20 American Cities With the Highest Uninsured Rates
Affan Mir
9 min read
In this article, we discuss the 20 American cities with the highest uninsured rates. To skip the details about the causes of rising uninsured rates and analysis of healthcare in the US, go directly to 5 American Cities With the Highest Uninsured Rates.
The US is one of the most medically advanced countries in the world. Yet the country is notorious for high healthcare costs. While a major chunk of population in the US remain uninsured for healthcare, the trend is changing and more and more people are coming in the health insurance net.
In September 2022, The US Census Bureau released latest US health insurance data. According to the report, the number of uninsured people for healthcare dropped to 8.3% in 2021 from 8.6% in 2020, which means that between this period the number of insured population increased by approximately 900,000. In 2021, 66% of the insured population had private health insurance plans. The most common private healthcare coverage was employment based at 54.3%, followed by 10.3% of people opting for direct purchase.
Among children under 19 years of age, the uninsured population dropped down from 5.6% in 2021 to 5.0%. The uninsured rate for children and people over 65 is less than the rate for people between 19 and 64 because parents’ health plans mostly cover children and they are also eligible for the Children’s Health Insurance Program (CHIP) and older people can get insured through Medicare. The highest number of uninsured people fell in the age bracket of 19-64 where the uninsured rates were 11.9% in 2020 and 11.6% in 2021.
Uninsured Rates by Race
According to the Census Bureau report, there was also a noteworthy change in the uninsured rates for healthcare among different races of people. This discrepancy is also due to the fact that a lot of immigrants face eligibility restrictions in the public sector. On top of that, it is estimated that over 11 million unauthorized immigrant population is living in the United States which is ineligible for public health care and barred from purchasing health insurance coverage from the marketplace.
Among children under 19 years of age, the percentage of uninsured people among the white population dropped from 3.8% to 3.4% between 2020 and 2021, and among the black population, the uninsured rates dropped from 5.9% to 4.3%. The Hispanic population had the most uninsured rates at 9.5% in 2020, which dropped to 8.6%. On the other hand, around 2.6% of the children under 19 in the Asian population were uninsured in 2020 and it increased to 4.6% in 2021.
Between the age bracket of 19 and 64, the highest number of uninsured population was among the Hispanic people which was 25.1% in 2021, up from 24.9% in 2020. One reason for such a high number of uninsured people among the Hispanic people could be that over 48% of the population is non-citizens of the United States and non-citizens make up the highest number of uninsured population in the country. The uninsured rates among the Black population dropped from 14.2% to 12.7% during the period, while the rates among the Asian population remained the same at 7.7%.
Uninsured Rates by State
The insurance coverage percentage also varies from state to state. According to research by an independent research company KFF, Texas is the state with the highest uninsured rates in the United States with 20.5% of the people lacking health insurance coverage and most of the cities on our list are also in Texas. One of the reasons for this high uninsured rate in Texas is that 1.4 million out of 5 million uninsured people in the state were noncitizens including the undocumented population. Additionally, a lot of Texas-based employers do not offer health care benefits and it is believed that insurance rates in the state are quite unregulated.
The high uninsured rates in Texas were followed by Oklahoma at 16.3% and Florida at 15.1%. Massachusetts had the lowest uninsured rates in the country at 2.9%.
In 2021, it was revealed that the number one reason for people not having insurance coverage was unaffordability followed by ineligibility for coverage. The lowest percentage was of those people who had recently lost a job.
The US government has been finding ways to make healthcare affordable to the public. However, some believe it has not been providing any incentives to healthcare companies to help them reduce healthcare costs, which is leading to healthcare costs rising year-over-year.
Some companies that are expected to benefit from the rising healthcare costs are UnitedHealth Group Incorporated (NYSE:UNH), Elevance Health, Inc. (NYSE:ELV), and Humana Inc. (NYSE:HUM).
American Cities With the Highest Uninsured Rates
Our Methodology
For this article, we collected the latest data (2021) from the US Census Bureau and listed the cities in ascending order of their uninsured rate percentage (for health insurance) of each city’s civilian noninstitutionalized population (the population that is 16 and over and is not serving in the armed forces or are not incarcerated by any prison system). To stay true to the data, we only chose cities in our list and did not use the data for metropolitan areas or census-designated places. The data provided does not include the population that lost their health insurance coverage during the calendar year, which means that if an individual was insured at any point in the year, that individual was considered a part of the insured population.
