# The Uninsured by State and Congressional District

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URL: https://www.frixlaw.com/law-library/documents/crs%3AR41621

## Record

- **Collection:** Congressional research report
- **Document type:** CRS Report
- **Published:** January 24, 2011
- **Citation:** R41621

## Text

The Uninsured by State and Congressional
District
(name redacted)
Specialist in Health Care Financing
January 24, 2011

Congressional Research Service
7-....
www.crs.gov
R41621

CRS Report for Congress
Prepared for Members and Committees of Congress

The Uninsured by State and Congressional District

Summary
The total U.S. civilian non-institutionalized population in 2009 was estimated to be slightly more
than 301 million of whom 15.1%, or 45.5 million, were estimated by the American Community
Survey to be without health insurance or uninsured. The uninsured are far more likely than those
with health insurance to report problems getting needed medical care, less likely to follow
recommended treatments because of costs, have less access to care, receive less preventive care,
and are more likely to be hospitalized for avoidable health problems. Moreover, it is widely
believed that the uninsured, when they need care, are less able to pay for their care since they do
not have health insurance and therefore it is further assumed that other payers take on the
financial burden of their care through higher prices.
Many Americans obtain their health insurance through employers. Local factors such as local
labor market conditions, the mix of firms and firm sizes, and demographic factors such as age,
play a role in the proportion of uninsured among those of working age. The Medicare program
has effectively provided health insurance to almost all elderly Americans while the Medicaid
program and the State Children’s Health Insurance Program have expanded health insurance
coverage to both the poor and to children. State policies to expand coverage, including
implementing Medicaid waivers to expand coverage, account for some of the differences across
states in the proportion of uninsureds. Similarly, state policies to expand coverage such as
employer or personal mandates to purchase insurance in Hawaii and Massachusetts further
explain some of the differences in the number of uninsureds across states.
The Patient Protection and Affordable Care Act (PPACA, P.L. 111-148, as amended), through an
expansion of Medicaid and the creation of state health insurance exchanges, is projected by the
Congressional Budget Office to reduce the share of legal non-elderly residents without health
insurance to 6% of the population by 2019.
This report, using the U.S. Census Bureau’s 2009 American Community Survey, details
differences in the number and proportion of uninsured across states, within states, and across
demographic groups.

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The Uninsured by State and Congressional District

Contents
Background...................................................................................................................................... 1
The Uninsured ........................................................................................................................... 1
Methodology.................................................................................................................................... 3
The Survey Question ................................................................................................................. 3
The ACS and Other Surveys of the Uninsured.......................................................................... 4
The Uninsured: National Analysis 2009.......................................................................................... 5
Estimates of the Number of Uninsured by Selected Demographic Characteristics .................. 5
The Patient Protection and Affordable Care Act and the Uninsured ......................................... 6
The Uninsured: Comparisons Across States .................................................................................... 8
Number and Percentage of Uninsureds by State ....................................................................... 8
One-Year Change in Uninsureds ............................................................................................... 8
The Uninsured: Characteristics by State, 2009.............................................................................. 14
The Uninsured: Characteristics by Congressional District (111th Congress)................................. 29
Alabama................................................................................................................................... 31
Alaska...................................................................................................................................... 33
Arizona .................................................................................................................................... 35
Arkansas .................................................................................................................................. 37
California................................................................................................................................. 39
Colorado .................................................................................................................................. 42
Connecticut.............................................................................................................................. 44
Delaware.................................................................................................................................. 46
District of Columbia ................................................................................................................ 48
Florida ..................................................................................................................................... 50
Georgia .................................................................................................................................... 52
Hawaii ..................................................................................................................................... 54
Idaho ........................................................................................................................................ 56
Illinois...................................................................................................................................... 58
Indiana ..................................................................................................................................... 60
Iowa ......................................................................................................................................... 62
Kansas ..................................................................................................................................... 64
Kentucky.................................................................................................................................. 66
Louisiana ................................................................................................................................. 68
Maine....................................................................................................................................... 70
Maryland.................................................................................................................................. 72
Massachusetts.......................................................................................................................... 74
Michigan.................................................................................................................................. 76
Minnesota ................................................................................................................................ 78
Mississippi............................................................................................................................... 80
Missouri................................................................................................................................... 82
Montana................................................................................................................................... 84
Nebraska.................................................................................................................................. 86
Nevada..................................................................................................................................... 88
New Hampshire ....................................................................................................................... 90
New Jersey............................................................................................................................... 92
New Mexico ............................................................................................................................ 94

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New York................................................................................................................................. 96
North Carolina ......................................................................................................................... 98
North Dakota ......................................................................................................................... 100
Ohio ....................................................................................................................................... 102
Oklahoma .............................................................................................................................. 104
Oregon ................................................................................................................................... 106
Pennsylvania.......................................................................................................................... 108
Rhode Island.......................................................................................................................... 110
South Carolina....................................................................................................................... 112
South Dakota ......................................................................................................................... 114
Tennessee............................................................................................................................... 116
Texas...................................................................................................................................... 118
Utah ....................................................................................................................................... 120
Vermont ................................................................................................................................. 122
Virginia .................................................................................................................................. 124
Washington ............................................................................................................................ 126
West Virginia ......................................................................................................................... 128
Wisconsin .............................................................................................................................. 130
Wyoming ............................................................................................................................... 132

Figures
Figure 1. Map: The Uninsured by State – 2009............................................................................. 12

Tables
Table 1. Estimates of the Uninsured by Selected Demographic Characteristics, 2009 ................... 7
Table 2. Number and Percentage of Uninsured, by State, 2009 ...................................................... 9
Table 3. Ranking of States, by Percentage Uninsured, 2009 ......................................................... 10
Table 4. One-year Change in Percentage Uninsured, by State, 2008-2009 ................................... 13
Table 5. Percentage Uninsured by Age, by State, 2009 ................................................................. 16
Table 6. Ranking of States by Percentage Uninsured by Age, 2009.............................................. 18
Table 7. Percentage Uninsured, by Income by State, 2009............................................................ 21
Table 8. Ranking of States by Percentage Uninsured by Income, 2009 ........................................ 23
Table 9. Percentage Uninsured by Marital and Employment Status by State, 2009...................... 24
Table 10. Ranking of States by Percentage Uninsured by Marital Status, 2009............................ 26
Table 11. Ranking of States by Percentage Uninsured by Employment Status, 2009 ................... 28
Table A-1. Alabama: Characteristics of the Uninsured, 2009........................................................ 31
Table A-2. Alabama: Number and Percentage of People Without Health Insurance, by
State and Congressional District (111th), 2009 ........................................................................... 32
Table A-3. Alaska: Characteristics of the Uninsured, 2009 ........................................................... 33
Table A-4. Alaska: Number and Percentage of People Without Health Insurance, by State
and Congressional District (111th), 2009 .................................................................................... 34

