U.S. Counties With the Highest Uninsured Rates: Top 100 (2024 ACS 5-Year)
County Health Insurance Gaps in the 2024 ACS
Oglala Lakota County, South Dakota has the highest uninsured rate in this Top 100 at 44.6%, followed by LaGrange County, Indiana at 44.4% and Buffalo County, South Dakota at 43.0%.
The ranking uses one official metric for every row: U.S. Census Bureau 2024 American Community Survey 5-Year Subject Table S2701, variable S2701_C05_001E, the published percent uninsured among the civilian noninstitutionalized population. Higher rates rank higher. The 2020-2024 ACS 5-Year release became public on January 29, 2026, so this is a 2026 page using 2024 ACS data rather than a 2026 estimate.
Coverage: Top 100 of 3,144 U.S. counties and county equivalents with ACS 5-Year data. Unit: percent uninsured. Direction: descending. Status: 100 official_value rows; no calculated values, forecasts or modeled projections.
Oglala Lakota County, South Dakota ranks first in ACS 2024 5-Year S2701.
Baylor County, Texas is the displayed No. 100; other counties also publish 20.6%, so the alphabetical tie-break matters.
Counties and county equivalents are compared using the same all-age ACS S2701 universe.
All 100 values are published official_value estimates from one Census table; no county rate is modeled by StatRanker.
What the county uninsured rate measures
S2701_C05_001E is the Census Bureau estimate of the percentage of the civilian noninstitutionalized population without health insurance. It is an all-age ACS measure. It is not interchangeable with the Census Bureau Small Area Health Insurance Estimates (SAHIE) under-65 measure released in August 2026.
This is a prevalence ranking, not a ranking by the number of uninsured residents. A small county can have a very high rate with relatively few uninsured people, while a large county with a lower rate can contain many more uninsured residents.
ACS 5-year estimates pool survey data across 2020-2024 and are subject to sampling error. Close ranks should therefore be interpreted with the published margins of error in mind. For a state-level comparison, see US States by Health Insurance Coverage, 2026.
Top 10 counties by uninsured rate
Four entries exceed 40% uninsured in the 2024 ACS 5-Year S2701 estimates: Oglala Lakota County, LaGrange County, Buffalo County and Holmes County. Texas first appears at rank 6 with Gaines County.
Top 10 U.S. counties and county equivalents by published ACS uninsured rate
| Rank | Entity | Uninsured rate | Source / method note |
|---|---|---|---|
| 1 | Oglala Lakota County, South Dakota | 44.6% | SD · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 2 | LaGrange County, Indiana | 44.4% | IN · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 3 | Buffalo County, South Dakota | 43.0% | SD · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 4 | Holmes County, Ohio | 41.5% | OH · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 5 | Scotland County, Missouri | 39.0% | MO · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 6 | Gaines County, Texas | 36.7% | TX · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 7 | Aleutians East Borough, Alaska | 35.6% | AK · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 8 | Presidio County, Texas | 33.6% | TX · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 9 | Lake and Peninsula Borough, Alaska | 32.2% | AK · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 10 | Hudspeth County, Texas | 31.4% | TX · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
Ranking uses the published one-decimal S2701 uninsured rate, descending. Where published rates are equal, entity name A-Z is the deterministic tie-break.
Chart: Top 20 county uninsured rates
The chart uses the same published rates as the ranking table. The leading values are unusually high: Oglala Lakota County is at 44.6%, LaGrange County at 44.4%, and Buffalo County at 43.0%. The 20th entry, San Saba County, is at 27.0%.
Methodology
The ranking uses U.S. Census Bureau ACS Subject Table S2701, "Selected Characteristics of Health Insurance Coverage in the United States." The ranking variable is S2701_C05_001E: Estimate, Percent Uninsured, Civilian noninstitutionalized population.
Metric and unit
Metric: published percent uninsured among the civilian noninstitutionalized population. Unit: percent. StatRanker does not recompute the county rate from separate numerator and denominator fields.
Direction and ties
Higher published rate ranks higher. Rows are sorted descending by the one-decimal S2701 value. Equal published rates are ordered A-Z by entity name for a deterministic display order.
