The United States is the only industrialized country in the world without universal health care — and as a result, most Americans under age 65 receive employer-based health insurance coverage. Under this system, an estimated 28.9 million Americans under 65 were uninsured in 2019 — 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 under 65 in 2020 will likely be higher than the 10.8% rate in 2019 — a continuation of the three-year trend of declining insurance coverage that began in 2017. Still, there are parts of the country where nearly every American under 65 is insured, either through their employer, Medicaid, or directly-purchased coverage.
Using data from the U.S. Census Bureau, 24/7 Wall St. identified the metropolitan area in every state with the best health insurance coverage. Metro areas are ranked based on the share of residents under age 65 — the age of eligibility for Medicare — who are uninsured. It is important to note that Delaware, New Hampshire, Rhode Island, and Vermont each have only one metropolitan area, and as a result, these places rank as having the best health insurance coverage by default only.
Uninsured rates vary considerably across the country, and as a result, a metro area’s ranking on this list does not necessarily mean the uninsured rate is low relative to the nation as a whole. In eight states, mostly located in the South, the lowest uninsured rate among metro areas is higher than the national rate. Uninsured rates in the metropolitan areas on this list range from 3.2% to 14.2%.
Click here to see the metro with the best health insurance coverage.
Click here to see our detailed methodology.
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