States ranked by percentage of uninsured residents in 2020

The Commonwealth Fund released its "2022 Scorecard on State Health System Performance" on June 16 to examine how well each state's healthcare system performed during the COVID-19 pandemic. The analysis included health insurance coverage rates in each state in 2020.

Uninsured rates nationwide were mostly unchanged in 2020 because of the ACA and federal relief. States that did not expand Medicaid reported the highest uninsured rates. The national average was 12.4 percent.

Though federal data does show a decline in uninsured rates in early 2021, they may go back up in the following few years. The temporary "continuous eligibility" Medicaid requirement ends when the federal public health emergency does, leading to as many as 15.8 million people losing Medicaid coverage. Furthermore, the American Rescue Plan Act's premium tax credits for ACA plans will expire at the end of this year without a congressional extension. Without an extension, up to 3 million people could lose coverage.

States ranked by uninsured rates in 2020, which includes ties:

  1. Texas: 23.6 percent
  2. Oklahoma: 21.7 percent
  3. Georgia: 18.7 percent
  4. Florida: 18.3 percent
  5. Mississippi: 17.4 percent
  6. Wyoming: 16.4 percent
  7. Nevada: 16.1 percent
  8. North Carolina: 15.7 percent
  9. Alaska: 15.5 percent
    South Carolina: 15.5 percent
  1. Arizona: 15.4 percent
  2. Alabama: 15 percent
  3. Tennessee: 14.6 percent
  4. Missouri: 14.3 percent
  5. South Dakota: 14.2 percent
  6. Idaho: 13.7 percent
    New Mexico: 13.7 percent
  1. Kansas: 13.3 percent
  2. Arkansas: 12.7 percent
  3. Louisiana: 12 percent
  4. Montana: 11.8 percent
  5. Nebraska: 11.4 percent
  6. Colorado: 11.3 percent
  7. Maine: 10.8 percent
    Utah: 10.8 percent
  1. West Virginia: 10.6 percent
  2. New Jersey: 10.5 percent
  3. Illinois: 10.4 percent
  4. Virginia: 10.1 percent
  5. California: 10 percent
  6. Indiana: 9.9 percent
  7. Delaware: 9.5 percent
  8. Oregon: 9.4 percent
  9. Ohio: 9.3 percent
  10. Washington: 9.2 percent
  11. North Dakota: 9 percent
  12. New Hampshire: 8.9 percent
  13. Pennsylvania: 8.2 percent
  14. Kentucky: 8 percent
    Maryland: 8 percent
  1. Michigan: 7.8 percent
  2. Wisconsin: 7.6 percent
  3. New York: 7.4 percent
  4. Iowa: 7.2 percent
  5. Minnesota: 6.9 percent
  6. Vermont: 6.5 percent
  7. Connecticut: 6.4 percent
  8. Hawaii: 5.4 percent
  9. Rhode Island: 5 percent
  10. District of Columbia: 4.3 percent
  11. Massachusetts: 3.6 percent

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