American Cities With the Highest Uninsured Rates For Healthcare
20. Arlington, Texas
Uninsured Population: 20.2%
Arlington, Texas is number 20 on our list of American cities with the highest uninsured rates as the US Census Bureau estimates that 79.8% of the city’s civilian noninstitutionalized population has insurance coverage. The Census Bureau provided a margin of error of 1.9% in the data.
19. Beaumont, Texas
Uninsured Population: 20.5%
Over 1.12 million people lived in Beaumont, Texas in 2021, and Census Bureau’s data reveals that 20.5% of the city’s population remained uninsured in the year. The Bureau kept a margin of error of 2.9% among the 79.5% insured population.
18. Springdale, Arkansas
Uninsured Population: 20.6%
Springdale’s total civilian noninstitutionalized population without health insurance coverage is 20.6%. Among the city’s population, 4.8% of the people under 19 years of age remain uninsured.
17. Elizabeth, New Jersey
Uninsured Population: 20.7%
Elizabeth is located in Union County. It is estimated that 79.3% of city’s civilian noninstitutionalized population has health insurance coverage with a margin of error of 2.7%.
16. Edinburg, Texas
Uninsured Population: 21.7%
Edinburg had a population of nearly 102,500 in 2021 and around 78.3% of its population had health coverage. The Census Bureau’s data provides a 4.4% margin of error in the data. The high uninsured rate in Edinburg could also be owed to the fact that McAllen-Edinburg-Mission is a part of one of the poorest metropolitan areas in the United States according to our 2019 data. The per capita income was recorded at $9,899 at the time.
15. Passaic, New Jersey
Uninsured Population: 21.7%
Passaic is a city in Passaic County in New Jersey. The US Census Bureau estimates that 21.7% of the city’s civilian noninstitutionalized population was uninsured at the time of its survey.
14. Harlingen, Texas
Uninsured Population: 22.6%
According to the Census Bureau’s estimates, around 77.4% of the city’s civilian noninstitutionalized population has health insurance coverage and the margin of error provided by the bureau was 4.1%.
13. Tyler, Texas
Uninsured Population: 22.7%
The city of Tyler was named after the 10th President of the United States, John Tyler, and is considered a center for rose cultivation. The Census Bureau’s data reveals that 22.7% of the city’s civilian noninstitutionalized population remained uninsured in 2021. The margin of error in the data is approximately 3.1%, which means it could either be tied up or have a lower uninsured rate than Harlingen.
12. Garland, Texas
Uninsured Population: 23.1%
Garland is in Dallas County, and part of it is located in Collin and Rockwall Counties. The Census Bureau estimates that 76.9% of the population is uninsured and the data has a margin of error of 2.4%.
11. Mesquite, Texas
Uninsured Population: 23.3%
Mesquite is the 21st most populous city of Texas and around 23.3% of its civilian noninstitutionalized population remained uninsured in 2021.
10. Dallas, Texas
Uninsured Population: 23.5%
Dallas has the third-largest population in the state of Texas. In its 1.3 million population, around 76.5% of the noninstitutionalized civilian population has health insurance coverage with a margin of error of 1.1%.
9. Irving, Texas
Uninsured Population: 23.6%
Irving is located in Dallas County and is one of the most diverse cities in the US. It is home to one of the biggest healthcare companies, McKesson Corporation (NYSE:MCK). The Census Bureau estimates that around 23.6% of the total noninstitutionalized civilian population does not have health insurance coverage.
8. McAllen, Texas
Uninsured Population: 23.9%
Named after a Scottish settler, McAllen is known as the City of Palms. It is Hidalgo County’s largest city. According to the Census Bureau Data, 76.1% of McAllen’s civilian noninstitutionalized population has health coverage with a 3.8% margin of error.
7. Houston, Texas
Uninsured Population: 24.5%
Houston is the largest and most populous city in Texas and one of the top 5 most populous cities in the United States. The uninsured rate of the city’s civilian noninstitutionalized population was 24.5% in 2021 according to the Census Bureau’s data. Corebridge Financial, Inc. (NYSE:CRBG) is also headquartered in Houston which provides health insurance through its subsidiary, Laya Healthcare.
6. Baytown, Texas
Uninsured Population: 26.4%
Located in Harris and Chambers counties, Baytown is home to over 82,000 people. It is the US city with the 6th highest uninsured rate with 26.4% of the civilian noninstitutionalized population without health insurance coverage.
