More Than a Third of People in This US City Have No Health Insurance

Updated: September 12, 2024 by 24/7 Tempo Staff

One of the most important aspects of a person’s life is health insurance, in particular, making sure you have accurate insurance to protect your health – and your wallet – should the need arise. Not only do many people have subpar coverage, but some have none at all. In the United States, health insurance is a vital part of employment, offering both individual and family plans for those working at a particular company.

Per the Affordable Care Act (ACA), businesses with 50 or more full-time employees must provide insurance to the majority (95%) of their employees or risk penalties. Many Americans actively search for work that will afford them the ability to enroll their families in a medical plan. In fact, according to a Gallup poll, one in six Americans remained in a job they didn’t like for fear of losing their health coverage.

The United States is consistently the most expensive nation worldwide for medical expenses. According to the World Economic Forum, in 2021 the average cost per person for medical expenses was $12,318; compared to Germany, which came in at $7,383 per person. The U.S. is not only 40% higher but quite often lags behind other nations in health coverage and life expectancy.

While the nation as a whole is lacking, some cities stand out for their high rates of uninsured and underinsured residents. An analysis of government data reveals the metropolitan areas where health coverage lags furthest behind state and national levels. The causes for lack of health insurance are complex, among them job instability, immigration status, and insurance costs. But the consequences are clear — limited preventive care, untreated chronic illness, and people declaring bankruptcy over medical bills.

To determine the city in every state with the worst health insurance coverage, 24/7 Tempo reviewed data on the health insurance coverage for the noninstitutionalized civilian population from the U.S. Census Bureau’s 2022 American Community Survey. The results depict a patchwork of underserved communities. (Health insurance is always important but even more so for costs due to potential injury, as could have been the case of two fishermen whose boat was capsized by a humpback whale.)

Rates of employer-provided plans also lag in many locales, leaving many to rely on Medicaid instead. For example, in San Luis, Arizona, just over 25% of those under 65 have workplace policies, while 42% are on Medicaid. Gaps emerge even in states known for robust health care like Massachusetts, where the city of Everett sees higher uninsurance and Medicaid usage than state averages. (See the health conditions with soaring medical costs in the U.S.)

Methodology

To determine the city in every state with the worst health insurance coverage, 24/7 Tempo reviewed data on the health insurance coverage for the noninstitutionalized civilian population from the U.S. Census Bureau’s 2022 American Community Survey. Cities, towns, villages, and Census-designated places were ranked based on the percentage of the population 65 and under that does not have health insurance.

We looked at the population under 65 as this age demographic in America is automatically entitled to Medicare benefits. While the vast majority of those qualified for Medicare are 65 or older, people under 65 are entitled to Medicare if they have certain disabilities or are afflicted with permanent kidney failure or amyotrophic lateral sclerosis (ALS, or Lou Gehrig’s disease). Only cities with at least 25,000 residents were considered.

It should be noted that Burlington is the only city in Vermont that meets the population requirements and therefore is the city that is the least insured in the state by default, despite having a population that is relatively highly insured.

Here is the city in every state with the worst health insurance coverage.