Year and release
Data year: 2024 ACS 5-Year, pooling 2020-2024 responses. The public release date was January 29, 2026. The page does not create a synthetic 2026 uninsured rate.
Coverage and geography
The ACS comparison includes U.S. counties and county equivalents, including Alaska boroughs and census areas and Virginia independent cities. The displayed ranking contains exactly 100 rows.
Numeric source: U.S. Census Bureau ACS 2024 5-Year S2701. Census API metadata is used to verify the field definition, and Census release documentation is used for the release date. No secondary ranking supplies a replacement value and conflicting values are not averaged.
Cutoff rule: Baylor County, Jefferson County and Throckmorton County, Texas each publish 20.6% in the 2024 ACS 5-Year data. Alphabetical ordering within that tie places Baylor County at No. 100; Jefferson and Throckmorton fall immediately outside the displayed Top 100. The tie-break is a display rule, not evidence that their underlying uninsured rates differ statistically.
ACS values are sample estimates with margins of error. This ranking sorts point estimates only and does not test statistical significance. It does not measure provider availability, care quality, affordability, medical debt, insurance generosity or the absolute number of uninsured residents.
Main ranking: Top 100 U.S. counties with the highest uninsured rates
Use the controls to search counties and county equivalents, filter by state or status, change sort order, or switch between Top 10, Top 20 and the full Top 100.
Top 100 by ACS 2024 5-Year S2701 percent uninsured
| Rank | Entity | Uninsured rate | Source / method note |
|---|---|---|---|
| 1 | Oglala Lakota County, South Dakota | 44.6% | SD · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 2 | LaGrange County, Indiana | 44.4% | IN · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 3 | Buffalo County, South Dakota | 43.0% | SD · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 4 | Holmes County, Ohio | 41.5% | OH · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 5 | Scotland County, Missouri | 39.0% | MO · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 6 | Gaines County, Texas | 36.7% | TX · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 7 | Aleutians East Borough, Alaska | 35.6% | AK · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 8 | Presidio County, Texas | 33.6% | TX · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 9 | Lake and Peninsula Borough, Alaska | 32.2% | AK · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 10 | Hudspeth County, Texas | 31.4% | TX · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 11 | Jim Hogg County, Texas | 29.0% | TX · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 12 | Starr County, Texas | 28.9% | TX · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 13 | Bailey County, Texas | 28.6% | TX · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 14 | Hidalgo County, Texas | 28.2% | TX · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 15 | Bennett County, South Dakota | 27.7% | SD · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 16 | Zapata County, Texas | 27.6% | TX · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 17 | Jackson County, South Dakota | 27.4% | SD · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 18 | Webb County, Texas | 27.3% | TX · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 19 | Cochran County, Texas | 27.2% | TX · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 20 | San Saba County, Texas | 27.0% | TX · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 21 | Terry County, Texas | 26.9% | TX · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 22 | Sterling County, Texas | 26.4% | TX · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 23 | Liberty County, Texas | 26.2% | TX · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 24 | Atkinson County, Georgia | 26.1% | GA · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 25 | Ziebach County, South Dakota | 26.0% | SD · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 26 | Cameron County, Texas | 25.8% | TX · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 27 | Stanton County, Kansas | 25.8% | KS · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 28 | Ochiltree County, Texas | 25.6% | TX · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 29 | Knox County, Missouri | 25.5% | MO · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 30 | Hamilton County, Kansas | 25.4% | KS · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 31 | Roosevelt County, Montana | 25.2% | MT · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 32 | Davis County, Iowa | 25.1% | IA · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 33 | Glasscock County, Texas | 25.1% | TX · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 34 | Lamb County, Texas | 25.1% | TX · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 35 | Mellette County, South Dakota | 25.0% | SD · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 36 | Yakutat City and Borough, Alaska | 24.9% | AK · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 37 | Kenedy County, Texas | 24.8% | TX · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 38 | Macon County, Georgia | 24.7% | GA · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 39 | Yukon-Koyukuk Census Area, Alaska | 24.5% | AK · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 40 | Dallam County, Texas | 24.4% | TX · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 41 | Parmer County, Texas | 24.1% | TX · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 42 | Morgan County, Missouri | 24.0% | MO · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 43 | Willacy County, Texas | 23.9% | TX · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 