tier plans and 12.3% for gold-tier plans between 2018 and 2019.

Delaware

Share of the population:

  • Without health insurance: 5.7%
  • With private insurance: 70.6%
  • With public insurance: 39.8%

More than two-thirds of Delaware residents had private health insurance in 2018. This includes coverage obtained through an employer or purchased directly from a federal or state marketplace established under the Affordable Care Act of 2010.

New Hampshire

Share of the population:

  • Without health insurance: 5.7%
  • With private insurance: 75.8%
  • With public insurance: 32.3%

New Hampshire found itself tied with Delaware in the Census Bureau data, with 5.7% of residents having no health insurance coverage in 2018.

However, an even greater share of New Hampshire residents than Delaware residents had private insurance plans while a smaller share relied on public health insurance programs.

Kentucky

Share of the population:

  • Without health insurance: 5.6%
  • With private insurance: 64.2%
  • With public insurance: 43.5%

Kentucky had one of the highest rates of residents, 43.5%, relying on some form of public insurance program. The most common type of public coverage among Kentucky residents was Medicaid.

Medicaid is a joint federal and state program that covers people with low incomes or disabilities and others who qualify for the program.

Pennsylvania

Share of the population:

  • Without health insurance: 5.5%
  • With private insurance: 72.4%
  • With public insurance: 37.4%

The share of Pennsylvania residents covered by Medicaid was roughly the same as the number covered by Medicare in 2018.

Medicare is the federal health insurance program generally for people age 65 and older.

Wisconsin

Share of the population:

  • Without health insurance: 5.5%
  • With private insurance: 74.8%
  • With public insurance: 33.0%

Wisconsin tied with Pennsylvania for the share of residents without health insurance in 2018.

Only 5.5% of the state’s population had no form of private or public health coverage.

Michigan

Share of the population:

  • Without health insurance: 5.4%
  • With private insurance: 71.1%
  • With public insurance: 39.1%

Wisconsin’s neighbor, Michigan, had an even smaller share of its population living without health coverage.

Just 5.4% of Michigan residents didn’t have any kind of public or private health insurance in 2018.

New York

Share of the population:

  • Without health insurance: 5.4%
  • With private insurance: 67.2%
  • With public insurance: 39.9%

New York tied with Michigan in the Census Bureau report, with each having 5.4% of residents without health coverage.

Among residents of New York state, Medicaid was the most common type of public health coverage.

Connecticut

Share of the population:

  • Without health insurance: 5.3%
  • With private insurance: 71.0%
  • With public insurance: 35.8%

New York’s neighbor Connecticut can boast even a smaller share of its residents who are uninsured.

Just 5.3% of the Constitution State’s population had no health coverage in 2018.

Iowa

Share of the population:

  • Without health insurance: 4.7%
  • With private insurance: 74.8%
  • With public insurance: 35.4%

Fewer than 5% of Iowa residents had no health coverage in 2018, according to the Census Bureau’s data.

Just 4.7% of the population didn’t have some form of public or private insurance. Of those served by public insurance programs, Medicaid coverage was roughly as common as Medicare among residents.

Minnesota

Share of the population:

  • Without health insurance: 4.4%
  • With private insurance: 76.1%
  • With public insurance: 33.2%

Just to the north of Iowa, more than three-quarters of Minnesota residents purchased health coverage from private insurers.

Rhode Island

Share of the population:

  • Without health insurance: 4.1%
  • With private insurance: 70%
  • With public insurance: 38.7%

More than two-thirds of Rhode Islanders had private health insurance coverage in 2018.

According to the Census Bureau data, only 4.1% of the population had no health insurance of any sort.

Hawaii

Share of the population:

  • Without health insurance: 4.1%
  • With private insurance: 76.3%
  • With public insurance: 35.2%

Hawaii topped the most recent U.S. News & World Report rankings of states for how well they meet citizens’ health care needs.

The Aloha State also had one of the largest shares among states on this list of residents with private health insurance, at 76.3%.

Vermont

Share of the population:

  • Without health insurance: 4.0%
  • With private insurance: 69.9%
  • With public insurance: 40.6%

Only 4% of Vermonters were going without health insurance of any kind in 2018.

Among the share being helped by public insurance programs, about the same number were enrolled in Medicaid as those with Medicare coverage.

Massachusetts

Share of the population:

  • Without health insurance: 2.8%
  • With private insurance: 74%
  • With public insurance: 36.6%

Just 2.8% of the population in Massachusetts had no health insurance in 2018. That state led the nation in passing a form of health care reform in 2006 under then-Gov. Mitt Romney, with the aim of providing insurance to nearly all of its residents.

The most recent U.S. News & World Report ranked the state in second place for how well residents’ health care needs are being met, just behind Hawaii.

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