Who is most at risk of being uninsured in the US in 2023?
In 2023, 21.1% of adults below 138% of the poverty line and 24.3% of unemployed workers lacked health insurance, per the 2023 ACS 1-year estimates (US Census Bureau). Working-age adults (19β64) averaged 11.3% uninsured, versus 6.0% for children. Gera tracks coverage gaps by state Γ demographic via the Gera Coverage Gap Score (GCGS).
Working-age (19β64) coverage gap β top 10 states by GCGS
US average: 11.3% (GCGS 100)
| State | Uninsured (19β64) | GCGS | vs US avg |
|---|---|---|---|
| Texas | 21.6% | 191 | +10.3 pp |
| Georgia | 16.5% | 146 | +5.2 pp |
| Oklahoma | 15.9% | 141 | +4.6 pp |
| Florida | 15.5% | 137 | +4.2 pp |
| Nevada | 15.5% | 137 | +4.2 pp |
| New Mexico | 14.9% | 132 | +3.6 pp |
| Alaska | 14.5% | 128 | +3.2 pp |
| Mississippi | 14.2% | 126 | +2.9 pp |
| Wyoming | 14.2% | 126 | +2.9 pp |
| Arizona | 13.8% | 122 | +2.5 pp |
Source: 2023 ACS 1-year estimates, B27001, US Census Bureau. Methodology β
Child (under-19) coverage gap β top 10 states by GCGS
US average: 6.0% (GCGS 100)
| State | Uninsured (under 19) | GCGS |
|---|---|---|
| Texas | 13.6% | 227 |
| Arizona | 9.3% | 155 |
| Wyoming | 9.0% | 150 |
| Alaska | 8.8% | 147 |
| Florida | 8.5% | 142 |
| Oklahoma | 8.5% | 142 |
| Idaho | 8.1% | 135 |
| Nevada | 8.0% | 133 |
| South Dakota | 8.0% | 133 |
| Georgia | 7.9% | 132 |
Below-138%-poverty coverage gap β top 10 states by GCGS
US average: 21.1% (GCGS 100). Below 138% poverty is the Medicaid eligibility threshold in expansion states.
| State | Uninsured (<138% poverty) | GCGS |
|---|---|---|
| Texas | 41.2% | 195 |
| Georgia | 32.4% | 154 |
| Wyoming | 29.4% | 139 |
| Florida | 27.5% | 130 |
| New Jersey | 27.5% | 130 |
| Tennessee | 27.3% | 129 |
| Kansas | 27.0% | 128 |
| South Carolina | 26.4% | 125 |
| Nevada | 26.0% | 123 |
| Oklahoma | 25.8% | 122 |
National uninsured rates by demographic band (2023)
| Demographic group | US uninsured rate |
|---|---|
| Children under 19 | 6.0% |
| Working-age adults 19β64 | 11.3% |
| Seniors 65 and older | 0.8% |
| Below 138% poverty (19β64) | 21.1% |
| 138β399% poverty (19β64) | 14.9% |
| 400%+ poverty (19β64) | 5.0% |
| Employed workers (19β64) | 10.0% |
| Unemployed workers (19β64) | 24.3% |
| Not in labor force (19β64) | 14.1% |
Coverage Gap Checker β by state and demographic
Select a state and demographic group to see its real ACS uninsured rate and Gera Coverage Gap Score
Select a state and demographic group to see its real 2023 ACS uninsured rate, how it compares to the national rate, and the Gera Coverage Gap Score for that demographic.
State deep-dives β all 50 states + DC
Every state has a dedicated page with all nine demographic band rates and GCGS values.
- Texas
- Georgia
- Oklahoma
- Florida
- Nevada
- New Mexico
- Alaska
- Mississippi
- Wyoming
- Arizona
- Tennessee
- South Carolina
- Arkansas
- Alabama
- Idaho
- Montana
- North Carolina
- Kansas
- Louisiana
- New Jersey
- Utah
- South Dakota
- Colorado
- Missouri
- Indiana
- Illinois
- Nebraska
- Delaware
- Kentucky
- Virginia
- Ohio
- Washington
- West Virginia
- Connecticut
- Maryland
- California
- Maine
- Pennsylvania
- Iowa
- Oregon
- North Dakota
- Wisconsin
- Michigan
- Minnesota
- New York
- New Hampshire
- Rhode Island
- Vermont
- District of Columbia
- Hawaii
- Massachusetts
Frequently asked questions
- What percentage of US adults below the poverty line are uninsured?
- In 2023, 21.1% of working-age adults (19β64) below 138% of the federal poverty level were uninsured, per 2023 ACS B27016 estimates. This is the Medicaid eligibility threshold in expansion states; higher rates persist in non-expansion states.
- Are employed workers in the US insured?
- Not all. 10.0% of employed workers aged 19β64 were uninsured in 2023 (2023 ACS B27011). This gap is largest in states with many low-wage, part-time, or gig-economy jobs that don't offer employer insurance.
- Why do children have a lower uninsured rate than adults?
- Children aged under 19 had a 6.0% uninsured rate in 2023 β lower than the 11.3% for working-age adults β primarily because Medicaid and CHIP cover most low-income children in all 50 states. Adults in non-expansion states can fall into a coverage gap.
- What is the Gera Coverage Gap Score (GCGS)?
- GCGS = round(state_rate Γ· national_rate Γ 100) for a specific demographic band. A GCGS of 100 means the state's uninsured rate for that demographic equals the US average. Above 100 = wider gap; below 100 = narrower gap. See the full methodology at https://geraclinic.com/us/insurance-demographics/methodology.
- Which state has the highest working-age uninsured rate?
- Texas had the highest working-age (19β64) uninsured rate in 2023 at 21.6%, giving a GCGS of 191 (far above national average vs the US average of 11.3%). Source: 2023 ACS B27001.
Uninsured? See a clinician online with no insurance required.
24.3% of unemployed US workers were uninsured in 2023. GeraClinic offers online consultations with no insurance needed β see a doctor from your phone or computer.
Contains public sector information published by US Census Bureau and licensed under the Public domain (US federal government work, 17 U.S.C. Β§105). Source: US Census Bureau β 2023 American Community Survey 1-Year Estimates (Tables B27001, B27011, B27016) (2023, published September 2024).
Informational/educational only β not a substitute for professional medical advice; a clinician interprets results.