States with the Most Uninsured Adults

About 1 in 6 adults in Texas (15.58%) report having no health coverage of any kind — the highest uninsured rate in the country, and more than six times the 2.57% in Hawaii, which ranks last. That gap is one of the widest in any of our maps: the spread between #1 and #50 here is far larger than what we see on health-behavior rankings like obesity (West Virginia 41.4% to Colorado 25.0%) or depression. When the top state is six times the bottom, you're not looking at small regional drift — you're looking at two genuinely different systems.

The states at the top cluster in the South and Mountain West: Texas leads, followed by Nevada (13.99%), Georgia (12.34%), Wyoming (11.31%), and Oklahoma (10.93%). That grouping tracks closely with a single policy fact this metric tends to surface — these are largely states that have not expanded Medicaid eligibility, which leaves more low-income working-age adults without a coverage pathway. We can't read any individual's circumstances out of a survey, but the geography is hard to miss: the highest uninsured rates concentrate where the public-coverage safety net is narrowest.

It's worth being precise about what this measures. The figure is self-reported coverage status from a phone survey, so it captures whether a respondent says they currently have insurance — not the quality of that coverage, how long they've gone without it, or why. Two people counted as "uninsured" here might be in very different situations: one between jobs for a month, another with no realistic path to a plan at all. So a high rank signals a coverage *gap*, but the map doesn't tell you the depth or duration of that gap. Read it as a snapshot, not a full account.

The contrast at the bottom is just as telling. Massachusetts (3.31%) and Hawaii (2.57%) anchor the low end, both states with long-standing coverage mandates or near-universal arrangements — and both reach near-total coverage despite very different costs of living (Hawaii also tops our electric-bill map at $212/month). High prices and high coverage clearly aren't mutually exclusive; coverage rates here track policy design far more than they track wealth or geography. Interestingly, Texas — #1 for uninsured adults — sits at the *bottom* of our arthritis map (#50, 21.2%), a reminder that a state can rank high on one health measure and low on another.

A note on method: every state here comes from the same CDC survey (BRFSS), one year (2024), one definition of uninsured, so the 50-state comparison is apples-to-apples. Because this is a self-reported survey rather than an enrollment count, treat the percentages as close estimates rather than exact tallies, and read the ranks — not hundredths of a point — as the real signal. The numbers are CDC's; the ranking and analysis are ours.