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Table A-5. Arizona: Characteristics of the Uninsured, 2009 ......................................................... 35
Table A-6. Arizona: Number and Percentage of People Without Health Insurance, by
State and Congressional District (111th), 2009 ........................................................................... 36
Table A-7. Arkansas: Characteristics of the Uninsured, 2009 ....................................................... 37
Table A-8. Arkansas: Number and Percentage of People Without Health Insurance, by
State and Congressional District (111th), 2009 ........................................................................... 38
Table A-9.California: Characteristics of the Uninsured, 2009....................................................... 39
Table A-10.California: Number and Percentage of People Without Health Insurance, by
State and Congressional District (111th), 2009 ........................................................................... 40
Table A-11.Colorado: Characteristics of the Uninsured, 2009 ...................................................... 42
Table A-12.Colorado: Number and Percentage of People Without Health Insurance, by
State and Congressional District (111th), 2009 ........................................................................... 43
Table A-13.Connecticut: Characteristics of the Uninsured, 2009.................................................. 44
Table A-14.Connecticut: Number and Percentage of People Without Health Insurance, by
State and Congressional District (111th), 2009 ........................................................................... 45
Table A-15.Delaware: Characteristics of the Uninsured, 2009...................................................... 46
Table A-16.Delaware: Number and Percentage of People Without Health Insurance, by
State and Congressional District (111th), 2009 ........................................................................... 47
Table A-17.District of Columbia: Characteristics of the Uninsured, 2009.................................... 48
Table A-18.District of Columbia; Number and Percentage of People Without Health
Insurance, by State and Congressional District (111th), 2009 ..................................................... 49
Table A-19.Florida: Characteristics of the Uninsured, 2009 ......................................................... 50
Table A-20.Florida: Number and Percentage of People Without Health Insurance, by
State and Congressional District (111th), 2009 ........................................................................... 51
Table A-21.Georgia: Characteristics of the Uninsured, 2009 ........................................................ 52
Table A-22.Georgia: Number and Percentage of People Without Health Insurance, by
State and Congressional District (111th), 2009 ........................................................................... 53
Table A-23. Hawaii: Characteristics of the Uninsured, 2009 ........................................................ 54
Table A-24. Hawaii: Number and Percentage of People Without Health Insurance, by
State and Congressional District (111th), 2009 ........................................................................... 55
Table A-25.Idaho: Characteristics of the Uninsured, 2009............................................................ 56
Table A-26.Idaho: Number and Percentage of People Without Health Insurance, by State
and Congressional District (111th), 2009 .................................................................................... 57
Table A-27.Illinois: Characteristics of the Uninsured, 2009.......................................................... 58
Table A-28.Illinois: Number and Percentage of People Without Health Insurance, by State
and Congressional District (111th), 2009 .................................................................................... 59
Table A-29.Indiana: Characteristics of the Uninsured, 2009 ......................................................... 60
Table A-30.Indiana: Number and Percentage of People Without Health Insurance, by
State and Congressional District (111th), 2009 ........................................................................... 61
Table A-31.Iowa: Characteristics of the Uninsured, 2009 ............................................................. 62

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Table A-32.Iowa: Number and Percentage of People Without Health Insurance, by State
and Congressional District (111th), 2009 .................................................................................... 63
Table A-33.Kansas: Characteristics of the Uninsured, 2009 ......................................................... 64
Table A-34.Kansas: Number and Percentage of People Without Health Insurance, by
State and Congressional District (111th), 2009 ........................................................................... 65
Table A-35.Kentucky: Characteristics of the Uninsured, 2009 ..................................................... 66
Table A-36.Kentucky: Number and Percentage of People Without Health Insurance, by
State and Congressional District (111th), 2009 ........................................................................... 67
Table A-37.Louisiana: Characteristics of the Uninsured, 2009 ..................................................... 68
Table A-38.Louisiana: Number and Percentage of People Without Health Insurance, by
State and Congressional District (111th), 2009 ........................................................................... 69
Table A-39.Maine: Characteristics of the Uninsured, 2009........................................................... 70
Table A-40.Maine: Number and Percentage of People Without Health Insurance, by State
and Congressional District (111th), 2009 .................................................................................... 71
Table A-41.Maryland: Characteristics of the Uninsured, 2009 ..................................................... 72
Table A-42.Maryland: Number and Percentage of People Without Health Insurance, by
State and Congressional District (111th), 2009 ........................................................................... 73
Table A-43.Massachusetts: Characteristics of the Uninsured, 2009.............................................. 74
Table A-44.Massachusetts: Number and Percentage of People Without Health Insurance,
by State and Congressional District (111th), 2009 ...................................................................... 75
Table A-45.Michigan: Characteristics of the Uninsured, 2009...................................................... 76
Table A-46.Michigan: Number and Percentage of People Without Health Insurance, by
State and Congressional District (111th), 2009 ........................................................................... 77
Table A-47.Minnesota: Characteristics of the Uninsured, 2009 .................................................... 78
Table A-48.Minnesota: Number and Percentage of People Without Health Insurance, by
State and Congressional District (111th), 2009 ........................................................................... 79
Table A-49.Mississippi: Characteristics of the Uninsured, 2009................................................... 80
Table A-50.Mississippi: Number and Percentage of People Without Health Insurance, by
State and Congressional District (111th), 2009 ........................................................................... 81
Table A-51.Missouri: Characteristics of the Uninsured, 2009....................................................... 82
Table A-52.Missouri: Number and Percentage of People Without Health Insurance, by
State and Congressional District (111th), 2009 ........................................................................... 83
Table A-53.Montana: Characteristics of the Uninsured, 2009....................................................... 84
Table A-54.Montana: Number and Percentage of People Without Health Insurance, by
State and Congressional District (111th), 2009 ........................................................................... 85
Table A-55. .Nebraska: Characteristics of the Uninsured, 2009.................................................... 86
Table A-56.Nebraska: Number and Percentage of People Without Health Insurance, by
State and Congressional District (111th), 2009 ........................................................................... 87
Table A-57.Nevada: Characteristics of the Uninsured, 2009......................................................... 88
Table A-58.Nevada: Number and Percentage of People Without Health Insurance, by
State and Congressional District (111th), 2009 ........................................................................... 89

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Table A-59.New Hampshire: Characteristics of the Uninsured, 2009........................................... 90
Table A-60.New Hampshire: Number and Percentage of People Without Health
Insurance, by State and Congressional District (111th), 2009 .................................................... 91
Table A-61.New Jersey: Characteristics of the Uninsured, 2009 .................................................. 92
Table A-62.New Jersey: Number and Percentage of People Without Health Insurance, by
State and Congressional District (111th), 2009 ........................................................................... 93
Table A-63.New Mexico: Characteristics of the Uninsured, 2009 ................................................ 94
Table A-64.New Mexico: Number and Percentage of People Without Health Insurance,
by State and Congressional District (111th), 2009 ...................................................................... 95
Table A-65.New York: Characteristics of the Uninsured, 2009..................................................... 96
Table A-66.New York: Number and Percentage of People Without Health Insurance, by
State and Congressional District (111th), 2009 ........................................................................... 97
Table A-67.North Carolina: Characteristics of the Uninsured, 2009............................................. 98
Table A-68.North Carolina: Number and Percentage of People Without Health Insurance,
by State and Congressional District (111th), 2009 ...................................................................... 99
Table A-69.North Dakota: Characteristics of the Uninsured, 2009 ............................................. 100
Table A-70.North Dakota: Number and Percentage of People Without Health Insurance,
by State and Congressional District (111th), 2009 .................................................................... 101
Table A-71.Ohio: Characteristics of the Uninsured, 2009 ........................................................... 102
Table A-72.Ohio: Number and Percentage of People Without Health Insurance, by State
and Congressional District (111th), 2009 .................................................................................. 103
Table A-73.Oklahoma: Characteristics of the Uninsured, 2009 .................................................. 104
Table A-74.Oklahoma: Number and Percentage of People Without Health Insurance, by
State and Congressional District (111th), 2009 ......................................................................... 105
Table A-75.Oregon: Characteristics of the Uninsured, 2009 ....................................................... 106
Table A-76.Oregon: Number and Percentage of People Without Health Insurance, by
State and Congressional District (111th), 2009 ......................................................................... 107
Table A-77.Pennsylvania: Characteristics of the Uninsured, 2009.............................................. 108
Table A-78.Pennsylvania: Number and Percentage of People Without Health Insurance,
by State and Congressional District (111th), 2009 .................................................................... 109
Table A-79.Rhode Island: Characteristics of the Uninsured, 2009.............................................. 110
Table A-80.Rhode Island: Number and Percentage of People Without Health Insurance,
by State and Congressional District (111th), 2009 .................................................................... 111
Table A-81.South Carolina: Characteristics of the Uninsured, 2009........................................... 112
Table A-82.South Carolina: Number and Percentage of People Without Health Insurance,
by State and Congressional District (111th), 2009 .................................................................... 113
Table A-83.South Dakota: Characteristics of the Uninsured, 2009 ............................................. 114
Table A-84.South Dakota: Number and Percentage of People Without Health Insurance,
by State and Congressional District (111th), 2009 .................................................................... 115
Table A-85.Tennessee: Characteristics of the Uninsured, 2009................................................... 116

