Insurance Coverage & Uninsured Rates

Pulse Atlas tracks the uninsured rate for every U.S. county using Census SAHIE 2023 (Small Area Health Insurance Estimates), the official federal source for sub-state coverage data. The 100 counties below have the country's highest uninsured rates — concentrated in non-Medicaid-expansion states, the rural South, and border regions with large undocumented populations.

Top 100 counties by uninsured rate

  1. Gaines County, TX — 33.5%
  2. Holmes County, OH — 31.5%
  3. LaGrange County, IN — 31.3%
  4. Presidio County, TX — 29.6%
  5. Kenedy County, TX — 29.2%
  6. Hansford County, TX — 29.1%
  7. Edwards County, TX — 28.8%
  8. Webb County, TX — 28.7%
  9. Hidalgo County, TX — 27.5%
  10. Cochran County, TX — 27.3%
  11. Ochiltree County, TX — 27.1%
  12. Dallam County, TX — 26.8%
  13. Sherman County, TX — 26.7%
  14. Parmer County, TX — 26.6%
  15. Bailey County, TX — 26.3%
  16. Zapata County, TX — 26.1%
  17. Cameron County, TX — 26.0%
  18. Moore County, TX — 25.8%
  19. Hudspeth County, TX — 25.7%
  20. San Saba County, TX — 25.6%
  21. Hall County, TX — 25.3%
  22. Wheeler County, TX — 25.3%
  23. Starr County, TX — 25.1%
  24. Yoakum County, TX — 25.0%
  25. Crockett County, TX — 24.5%
  26. Terry County, TX — 24.5%
  27. Aleutians East Borough, AK — 24.4%
  28. Gonzales County, TX — 24.1%
  29. Knox County, TX — 24.0%
  30. Titus County, TX — 23.9%
  31. Dawson County, TX — 23.8%
  32. Hale County, TX — 23.8%
  33. Liberty County, TX — 23.8%
  34. Maverick County, TX — 23.7%
  35. Menard County, TX — 23.7%
  36. Potter County, TX — 23.7%
  37. King County, TX — 23.6%
  38. Glades County, FL — 23.5%
  39. Deaf Smith County, TX — 23.5%
  40. La Salle County, TX — 23.5%
  41. El Paso County, TX — 23.4%
  42. Atkinson County, GA — 23.3%
  43. Comanche County, TX — 23.3%
  44. Dallas County, TX — 23.3%
  45. Lamb County, TX — 23.3%
  46. Swisher County, TX — 23.2%
  47. Uvalde County, TX — 23.0%
  48. DeSoto County, FL — 22.9%
  49. Castro County, TX — 22.9%
  50. Floyd County, TX — 22.9%
  51. Navarro County, TX — 22.9%
  52. Hendry County, FL — 22.7%
  53. Collingsworth County, TX — 22.7%
  54. Ector County, TX — 22.6%
  55. Jack County, TX — 22.6%
  56. Caldwell County, TX — 22.5%
  57. Madison County, TX — 22.5%
  58. Harris County, TX — 22.2%
  59. Haskell County, TX — 22.0%
  60. Lipscomb County, TX — 22.0%
  61. Gray County, TX — 21.9%
  62. Hamilton County, TX — 21.9%
  63. Shelby County, TX — 21.9%
  64. Yakutat City and Borough, AK — 21.8%
  65. Clark County, ID — 21.8%
  66. Texas County, OK — 21.8%
  67. Sutton County, TX — 21.8%
  68. McCulloch County, TX — 21.6%
  69. Willacy County, TX — 21.6%
  70. Andrews County, TX — 21.5%
  71. Colorado County, TX — 21.5%
  72. Gillespie County, TX — 21.5%
  73. Jefferson County, TX — 21.5%
  74. Palo Pinto County, TX — 21.5%
  75. Cherokee County, TX — 21.4%
  76. Erath County, TX — 21.3%
  77. Hopkins County, TX — 21.3%
  78. Leon County, TX — 21.3%
  79. Mason County, TX — 21.3%
  80. Pecos County, TX — 21.3%
  81. Reeves County, TX — 21.3%
  82. Van Zandt County, TX — 21.3%
  83. Bastrop County, TX — 21.2%
  84. Frio County, TX — 21.2%
  85. Matagorda County, TX — 21.0%
  86. Red River County, TX — 21.0%
  87. Freestone County, TX — 20.9%
  88. Live Oak County, TX — 20.9%
  89. Nacogdoches County, TX — 20.9%
  90. Wharton County, TX — 20.9%
  91. Camp County, TX — 20.8%
  92. Donley County, TX — 20.8%
  93. Lee County, TX — 20.8%
  94. Schleicher County, TX — 20.8%
  95. Briscoe County, TX — 20.7%
  96. Kerr County, TX — 20.7%
  97. Young County, TX — 20.7%
  98. Burnet County, TX — 20.6%
  99. Wood County, TX — 20.6%
  100. Macon County, GA — 20.5%

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