States With the Lowest Rates of Uninsured Residents

Rates of uninsured individuals vary dramatically across the country, and while some states made huge gains in covered individuals, others have lagged behind. In the first half of 2015, the country’s overall uninsured rate fell to 11.7%, while before the implementation of the Affordable Care Act (ACA) the rate was 17.3% in 2013, according to Gallup.

WalletHub analyzed the uninsured rates in each state, plus the District of Columbia, after the implementation of the ACA and even looked at categories such as race and income level. Overall, red states still have higher rates of uninsured residents compared with blue states, and red states tend to be the ones that did not expand Medicaid. The average uninsured rate for states that did not expand Medicaid is 12.74% compared with 9.35% for states that did expand the federal program under the ACA.

The states with the lowest rate of uninsured tended to be situation in the Northeast or the Midwest, with the South having the highest rates of uninsured.

WalletHub used absolute difference—the difference between the percentage of uninsured/insured in 2014 and 2010—and relative difference—the percentage of uninsured that was reduced to bring the uninsured rate to zero, which was calculated as such:

(Uninsured Rate in 2014 — Uninsured Rate in 2010) / (0 - Uninsured Rate in 2010)

The data used to create the rankings were obtained from the US Census Bureau.

Here are the states that had the lowest uninsured rates in 2014.

5. Minnesota

Uninsured rate in 2014: 5.88%

The absolute difference in the uninsured rate from 2010 to 2014 is -3.19%, which is slightly better than average for the country as a whole (-3.8%). The state did better than average when it came to reducing the children’s uninsured rate, which was just 3.83% in 2014 and ranked 13 in the country.

Where Minnesota didn’t do so well was the difference in the uninsured rates between Hispanics and whites, which was 20.78%, and ranked 40 in the country. The difference in uninsured rates between blacks and whites was 5.85% and ranked 32 in the country.

Minnesota had the eleventh smallest difference between the uninsured rates for low-income households (9.93%) and high-income households (2.31%).

From 2010 to 2014, the rate of people insured with private health insurance was mostly flat (-0.04%), while the rate of insured with public health insurance increased 3.23%. The percent of residents with employer-based health insurance was mostly unchanged, but up slightly (0.21%), from 2010 to 2014.

4. District of Columbia

Uninsured rate in 2014: 5.28%

The District of Columbia already had a low uninsured rate, and the absolute difference between 2014 and 2010 was just 12.32%, which ranks 38. The nation’s capital had the largest increase in its rate for employer-based health insurance, which went up 4.47% from 48.80% in 2010 to 53.27% in 2014. The rate of people with private insurance only went up 0.06% and the rate of people with public health insurance went up 2.26%.

The District of Columbia had one of the smallest differences in uninsured rate based on income, but did not perform very well when it came to the difference between whites and minorities. The district ranked 29 in the country because the difference in uninsured rate between Hispanics and whites was 14.40%, but ranked better (13) for the 3.09% difference in uninsured rate between blacks and whites.

The nation’s capital also had one of the second-lowest uninsured rates in the country for low-income households (6.28%) and the second-smallest difference in the uninsured rates between low-income and high-income households (3.50%).

The District of Columbia had the second-lowest uninsured rate for children (2.08%), although it hadn’t change much from 2010 to 2014 (-0.21%).

3. Hawaii

Uninsured rate in 2014: 5.27%

The uninsured rate for Hawaii’s adult population (5.9%) is the third-lowest in the country, while its uninsured rate for children (3.10%) is ranked fifth in the country. Where Hawaii really shines is when it comes to racial/ethnic disparities.

Hawaii ranked first in the country for the smallest difference in uninsured rates between Hispanics and whites (0.09%) and second in the country for the difference in the uninsured rates between blacks and whites (-3.94%).

Like the District of Columbia, Hawaii had one of the best uninsured rates for low-income households (8.11%, ranked 4) and one of the smallest differences in the rate for low-income and high-income households (4.62%, ranked 4).

Hawaii had one of the biggest increases in the rate of employer-based health insurance, ranking second behind the District of Columbia with a difference of 4.29%. In 2014, the employer-based health insurance rate was 57.69%, up from 53.40%.

2. Vermont

Uninsured rate in 2014: 4.95%

With less than 5%, Vermont has the second-best uninsured rate in the country, and it maintains that rank for adults (5.63%), although it slips to third for children’s uninsured rate (2.17%).

Vermont also has one of the smallest ethnic and racial health disparities gaps with the second-smallest difference in uninsured rates between Hispanics and whites (1.18%) and the third-smallest difference between blacks and whites (0.32%).

The state also performed well when it came to economic differences and had the third-lowest uninsured rate for low-income households (6.8%) and the third-smallest difference in the uninsured rate between low-income and high-income households (3.98%).

Where Vermont didn’t do as well was with employer-based health insurance. The difference between the employer-based health insurance in 2010 and 2014 was almost flat (0.60%) and it actually slipped in the rankings from 25 in 2010 (54.01%) to 27 (54.61%).

1. Massachusetts

Uninsured rate in 2014: 3.28%

Thanks to Romneycare, Massachusetts already had a low uninsured rate. As such, the absolute difference in the uninsured rate from 2010 to 2014 is only -1.13%, which is the second lowest in the entire country. The only state that did worse was Maine, which actually had a positive absolute difference (0.01%).

The state ranked first in the country for its low rate of uninsured children (1.54%) and its low rate for the adult population (3.74%). The difference in the uninsured rates between Hispanics and whites (3.91%) ranked better (4) than the difference between blacks and whites (3.67%, ranked 19).

However, Massachusetts performed better when it came to income. The state had the lowest uninsured rate for low-income households (5.12%) and it was the only state to have an uninsured rate for high-income households that was below 2% (1.78%). Massachusetts also had the smallest difference in uninsured rate between low-income and high-income households (3.35%).