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Table A-86.Tennessee: Number and Percentage of People Without Health Insurance, by
State and Congressional District (111th), 2009 ......................................................................... 117
Table A-87.Texas: Characteristics of the Uninsured, 2009.......................................................... 118
Table A-88.Texas: Number and Percentage of People Without Health Insurance, by State
and Congressional District (111th), 2009 .................................................................................. 119
Table A-89.Utah: Characteristics of the Uninsured, 2009 ........................................................... 120
Table A-90.Utah: Number and Percentage of People Without Health Insurance, by State
and Congressional District (111th), 2009 .................................................................................. 121
Table A-91.Vermont: Characteristics of the Uninsured, 2009 ..................................................... 122
Table A-92.Vermont: Number and Percentage of People Without Health Insurance, by
State and Congressional District (111th), 2009 ......................................................................... 123
Table A-93.Virginia: Characteristics of the Uninsured, 2009 ...................................................... 124
Table A-94.Virginia: Number and Percentage of People Without Health Insurance, by
State and Congressional District (111th), 2009 ......................................................................... 125
Table A-95.Washington: Characteristics of the Uninsured, 2009 ................................................ 126
Table A-96.Washington: Number and Percentage of People Without Health Insurance, by
State and Congressional District (111th), 2009 ......................................................................... 127
Table A-97.West Virginia: Characteristics of the Uninsured, 2009 ............................................. 128
Table A-98.West Virginia: Number and Percentage of People Without Health Insurance,
by State and Congressional District (111th), 2009 .................................................................... 129
Table A-99.Wisconsin: Characteristics of the Uninsured, 2009 .................................................. 130
Table A-100.Wisconsin: Number and Percentage of People Without Health Insurance, by
State and Congressional District (111th), 2009 ......................................................................... 131
Table A-101.Wyoming: Characteristics of the Uninsured, 2009 ................................................. 132
Table A-102.Wyoming: Number and Percentage of People Without Health Insurance, by
State and Congressional District (111th), 2009 ......................................................................... 133

Appendixes
Appendix. State and Congressional District Data Tables .............................................................. 31

Contacts
Author Contact Information......................................................................................................... 133
Acknowledgments ....................................................................................................................... 133

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Background
The Uninsured
Roughly 15% of Americans are not covered by health insurance.1 The uninsured are more likely
to:2
•

report problems getting needed medical care; and

•

be hospitalized for avoidable health problems.

In addition, they are less likely, among other things, to:
•

follow recommended treatments because of costs;

•

have access to care; or

•

receive preventive care.

Moreover, it is widely believed that the uninsured, when they need care, face higher prices since
they do not benefit from negotiated discounts.3 In addition, they are less able to pay for their care
since they do not have health insurance and therefore other payers are forced indirectly to assume
the financial burden of their care through higher prices.
While two-thirds of the uninsured are poor or near poor (i.e., with family incomes less than 133%
of federal poverty level (FPL)), in 2008 it was estimated that “the uninsured contributed $30
billion toward their own medical care. In addition, they benefited from $56 billion in
uncompensated care—$43 billion of which was government spending for care on behalf of the
uninsured (Medicaid disproportionate share hospital (DSH) and supplemental payment programs,
Medicare DSH and indirect medical education (IME) payments,4 various direct care programs,
and state and local tax appropriations).”5 The Institute of Medicine has estimated that among

1

While the actual proportion of uninsured varies somewhat from survey to survey, the various well designed federally
sponsored surveys provide consistent and reliable estimates over time. See Office of the Assistant Secretary for
Planning and Evaluation, Understanding Estimates of the Uninsured: Putting the Differences in Context , Department
of Health and Human Services, ASPE Issue Brief, Washington, DC, September 2005, http://aspe.hhs.gov/health/
reports/05/uninsured-understanding-ib/index.htm.
2
The Henry J. Kaiser Family Foundation, The Uninsured: A Primer, Washington, DC, October 2009,
http://www.kff.org/uninsured/upload/7451-05.pdf.
3
L. Lagnado, “Hospitals Try Extreme Measures to Collect Their Overdue Debts,” The Wall Street Journal, October
30, 2003, but also see Glenn A. Melnick and Katya Fonkych , “Hospital Pricing And The Uninsured: Do The
Uninsured Pay Higher prices?,” Health Affairs, vol. 27, no. 2 (2008), pp. w116-w122 .
4
Medicaid DSH payments or disproportionate share hospital payments are additional payments made to hospitals that
serve a large number of low-income patients. See Christie Provost Peters, The Basics: Medicaid Disproportionate
Hospital (DSH) Payments, National Health Policy Forum, Washington, DC, June 15, 2009, http://www.nhpf.org/
library/the-basics/Basics_DSH_06-15-09.pdf. Indirect Medical Education payments, or IME payments, are additional
Medicare payments to teaching hospitals for the higher cost of patient care in those facilities.
5
Jack Hadley, John Holahan, and Teresa Coughlin, et al., “Covering The Uninsured In 2008: Current Costs, Sources
Of Payment, And Incremental Costs,” Health Affairs Web Exclusive, August 25, 2008, pp. W411-W413.

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individuals ages 25-64, approximately 18,000 excess deaths per year can be attributed to the lack
of health insurance.6
As this report details, there are considerable differences across states, within states, and across
demographic groups in the proportion of uninsured. The Medicare program has effectively
provided health insurance to almost all elderly Americans while the Medicaid program and the
State Children’s Health Insurance Program have expanded health insurance coverage to both the
poor and to children. State policies to expand health insurance coverage, including Medicaid
waivers, account for some of the differences across states in the proportion of uninsureds.7 For
instance, Vermont has extended Medicaid benefits to childless adults with incomes up to 150% of
FPL and only 8.6% of the state’s population is uninsured.8 Similarly, state policies such as
employer or personal mandates to purchase health insurance in Hawaii and Massachusetts further
explain some of the differences.
The explanation for variations in health insurance coverage among working adults is complex
since it must include decisions on the part of employers to offer coverage and decisions regarding
the nature of the coverage, including cost sharing, if insurance is offered. In addition, it needs to
take into consideration employees’ decisions to purchase insurance. According to the Kaiser
Family Foundation, 61% of the non-elderly population received employer-sponsored health
insurance in 2009.9 While employer-based health insurance is nearly universally offered by large
employers (over 200 employees), only 59% of small firms (3-9 employees) offered health
insurance.10 Thus, the working uninsured, poor, and unemployed who are not otherwise eligible
for a public program, covered under a family member’s policy, or cannot afford coverage are
either relegated to the more expensive individual market or to do without coverage.
To understand those who are employed and have health insurance, one needs to understand the
decision-making process that firms engage in when deciding whether to offer employees health
insurance and how to share these costs. While many policy analysts have focused on the tax
treatment of health insurance premiums as one impetus for employer provided health insurance,
other factors such as local labor market conditions and company image are also likely to play a
role in these decisions. Even if one is employed and works for a firm that offers health insurance,
there is a further set of calculations that employees make regarding whether to take-up the offer
of health insurance. These considerations include: one’s current health status, one’s expectation of
future health insurance requirements, cost (including cost sharing of the premium, deductibles,
and coinsurance), and the availability of other benefits through Section 125 cafeteria plans (where
employees can personalized benefits from a set of offerings). In 2005, it was estimated that about
7% of those who are offered employer health insurance are actually uninsured.11 All of these
6

Institute of Medicine, Care without Coverage: Too Little, Too Late , Washington , DC: National Academies Press,
2002.
7
For additional background on Medicaid waivers, see CRS Report RL33202, Medicaid: A Primer, by (name redacted).
8
See Kaiser State Health Facts – Income Eligibility – Childless Adults. http://www.statehealthfacts.org/
comparetable.jsp?ind=749&cat=4.
9
Jonathan Gruber, The Tax Exclusion For Employer-Sponsored Health Insurance, National Bureau Of Economic
Research, Working Paper 15766, Cambridge, MA, February 2010, http://www.nber.org/papers/w15766 citing Kaiser
Family Foundation.
10
Smaller firms also tend to have higher employee contributions to premiums and less generous benefits. See Kaiser
Family Foundation and Health Research & Educational Trust, Employer Health Benefits: 2010 Summary of Findings,
2010, http://ehbs.kff.org/pdf/2010/8086.pdf.
11
Jonathan Gruber and Ebonya Washington, “Subsidies to Employee Health Insurance Premiums and the Health
(continued...)