44 | Swain County, North Carolina | 23.8% | NC · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 45 | Glacier County, Montana | 23.6% | MT · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 46 | Menard County, Texas | 23.6% | TX · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 47 | Wheeler County, Georgia | 23.6% | GA · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 48 | Maverick County, Texas | 23.4% | TX · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 49 | Floyd County, Texas | 23.3% | TX · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 50 | Swisher County, Texas | 23.3% | TX · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 51 | Golden Valley County, Montana | 22.9% | MT · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 52 | Glades County, Florida | 22.8% | FL · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 53 | Moore County, Texas | 22.8% | TX · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 54 | Schleicher County, Texas | 22.8% | TX · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 55 | Todd County, South Dakota | 22.8% | SD · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 56 | Stewart County, Georgia | 22.6% | GA · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 57 | Clark County, Wisconsin | 22.5% | WI · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 58 | Dawson County, Texas | 22.5% | TX · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 59 | Yoakum County, Texas | 22.5% | TX · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 60 | Andrews County, Texas | 22.4% | TX · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 61 | Coal County, Oklahoma | 22.4% | OK · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 62 | Castro County, Texas | 22.2% | TX · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 63 | Duval County, Texas | 22.2% | TX · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 64 | Collingsworth County, Texas | 22.1% | TX · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 65 | Ector County, Texas | 22.1% | TX · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 66 | Manassas Park city, Virginia | 22.1% | VA · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 67 | Rolette County, North Dakota | 22.1% | ND · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 68 | Clinch County, Georgia | 22.0% | GA · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 69 | Daviess County, Indiana | 21.9% | IN · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 70 | Jeff Davis County, Georgia | 21.9% | GA · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 71 | Owyhee County, Idaho | 21.9% | ID · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 72 | Bastrop County, Texas | 21.8% | TX · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 73 | Big Horn County, Montana | 21.7% | MT · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 74 | Hendry County, Florida | 21.7% | FL · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 75 | Kinney County, Texas | 21.7% | TX · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 76 | El Paso County, Texas | 21.6% | TX · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 77 | Dallas County, Texas | 21.5% | TX · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 78 | Platte County, Wyoming | 21.5% | WY · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 79 | Titus County, Texas | 21.5% | TX · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 80 | Webster County, Georgia | 21.5% | GA · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 81 | Brooks County, Texas | 21.4% | TX · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 82 | Caldwell County, Texas | 21.4% | TX · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 83 | Coleman County, Texas | 21.3% | TX · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 84 | Hansford County, Texas | 21.3% | TX · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 85 | Lyman County, South Dakota | 21.3% | SD · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 86 | Dewey County, South Dakota | 21.2% | SD · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 87 | Wheeler County, Texas | 21.2% | TX · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 88 | Echols County, Georgia | 21.1% | GA · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 89 | Sioux County, North Dakota | 21.1% | ND · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 90 | Deaf Smith County, Texas | 21.0% | TX · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 91 | Hale County, Texas | 21.0% | TX · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 92 | Harris County, Texas | 20.9% | TX · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 93 | Jim Wells County, Texas | 20.9% | TX · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 94 | Shelby County, Texas | 20.9% | TX · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 95 | Bristol Bay Borough, Alaska | 20.8% | AK · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 96 | Adams County, Indiana | 20.7% | IN · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 97 | Comanche County, Texas | 20.7% | TX · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 98 | Motley County, Texas | 20.7% | TX · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 99 | Telfair County, Georgia | 20.7% | GA · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
| 100 | Baylor County, Texas | 20.6% | TX · official_value · U.S. Census Bureau ACS 2024 5-Year S2701 · published percent uninsured · all-age civilian noninstitutionalized population. |
All 100 rows are official_value from U.S. Census Bureau ACS 2024 5-Year S2701. Baylor County is displayed at No. 100 at 20.6%; Jefferson County and Throckmorton County, Texas also publish 20.6% and fall just outside the displayed Top 100 under the disclosed A-Z tie-break.
