Health Insurance

The Most and Least Insured Cities: Roughly One in Three People Have No Health Insurance in This City

The Most and Least Insured Cities: Roughly One in Three People Have No Health Insurance in This City

Nationwide, an estimated 28.5 million people were without insurance for the entire 2017 calendar year. Without insurance, these Americans could be without access to health care or crippled with debt as the result of seeking lifesaving treatment. ValuePenguin analyzed the rate of health insurance participation across the country to find where the most people are without insurance.
Doctors in the waiting room with patients
Doctors in the waiting room with patients Source: Getty Images

Cities with the highest concentration of uninsured populations

Of the cities that ranked in the top 30 for the lowest rate of health insurance, more than half were located in Texas. This is both a function of the abundance of cities that fit the criteria for municipalities included in our study that are located in the state and Texas' high statewide rate of residents without health insurance. Furthermore, there were only two cities with populations of at least 65,000 residents where uninsured rates were over 30% — both located in Texas.


% of population without health insurance
1Mission, Texas32.3%
2Brownsville, Texas30.1%
3Laredo, Texas29.1%
4McAllen, Texas27.1%
5Pasadena, Texas26.5%
6Passaic, New Jersey25.9%
7Pharr, Texas25.8%
8Dallas, Texas24.0%
9Homestead, Florida23.1%
10Houston, Texas22.8%
11Miami Gardens, Florida22.7%
12Union City, New Jersey22.4%
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Why are so many people uninsured in some cities?

There are a number of reasons that some areas have higher concentrations of people without health insurance coverage. Often the economy of the city, including what kind of industries exist and the rate of unemployment, have an impact on the percentage of the population without health insurance coverage. Certain industries, such as those related to providing health care services, have very high rates of health insurance. There are also certain professions, which include many manual labor occupations, where a large percentage of the workforce don't carry health insurance.

Another factor that can influence unemployment rates is whether or not a given state has chosen to expand Medicaid as part of the Affordable Care Act (ACA). Across the 14 states that have not adopted expanded Medicaid availability for adults, the average unemployment rate was 11.1% in 2017 — which is 27% higher than the national average.

Cities with the highest concentration of insured populations

Many of the cities with the highest rates of residents with health insurance coverage are located in California. Half of the cities that ranked in the top 30 for the percentage of residents with this insurance coverage included in our study are located in California. Additionally, many of these cities — including the top-ranked municipality, Union City — are located in the greater San Francisco Bay area.

% of population with health insurance
1Union City, California99.1%
2Bethesda, Maryland99.0%
3Newton, Massachusetts98.9%
4Fremont, California98.8%
T - 5Yorba Linda, California98.6%
T - 5Ann Arbor, Michigan98.6%
7Milpitas, California98.5%
8Chino Hills, California98.4%
T - 9Folsom, California98.3%
T - 9Livermore, California98.3%
T - 9Santa Clara, California98.3%
T - 9Walnut Creek, California98.3%
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Doctors have the highest rate of health insurance coverage while construction workers have the lowest rate

Topping the list of professions with low populations of uninsured professionals are physicians and surgeons. According to our study, there are only 13,443 people in these professions without health insurance compared to 1,017,472 with coverage. On the other end of the spectrum, construction laborers — who are likely to not have the option of purchasing health insurance through their employer — are the professions with the lowest instance of health insurance in the country. According to our study, there are over 800,000 people in this profession who don't have health insurance.

Chart comparing the professions with the highest and lowest rates of health insurance.
Chart comparing the professions with the highest and lowest rates of health insurance.

Health insurance coverage by age: Young people are the least insured segment of the populace

We found that the percentage of people with health insurance increases as you look at older age bands. Young adults who can no longer be on their parents' health insurance policy are the least likely age segment to have health insurance coverage. This population is 15% less likely to have health coverage than those who are automatically eligible for Medicare (age 65+).

A chart comparing the percentage of people in the U.S. with health insurance coverage by age group.
A chart comparing the percentage of people in the U.S. with health insurance coverage by age group.


Data on the percentage of people with health insurance by city, age and occupation comes from the U.S. Census Bureau's 2017 American Community Survey. Only cities with at least 65,000 residents were included in our city rankings. People who did not have health insurance at any point during the 2017 calendar year were considered to be uninsured in our study.