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factors, in addition to others, will affect the proportion of working aged Americans without health
insurance.

Methodology
This report employs the U.S. Census Bureau’s 2009 American Community Survey (ACS) to
describe the characteristics of the uninsured and provide estimates of the number and percentage
of uninsureds at the national, state, and congressional district level.12 The survey is briefly
described below and more fully documented at the U.S. Census Bureau’s Website.13
The ACS is representative of the civilian non-institutionalized population and is designed to
produce reliable estimates of the number of uninsured at the time of the survey. Respondents in
the 2009 survey were sampled between January 1 and December 31, 2009. The ACS is a
mailout/mailback survey with telephone and in-person nonresponse follow-up, conducted
continuously throughout the year, with results consolidated to produce annual estimates using
90% confidence intervals.
This is the second year that the Congressional Research Service has used the ACS to generate
these estimates. While this year we report the state-level change in the proportion of uninsured in
2009 compared to 2008, in future years we will use the ACS to track changes in the number and
proportion of uninsured over a longer period of time.

The Survey Question
The ACS contains a single multipart question (question 16) addressing health insurance coverage.
The question is replicated below. Someone who responds “no” to every item is characterized as
uninsured.

(...continued)
Insurance Market,” Journal of Health Economics, vol. 24, no. 2 (2005), p. 590.
12
The 2009 American Community Survey dataset was released by the U.S. Census Bureau in October 2010.
13
http://www.census.gov/acs/www.

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ACS Health Insurance Question
16. Is this person CURRENTLY covered by any of the following types of health insurance of health
coverage plans? Mark “Yes” or “No” for EACH type of coverage for items a – h.
Item

Yes

No

Insurance through a current or former employer or union (of
this person or another family member)

[]

[]

b.

Insurance purchased directly from an insurance company (by
this person or another family member)

[]

[]

c.

Medicare, for people 65 or older, or people with certain
disabilities

[]

[]

d.

Medicaid, Medical Assistance, or any kind of governmentassistance plan for those with low incomes or a disability

[]

[]

e.

TRICARE or other military health care

[]

[]

f.

VA (including those who have ever used or enrolled for VA
health care)

[]

[]

g.

Indian Health Service

[]

[]

h.

Any other type of health insurance or health coverage plan –

[]

[]

a.

Specify ______________________________
Source: U.S. Census Bureau, 2009 American Community Survey (ACS).

The ACS and Other Surveys of the Uninsured
There are several national surveys that estimate the uninsured including the Current Population
Survey (CPS), the American Community Survey (ACS), and the National Health Interview
Survey (NHIS). Each of these efforts have limitations – many of which have been well
documented and acknowledged by the Census Bureau and other research organizations.14 For
example, the CPS and NHIS have historically undercounted Medicaid beneficiaries and estimates
are less reliable for small states.15
The ACS, with a sample size of roughly 2 million completed surveys per year, allows for
reasonably accurate estimates of areas with a population of 65,000 or more. Therefore, the ACS
does a better job of reducing error associated with small sample size as compared to either the
CPS or NHIS. However, regardless of the survey used, discrepancies exist between survey
estimates of the number of uninsureds and estimates based on state and national administrative
data.

14

See Thomas J. Plewes, Rapporteur National Research Council and National Research Council, “Federal Surveys,” in
Databases for Estimating Health Insurance Coverage for Children: A Workshop Summary, http://www.nap.edu/
catalog.php?record_id=13024 ed. (Washington , DC: National Academies Press, 2010).
15
U.S. Census Bureau, “Income, Poverty, and Health Insurance Coverage in the United States: 2008,” Current
Population Reports P60-236(RV), Washington, DC, 2009, at http://www.census.gov/prod/2009pubs/p60-236.pdf, p. 20
and p. 57.

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The ACS is not without its limitations, including that:16
•

it is primarily a mail survey completed without the assistance of an interviewer;

•

there is a single health insurance question that uses an itemized list of coverage
types;

•

the survey does not clearly delineate the coverage categories or clearly direct
respondents that “direct purchase” of insurance should be completely
independent of a current or former employer; and

•

the characterization of uninsured is not collected directly, rather uninsured status
is derived from the answers to the various types of coverage and the result is not
verified.

Despite these limitations, the ACS produces results that are generally very similar to those
obtained from other surveys and the larger sample size allows for reliable state and congressional
district estimates of the uninsured.17

The Uninsured: National Analysis 2009
Estimates of the Number of Uninsured by Selected Demographic
Characteristics
The total U.S. civilian non-institutionalized population in 2009 was estimated to be slightly more
than 301 million of whom 15.1%, or 45.7 million, were uninsured (see Table 1). Women were
about 20% more likely to be uninsured than men with 16.9% of women being uninsured
compared to 13.4% of men. Older Americans, above age 65, were least likely to be uninsured,
fewer than 1%, because of the near universal coverage offered by Medicare. Those under age 19
were also less likely to be uninsured (9.0%) with only about 5% of those under age 1 and 7% of
those under age 6 being uninsured. Individuals age 19 through 21 were most likely to be
uninsured (29.7%).
Low income is associated with not having health insurance and individuals with incomes equal or
less than 133% of FPL are least likely to have health insurance (27.7%) compared to other
income groups. Almost 95% of those at 400% or more of FPL have health insurance.
Marital and employment status are also associated with being uninsured. Single individuals, age
18-64, were twice as likely to be uninsured compared to married individuals and those working
part-time were almost twice as likely to be uninsured compared to individuals working full time.18

16
Thomas J. Plewes, Rapporteur National Research Council and National Research Council, “Federal Surveys,” in
Databases for Estimating Health Insurance Coverage for Children: A Workshop Summary, http://www.nap.edu/
catalog.php?record_id=13024 ed. (Washington , DC: National Academies Press, 2010).
17
Ibid.
18
Full time is defined in PPACA § 1513(c)(4) as working 30 hours a week. To align with PPACA’s definition, full
time is defined in this report as working 30 or more hours a week for 50 or more weeks and part-time is defined as
working fewer than 30 hours a week or less than 50 weeks per year.