Insights from the Top 100
Key Insight
The Top 100 is a high-rate group even at its lower edge: the cutoff is 20.6%, while the leader is 44.6%. The average of the 100 published rates is 24.9%, calculated directly from the table.
Notable Pattern
The median published rate inside this Top 100 is 23.1%. This means half of the listed county equivalents are at or above 23.1% and half are at or below 23.1% within this selected high-rate subset.
Regional / Source Concentration
Texas accounts for 53 of the 100 entries. South Dakota and Georgia each contribute 9, Alaska contributes 5, and 18 states are represented overall. All row values use the same official ACS S2701 metric.
Outlier
Oglala Lakota County and LaGrange County are nearly tied at 44.6% and 44.4%. Their rates are roughly double the 20.6% cutoff for the 100th displayed entry.
How to interpret the ranking
A high rank means a larger estimated share of the county's civilian noninstitutionalized population lacked health insurance in the 2020-2024 ACS 5-Year period. It does not mean the county has the largest number of uninsured residents or the lowest quality of health care.
Every row is an official Census estimate. The main interpretation risk is precision: small counties can have relatively wide margins of error, so neighboring ranks with similar point estimates should not be treated as exact performance differences.
Download the U.S. Counties With the Highest Uninsured Rates: Top 100 (2024 ACS 5-Year) dataset
U.S. Counties With the Highest Uninsured Rates: Top 100 (2024 ACS 5-Year)
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Download Excel + CSV Data PackFAQ
Which U.S. county has the highest uninsured rate in this ranking?
Oglala Lakota County, South Dakota ranks first at 44.6% in the 2024 ACS 5-Year S2701 estimate, followed by LaGrange County, Indiana at 44.4%.
Are these 2026 uninsured rates?
No. The page is current in 2026, but the values are 2024 ACS 5-Year estimates based on survey data collected across 2020-2024. The dataset was released on January 29, 2026.
Are the county values official?
Yes. Each displayed percentage is an official_value from Census Bureau ACS Subject Table S2701. StatRanker does not calculate or project the county uninsured percentages.
Is this the same metric as 2024 SAHIE county uninsured rates?
No. SAHIE 2024, released in August 2026, provides modeled single-year estimates for people under age 65. This ranking uses ACS 5-year survey estimates for the civilian noninstitutionalized population of all ages.
Why do Alaska boroughs, census areas and Virginia independent cities appear?
They are Census county equivalents and are included at the same geographic level as counties.
How are ties handled at the Top 100 cutoff?
Equal published one-decimal rates are ordered alphabetically by entity name. Baylor, Jefferson and Throckmorton counties in Texas each publish 20.6%; Baylor is the first alphabetically and therefore appears at No. 100.
Does a high uninsured rate mean poor health care quality?
No. Insurance status is not a direct measure of provider availability, quality of care, health outcomes, medical debt or insurance generosity.
Sources
U.S. Census Bureau — ACS 2024 5-Year S2701
Primary numeric source for all 100 county and county-equivalent uninsured rates in the ranking.
Census Data API — S2701 metadata
Official variable dictionary confirming that S2701_C05_001E is Percent Uninsured for the civilian noninstitutionalized population.
https://api.census.gov/data/2024/acs/acs5/subject/groups/S2701.html
U.S. Census Bureau — 2024 ACS release schedule
Official release documentation showing the 2024 ACS 5-Year data release date of January 29, 2026.
https://www.census.gov/programs-surveys/acs/news/data-releases/2024/release-schedule.html
U.S. Census Bureau — 2024 SAHIE release
Official comparison source documenting that SAHIE 2024 is a separate single-year under-65 county insurance product and should not be mixed with the all-age ACS S2701 ranking.
https://www.census.gov/newsroom/press-releases/2026/sahie-uninsured-rates.html
Download data archive
ZIP archive with CSV and HTML copies of the tables published on this page, plus external source links, a manifest and README. The archive does not add new estimates or recalculate ranking values.