Congressional Research Service

5

The Uninsured by State and Congressional District

The Patient Protection and Affordable Care Act and the Uninsured
The Patient Protection and Affordable Care Act (PPACA, P.L. 111-148, as amended) was
designed, in part, to expand access to health insurance. For instance, beginning with renewals
from September 23, 2010, PPACA provides that dependent children up to age 26 can remain on
their parent’s health insurance generally beginning with the next subsequent renewal. Beginning
in 2014, or sooner at state option, PPACA requires states to expand Medicaid to certain
individuals who are under age 65 with income up to 133% of FPL. This reform not only expands
eligibility to a group that is not currently eligible for Medicaid (low income childless adults), but
also raises Medicaid’s mandatory income eligibility level for certain existing groups to 133% of
the FPL.19 The Congressional Budget Office (CBO) and Joint Committee on Taxation estimated
that the coverage expansion provisions in the health reform law would result in a Medicaid
enrollment increase, over what otherwise would have been the case, of approximately 16 million
by FY2019.20
Under PPACA, states are to establish health insurance exchanges that provide eligible individuals
and small businesses with access to health insurance. In addition, individuals with incomes
greater than 133% of FPL up to 400% of FPL are eligible for premium tax credits and costsharing subsidies. CBO estimates that 24 million individuals will obtain health insurance through
an exchange and 5 million more will obtain their insurance through their employer’s participation
in an exchange. While some individuals who are currently privately insured will be covered
through an exchange in the future, CBO estimated that, on net, PPACA will reduce the number of
uninsured by 32 million by 2019, leaving 23 million (or 6%) of non-elderly Americans
uninsured.21

19

PPACA extended Medicaid coverage of children 6 through 18 up to 133% of FPL but the subsequent Medicare and
Medicaid Extenders Act of 2010 (P.L. 111-309).
20
Congressional Budget Office, letter to Honorable Nancy Pelosi, March 20, 2010, available at
http://www.cbo.gov/doc.cfm?index=11379.
21
Ibid.

Congressional Research Service

6

The Uninsured by State and Congressional District

Table 1. Estimates of the Uninsured by Selected Demographic Characteristics, 2009
(numbers in thousands)
Above (+), At
(x), Below (-)
Overall
National
Averageb

Total
Population

Number
Uninsured

Percent
Uninsured

301,472

45,665

15.1

Male

153,927

20,699

13.4

-

Female

147,545

24,966

16.9

+

Under 1 Year

4,054

207

5.1

-

Under Age 6

25,201

1,764

7.0

-

Under Age 19

79,011

7,116

9.0

-

Under Age 26

108,259

16,399

15.1

x

Age 19 through 21

13,038

3,873

29.7

+

Age 21 through 64

175,729

35,665

20.3

+

Age 65 and over

37,932

358

0.9

-

Poverty Status

298,038

45,395

15.2

≤133% FPL

61,314

16,991

27.7

+

>133 to <400% FPL

127,517

22,486

17.6

+

≥400% + FPL

109,206

5,918

5.4

-

189,181

38,937

20.6

Singlec

90,884

25,608

28.2

+

Married

98,297

13,329

13.6

-

Employed Full Timed

100,110

14,295

14.3

-

Employed Part Timee

33,093

8,759

26.5

+

Total Populationa

Total Population Age 18-64

Source: CRS analysis of data from 2009 American Community Survey, U.S. Census Bureau.
a.

All figures are for the civilian non-institutionalized population. Each value in the table is an estimate with a
confidence interval around the estimate. While the confidence intervals are not presented, they are
available.

b.

Above (below) the national level means that subgroup has, with a 90% confidence level, a statistically
significantly higher (lower) likelihood of being uninsured as compared to the overall national average. If a
subgroup is at the national level, there is no statistical difference between the proportion of individuals
uninsured in the subgroup and the national average.

c.

The population estimates based on poverty status are less than the total population estimates since these
estimates exclude people in military group quarters, people in college dormitories, and unrelated individuals
under 15 years old as well as institutionalized individuals.

d.

Never married, separated, divorced, or widowed.

e.

Working 30 or more hours for 50 or more weeks a year. 6: Working fewer than 30 hours a week for
fewer than 50 weeks a year.

Congressional Research Service

7

The Uninsured by State and Congressional District

The Uninsured: Comparisons Across States
Number and Percentage of Uninsureds by State
There is wide variation across states in terms of the percentage of each state’s civilian noninstitutionalized population not having insurance (see Table 2). For instance, residents of Texas
are five times more likely not to have health insurance as residents of Massachusetts. Table 3
ranks orders the states from lowest to highest in terms of each state’s percent uninsured
population and Figure 1 presents the same data on a map of the United States.
While there are many factors that can potentially influence these estimates, two of the 10 states
with the lowest percentage of uninsureds, Massachusetts and Hawaii, have insurance mandates
(see Table 3). Hawaii has had an employer health insurance mandate since 1974 which covers
employees who work 20 hours a week or more;22 and Massachusetts adopted an individual
mandate beginning in July 2007. The District of Columbia has a low proportion of uninsureds in
part due to its low-income childless-adult Medicaid waiver and the District’s Healthcare Alliance
Program which provides care to non-disabled childless-adults, non-qualified aliens and some
individuals who are over-income for Medicaid. Most of the remaining states in the top ten, with
the exception of Iowa, also have Medicaid waivers that cover low-income childless adults. Iowa
has a high percentage of non-elderly adults covered by private health insurance and a low
percentage of uninsured children.

One-Year Change in Uninsureds
While in aggregate there was not a change in the percentage of uninsureds in the United States
between 2008 and 2009, several states experienced either a disproportionate increase or decrease
in the number of uninsureds. Table 4 presents the percentage of uninsured in each state in 2008
and 2009, the one year change in the percentage uninsured and the one-year percentage change in
the percentage uninsured.
Arizona, Arkansas, Colorado, the District of Columbia, New Mexico, and West Virginia
experienced the largest declines in the percentage uninsured while Alaska, Kansas, Nebraska,
Rhode Island, South Dakota, and Wyoming experienced the largest increases in the percentage of
uninsured (column 4). Arizona, Colorado, the District of Columbia, New Mexico, North Dakota,
and West Virginia each experienced a year-on-year decline of more than 7% (column 5). Kansas,
Nebraska, Rhode Island, South Dakota, and Wyoming each experienced a year-on-year increase
of more than 7% (column 5).

22

Gardiner Harris, “In Hawaii’s Health System, Lessons for Lawmakers ,” The New York Times, October 16, 2009,
http://www.nytimes.com/2009/10/17/health/policy/17hawaii.html.

Congressional Research Service

8

The Uninsured by State and Congressional District

Table 2. Number and Percentage of Uninsured, by State, 2009
Uninsured
State

Total Population (in
thousands)a

United States

Number (in thousands)

Percent

301,472

45,522

15.1

Alabama

4,616

637

13.8

Alaska

678

143

21.1

Arizona

6,502

1,127

17.3

Arkansas

2,833

483

17.0

California

36,377

6,559

18.0

Colorado

4,930

778

15.8

Connecticut

3,457

305

8.8

Delaware

869

89

10.2

District of Columbia

589

41

7.0

Florida

18,193

3,795

20.9

Georgia

9,594

1,836

19.1

Hawaii

1,232

86

7.0

Idaho

1,521

264

17.4

Illinois

12,720

1,694

13.3

Indiana

6,316

901

14.3

Iowa

2,957

255

8.6

Kansas

2,757

363

13.2

Kentucky

4,225

613

14.5

Louisiana

4,392

762

17.4

Maine

1,301

137

10.5

Maryland

5,590

621

11.1

Massachusetts

6,496

271

4.2

Michigan

9,835

1,203

12.2

Minnesota

5,197

473

9.1

Mississippi

2,880

514

17.9

Missouri

5,871

774

13.2

Montana

958

174

18.2

Nebraska

1,763

210

11.9

Nevada

2,610

572

21.9

New Hampshire

1,309

134

10.2

New Jersey

8,583

1,084

12.6

New Mexico

1,976

390

19.7

New York

19,264

2,195

11.4

North Carolina

9,149

1,471

16.1

Congressional Research Service

9

The Uninsured by State and Congressional District

Uninsured
Total Population (in
thousands)a

Number (in thousands)

Percent

630

61

9.7

Ohio

11,352

1,383

12.2

Oklahoma

3,590

672

18.7

Oregon

3,780

643

17.0

Pennsylvania

12,366

1,220

9.9

Rhode Island

1,035

117

11.3

South Carolina

4,454

750

16.8

South Dakota

793

104

13.1

Tennessee

6,188

883

14.3

Texas

24,292

5,783

23.8

Utah

2,755

401

14.6

Vermont

615

53

8.6

Virginia

7,644

908

11.9

Washington

6,546

878

13.4

West Virginia

1,793

254

14.2

Wisconsin

5,566

521

9.4

Wyoming

534

81

15.2

State
North Dakota

Source: CRS analysis of data from 2009 American Community Survey, U.S. Census Bureau.
a.

All figures are for the civilian non-institutionalized population. Each value in the table is an estimate and
there is a confidence interval around the estimate. While the confidence level are not presented, they are
available.

Table 3. Ranking of States, by Percentage Uninsured, 2009
(lowest to highest)
Total Population
(in thousands)

Number Uninsured
(in thousands)

6,496

271

4.2

589

41

7.0

2. Hawaii

1,232

86

7.0

4. Iowa

2,957

255

8.6

4. Vermont

615

53

8.6

4. Connecticut

3,457

305

8.8

7. Minnesota

5,197

473

9.1

8. Wisconsin

5,566

521

9.4

9. North Dakota

630

61

9.7

10. Pennsylvania

12,366

1,220

9.9

11. Delaware

869

89

10.2

Rank/Statea
1. Massachusetts
2. District of Columbia

Congressional Research Service

Percent Uninsured

10

The Uninsured by State and Congressional District

Total Population
(in thousands)

Number Uninsured
(in thousands)

11. New Hampshire

1,309

134

10.2

13. Maine

1,301

137

10.5

14. Maryland

5,590

621

11.1

15. Rhode Island

1,035

117

11.3

16. New York

19,264

2,195

11.4

17. Nebraska

1,763

210

11.9

17. Virginia

7,644

908

11.9

19. Michigan

9,835

1,203

12.2

19. Ohio

11,352

1,383

12.2

21. New Jersey

8,583

1,084

12.6

22. South Dakota

793

104

13.1

23. Kansas

2,757

363

13.2

23. Missouri

5,871

774

13.2

25. Illinois

12,720

1,694

13.3

26. Washington

6,546

878

13.4

27. Alabama

4,616

637

13.8

28. West Virginia

1,793

254

14.2

29. Indiana

6,316

901

14.3

29. Tennessee

6,188

883

14.3

31. Kentucky

4,225

613

14.5

32. Utah

2,755

401

14.6

301,472

45,522

15.1

33. Wyoming

534

81

15.2

34. Colorado

4,930

778

15.8

35. North Carolina

9,149

1,471

16.1

36. South Carolina

4,454

750

16.8

37. Arkansas

2,833

483

17.0

37. Oregon

3,780

643

17.0

39. Arizona

6,502

1,127

17.3

40. Idaho

1,521

264

17.4

40. Louisiana

4,392

762

17.4

42. Mississippi

2,880

514

17.9

43. California

36,377

6,559

18.0

44. Montana

958

174

18.2

45. Oklahoma

3,590

672

18.7

46. Georgia

9,594

1,836

19.1

Rank/Statea

United States

Congressional Research Service

Percent Uninsured

11

The Uninsured by State and Congressional District

Total Population
(in thousands)

Number Uninsured
(in thousands)

47. New Mexico

1,976

390

19.7

48. Florida

18,193

3,795

20.9

49. Alaska

678

143

21.1

50. Nevada

2,610

572

21.9

51. Texas

24,292

5,783

23.8

Rank/Statea

Percent Uninsured

Source: CRS analysis of data from 2009 American Community Survey, U.S. Census Bureau.
a.

All figures are for the civilian non-institutionalized population. Each value in the table is an estimate and
there is a confidence interval around the estimate. While the intervals at the 90% confidence level are not
presented, they are available.

Figure 1. Map: The Uninsured by State – 2009

Source: CRS analysis of data from 2009 American Community Survey, U.S. Census Bureau.

Congressional Research Service

12

The Uninsured by State and Congressional District

Table 4. One-year Change in Percentage Uninsured, by State, 2008-2009

Statea

2008 Estimate
of Percentage
Uninsured (%)

2009 Estimate
of Percentage
Uninsured (%)

One-year Change
in Percentage
Uninsured
(Percentage
Points)

United States

15.1

15.1

0.0

0.0%

Alabama

14.0

13.8

-0.2

-1.43%

Alaska

20.1

21.1

+1.0

4.98%

Arizona

18.7

17.3

-1.4

-7.49%

Arkansas

18.0

17.0

-1.0

-5.56%

California

17.8

18.0

+0.2

1.12%

Colorado

17.2

15.8

-1.4

-8.14%

Connecticut

9.0

8.8

-0.2

-2.22%

Delaware

10.3

10.2

-0.1

-0.97%

District of
Columbia

8.0

7.0

-1.0

-12.50%

Florida

20.8

20.9

+0.1

0.48%

Georgia

18.8

19.1

+0.3

1.60%

Hawaii

6.7

7.0

+0.3

4.48%

Idaho

17.8

17.4

-0.4

-2.25%

Illinois

12.8

13.3

+0.5

3.91%

Indiana

13.9

14.3

+0.4

2.88%

Iowa

9.1

8.6

-0.5

-5.49%

Kansas

12.2

13.2

+1.0

8.20%

Kentucky

14.1

14.5

+0.4

2.84%

Louisiana

17.8

17.4

-0.4

-2.25%

Maine

10.9

10.5

-0.4

-3.67%

Maryland

11.1

11.1

0.0

0.00%

Massachusetts

4.1

4.2

+0.1

2.44%

Michigan

11.5

12.2

+0.7

6.09%

Minnesota

8.7

9.1

+0.4

4.60%

Mississippi

17.9

17.9

0.0

0.00%

Missouri

13.0

13.2

+0.2

1.54%

Montana

18.5

18.2

-0.3

-1.62%

Nebraska

11.1

11.9

+0.8

7.21%

Nevada

21.3

21.9

+0.6

2.82%

New Hampshire

10.8

10.2

-0.6

-5.56%

New Jersey

12.4

12.6

+0.2

1.61%

New Mexico

21.4

19.7

-1.7

-7.94%

Congressional Research Service

One-year Percentage
Change in Percentage
Uninsured
(Percentage Change)

13

The Uninsured by State and Congressional District

2008 Estimate
of Percentage
Uninsured (%)

2009 Estimate
of Percentage
Uninsured (%)

One-year Change
in Percentage
Uninsured
(Percentage
Points)

New York

11.8

11.4

-0.4

-3.39%

North Carolina

15.9

16.1

+0.2

1.26%

North Dakota

10.5

9.7

-0.8

-7.62%

Ohio

11.8

12.2

+0.4

3.39%

Oklahoma

19.5

18.7

-0.8

-4.10%

Oregon

16.4

17.0

+0.6

3.66%

Pennsylvania

9.4

9.9

+0.5

5.32%

Rhode Island

10.5

11.3

+0.8

7.62%

South Carolina

17.4

16.8

-0.6

-3.45%

South Dakota

11.7

13.1

+1.4

11.97%

Tennessee

13.6

14.3

+0.7

5.15%

Texas

24.1

23.8

-0.3

-1.24%

Utah

15.5

14.6

-0.9

-5.81%

Vermont

9.1

8.6

-0.5

-5.49%

Virginia

12.0

11.9

-0.1

-0.83%

Washington

13.1

13.4

+0.3

2.29%

West Virginia

15.8

14.2

-1.6

-10.13%

Wisconsin

9.1

9.4

+0.3

3.30%

Wyoming

13.9

15.2

+1.3

9.35%

Statea

One-year Percentage
Change in Percentage
Uninsured
(Percentage Change)

Source: CRS analysis of data from 2008 and 2009 American Community Survey, U.S. Census Bureau.
a.

Data are based on a sample and are subject to sampling variability. The reported year-on-year change are
based solely on the point estimates and therefore should be interpreted with the understanding that these
differences may be within the confidence interval.

The Uninsured: Characteristics by State, 2009
Table 5 presents the percentage uninsured in each state by four age categories: under age 6, under
age 19, age 21 through age 64, and age 65 and above.23 The first two categories depict two
overlapping groups children, the third category generally captures working adults, and the final
category describes the elderly who are generally covered by Medicare.

23

The under age 6 category is relevant as there is mandatory eligibility for Medicaid for these children with family
incomes up to 133% of FPL. The under age 19 category is relevant since there is also mandatory eligibility for
Medicaid for children ages 6 through 18 with family incomes up to 100% of FPL and 133% of FPL beginning January
1, 2014 although states can choose to extend this coverage prior to 2014.

Congressional Research Service

14

The Uninsured by State and Congressional District

Table 6 rank orders states by the percentage uninsured in each of the age categories, from lowest
to highest. Nationally, 7% of children under age 6 and 9% of children under age 19 were
uninsured. Massachusetts had the lowest proportion of uninsured children, 1.2% under age 6 and
1.5% under age 19, followed by Hawaii, the District of Columbia, and Vermont. Nevada had the
highest proportion of uninsured children, 16.8% under age 6 and 18.4% under age 19, followed
by Alaska, Montana, Texas, and Florida.
Among those adults age 21 through 64, nationally 20.3% were uninsured (see Table 5).
Massachusetts had the lowest proportion of non-elderly adults uninsured with 5.9% followed by
the District of Columbia, Hawaii, Minnesota, and Vermont. Texas, with 30.3%, had the highest
proportion of non-elderly adults uninsured followed by Florida, New Mexico, Nevada, and
Alaska (see Table 6). While no state had more than 1.9% of its elderly population, over age 65,
uninsured, the proportion across the states ranged from 0.1% in Vermont, West Virginia, and Iowa
to 1.9% in Nevada.
Table 7 presents the percentage uninsured in each state by three income categories: under 133%
of FPL , between 133% and 400% of FPL, and above 400% of FPL. Table 8 rank orders the
states by the percentage uninsured in each of the three income categories, from lowest to highest.
Nationally, 27.7% of individual with incomes under 133% of FPL were uninsured, 17.6% of
individuals with incomes between 133% and 400% of FPL were uninsured, and 5.4% of
individuals with incomes over 400% of FPL were uninsured. Massachusetts had the lowest
proportion of individuals with incomes under 133% of FPL, 7.6%, followed by the District of
Columbia, Vermont, and Hawaii. Nevada had the highest proportion of individuals with incomes
under 133% of FPL uninsured, 41.8%, followed by Texas, Florida, Georgia, and Alaska (see
Table 8).
Table 9 presents the percentage uninsured in each state by marital status (single/married). Table
10 rank orders the states by the percentage uninsured by marital status, lowest to highest.
Nationally, 28.2% of those individuals not married (single, separated, divorced, or widowed)
were uninsured whereas 13.6% of those individuals who were married were uninsured.
Massachusetts had the lowest proportion of single adults, age 18 through 64, uninsured with 8.9%
followed by the District of Columbia, Hawaii, Connecticut, and Minnesota. Texas, with 38.4%,
had the highest proportion of single adults, age 18 through 64, uninsured followed by Alaska,
Florida, Nevada, and Oklahoma. Massachusetts had the lowest proportion of married adults, age
18 through 64, uninsured with 2.8% followed by the District of Columbia, Hawaii, Minnesota,
and Vermont. Texas, with 24.3%, had the highest proportion of married adults, age 18 through 64,
uninsured followed by Florida, New Mexico, Nevada, and Oklahoma.
Table 9 also presents the percentage uninsured in each state by employment status (full/part time)
and Table 11 rank orders the states by the percentage uninsured by employment status, lowest to
highest. Nationally, 14.3% of those employed full-time were uninsured while 26.5% of those
employed part-time were uninsured.24 Massachusetts had the lowest proportion of full-time
employed adults, age 18 through 64, uninsured with 4.0% followed by Hawaii, the District of
Columbia, Connecticut, and Minnesota. Texas, with 23.0%, had the highest proportion of full
time employed adults, age 18 through 64, uninsured followed by New Mexico, Florida, Montana,
and Louisiana. Massachusetts had the lowest proportion of part-time employed adults, age 18
24

Individuals did not necessarily obtain their health insurance coverage from their employer and an insured working
part-time may have been covered by another family member working full-time.

Congressional Research Service

15

The Uninsured by State and Congressional District

through 64, uninsured with 8.0% followed by the District of Columbia, Hawaii, Minnesota, and
Iowa. Texas, with 41.2%, had the highest proportion of part-time employed adults, age 18 through
64, uninsured followed by Arkansas, Florida, Nevada, and Oklahoma.
Table 5. Percentage Uninsured by Age, by State, 2009
Under Age 6 (%)

Under Age 19
(%)b

Age 21 Through
64 (%)

Age 65 and Over
(%)

United States

7.0

9.0

20.3

0.9

Alabama

4.5

6.2

19.5

0.5

Alaska

13.7

14.6

26.0

0.7

Arizona

10.0

12.7

22.6

1.3

Arkansas

5.1

7.0

24.6

0.5

California

7.0

10.0

24.1

1.8

Colorado

8.2

10.6

20.0

1.0

Connecticut

3.7

4.0

12.3

0.7

Delaware

4.6

5.6

14.2

0.6

District of Columbia

1.7

3.4

9.4

0.7

Florida

12.1

15.3

28.3

1.3

Georgia

9.2

11.6

25.1

1.2

Hawaii

1.4

2.9

10.0

0.8

Idaho

7.2

11.8

23.0

0.7

Illinois

3.4

4.9

18.8

1.3

Indiana

8.3

9.1

18.9

0.4

Iowa

4.1

4.9

11.9

0.1

Kansas

7.4

8.7

17.3

0.5

Kentucky

5.4

6.9

19.9

0.5

Louisiana

4.8

7.2

24.8

0.8

Maine

5.0

5.8

14.6

0.2

Maryland

3.1

5.1

15.3

0.8

Massachusetts

1.2

1.5

5.9

0.2

Michigan

3.7

5.1

15.3

0.8

Minnesota

5.3

6.7

11.4

0.3

Mississippi

8.7

10.9

24.2

0.2

Missouri

5.9

7.3

18.0

0.4

Montana

12.7

13.1

24.1

0.3

Nebraska

5.2

6.6

16.2

0.6

Nevada

16.8

18.4

26.4

1.9

New Hampshire

3.1

4.9

13.9

0.3

New Jersey

4.8

6.7

17.1

1.4

Statea

Congressional Research Service

16

The Uninsured by State and Congressional District

Under Age 6 (%)

Under Age 19
(%)b

Age 21 Through
64 (%)

Age 65 and Over
(%)

New Mexico

8.3

12.3

26.8

1.3

New York

4.1

4.9

15.9

1.0

North Carolina

5.6

8.7

22.0

0.6

North Dakota

6.2

5.7

13.4

0.4

Ohio

5.2

6.7

16.7

0.4

Oklahoma

10.3

11.7

25.4

0.6

Oregon

8.8

10.9

22.6

0.8

Pennsylvania

5.0

5.6

13.6

0.5

Rhode Island

4.9

5.7

15.5

0.5

South Carolina

9.1

10.5

22.6

0.4

South Dakota

6.8

7.8

18.1

0.4

Tennessee

4.9

6.4

20.3

0.4

Texas

12.5

16.9

30.3

1.8

Utah

9.0

10.6

18.6

0.7

Vermont

2.0

3.5

11.8

0.1

Virginia

5.8

6.9

15.8

0.7

Washington

5.7

7.4

17.8

0.8

West Virginia

4.5

6.0

20.2

0.1

Wisconsin

3.9

5.3

12.4

0.4

Wyoming

8.1

9.3

20.0

0.5

Statea

Source: CRS analysis of data from 2009 American Community Survey, U.S. Census Bureau.
a.

All figures are for the civilian non-institutionalized population. Each value in the table is an estimate and
there is a confidence interval around the estimate. While the intervals at the 90% confidence level are not
presented, they are available.

b.

Under age 19 is includes those under age 6 (i.e., the first two columns are not mutually exclusive). See
footnote 23 for the justification for these age categories.

Congressional Research Service

17

Table 6. Ranking of States by Percentage Uninsured by Age, 2009
Under Age 6 (lowest to highest)
Ranking/Statea

Percent (%)

Under Age 19 (lowest to highest)b
Ranking/State

Percent (%)

Age 21 Through 64 (lowest to
highest)
Ranking/State

Percent (%)

Age 65 and Over (lowest to highest)
Ranking/State

Percent (%)

1. Massachusetts

1.2

1. Massachusetts

1.5

1. Massachusetts

5.9

1. Iowa

0.1

2. Hawaii

1.4

2. Hawaii

2.9

2. District of Columbia

9.4

1. Vermont

0.1

3. District of Columbia

1.7

3. District of Columbia

3.4

3. Hawaii

10.0

1. West Virginia

0.1

4. Vermont

2.0

4. Vermont

3.5

4. Minnesota

11.4

4. Maine

0.2

5. Maryland

3.1

5. Connecticut

4.0

5. Vermont

11.8

4. Massachusetts

0.2

5. New Hampshire

3.1

6. Illinois

4.9

6. Iowa

11.9

4. Mississippi

0.2

7. Illinois

3.4

6. Iowa

4.9

7. Connecticut

12.3

7. Minnesota

0.3

8. Connecticut

3.7

6. New Hampshire

4.9

8. Wisconsin

12.4

7. Montana

0.3

8. Michigan

3.7

6. New York

4.9

9. North Dakota

13.4

7. New Hampshire

0.3

10. Wisconsin

3.9

10. Maryland

5.1

10. Pennsylvania

13.6

10. Indiana

0.4

11. Iowa

4.1

10. Michigan

5.1

11. New Hampshire

13.9

10. Missouri

0.4

11. New York

4.1

12. Wisconsin

5.3

12. Delaware

14.2

10. North Dakota

0.4

13. Alabama

4.5

13. Delaware

5.6

13. Maine

14.6

10. Ohio

0.4

13. West Virginia

4.5

13. Pennsylvania

5.6

14. Maryland

15.3

10. South Carolina

0.4

15. Delaware

4.6

15. North Dakota

5.7

14. Michigan

15.3

10. South Dakota

0.4

16. Louisiana

4.8

15. Rhode Island

5.7

16. Rhode Island

15.5

10. Tennessee

0.4

16. New Jersey

4.8

17. Maine

5.8

17. Virginia

15.8

10. Wisconsin

0.4

18. Rhode Island

4.9

18. West Virginia

6.0

18. New York

15.9

18. Alabama

0.5

18. Tennessee

4.9

19. Alabama

6.2

19. Nebraska

16.2

18. Arkansas

0.5

20. Maine

5.0

20. Tennessee

6.4

20. Ohio

16.7

18. Kansas

0.5

20. Pennsylvania

5.0

21. Nebraska

6.6

21. New Jersey

17.1

18. Kentucky

0.5

22. Arkansas

5.1

22. Minnesota

6.7

22. Kansas

17.3

18. Pennsylvania

0.5

23. Nebraska

5.2

22. New Jersey

6.7

23. Washington

17.8

18. Rhode Island

0.5

CRS-18

Under Age 6 (lowest to highest)
Ranking/Statea

Percent (%)

Under Age 19 (lowest to highest)b
Ranking/State

Percent (%)

Age 21 Through 64 (lowest to
highest)
Ranking/State

Percent (%)

Age 65 and Over (lowest to highest)
Ranking/State

Percent (%)

23. Ohio

5.2

22. Ohio

6.7

24. Missouri

18.0

18. Wyoming

0.5

25. Minnesota

5.3

25. Kentucky

6.9

25. South Dakota

18.1

25. Delaware

0.6

26. Kentucky

5.4

25. Virginia

6.9

26. Utah

18.6

25. Nebraska

0.6

27. North Carolina

5.6

27. Arkansas

7.0

27. Illinois

18.8

25. North Carolina

0.6

28. Washington

5.7

28. Louisiana

7.2

28. Indiana

18.9

25. Oklahoma

0.6

29. Virginia

5.8

29. Missouri

7.3

29. Alabama

19.5

29. Alaska

0.7

30. Missouri

5.9

30. Washington

7.4

30. Kentucky

19.9

29. Connecticut

0.7

31. North Dakota

6.2

31. South Dakota

7.8

31. Colorado

20.0

29. District of Columbia

0.7

32. South Dakota

6.8

32. Kansas

8.7

31. Wyoming

20.0

29. Idaho

0.7

33. California

7.0

32. North Carolina

8.7

33. West Virginia

20.2

29. Utah

0.7

United States

7.0

United States

9.0

34. Tennessee

20.3

29. Virginia

0.7

34. Idaho

7.2

34. Indiana

9.1

United States

20.3

35. Hawaii

0.8

35. Kansas

7.4

35. Wyoming

9.3

35. North Carolina

22.0

35. Louisiana

0.8

36. Wyoming

8.1

36. California

10.0

36. Arizona

22.6

35. Maryland

0.8

37. Colorado

8.2

37. South Carolina

10.5

36. Oregon

22.6

35. Michigan

0.8

38. Indiana

8.3

38. Colorado

10.6

36. South Carolina

22.6

35. Oregon

0.8

38. New Mexico

8.3

38. Utah

10.6

39. Idaho

23.0

35. Washington

0.8

40. Mississippi

8.7

40. Mississippi

10.9

40. California

24.1

United States

0.9

41. Oregon

8.8

40. Oregon

10.9

40. Montana

24.1

41. Colorado

1.0

42. Utah

9.0

42. Georgia

11.6

42. Mississippi

24.2

41. New York

1.0

43. South Carolina

9.1

43. Oklahoma

11.7

43. Arkansas

24.6

43. Georgia

1.2

44. Georgia

9.2

44. Idaho

11.8

44. Louisiana

24.8

44. Arizona

1.3

45. Arizona

10.0

45. New Mexico

12.3

45. Georgia

25.1

44. Florida

1.3

46. Oklahoma

10.3

46. Arizona

12.7

46. Oklahoma

25.4

44. Illinois

1.3

47. Florida

12.1

47. Montana

13.1

47. Alaska

26.0

44. New Mexico

1.3

CRS-19

Under Age 6 (lowest to highest)
Ranking/Statea

Percent (%)

Under Age 19 (lowest to highest)b
Ranking/State

Percent (%)

Age 21 Through 64 (lowest to
highest)
Ranking/State

Percent (%)

Age 65 and Over (lowest to highest)
Ranking/State

Percent (%)

48. Texas

12.5

48. Alaska

14.6

48. Nevada

26.4

48. New Jersey

1.4

49. Montana

12.7

49. Florida

15.3

49. New Mexico

26.8

49. California

1.8

50. Alaska

13.7

50. Texas

16.9

50. Florida

28.3

49. Texas

1.8

51. Nevada

16.8

51. Nevada

18.4

51. Texas

30.3

51. Nevada

1.9

Source: CRS analysis of data from 2009 American Community Survey, U.S. Census Bureau.
a.

All rankings are for the civilian non-institutionalized population. While the rankings are based on the point estimates, there is a confidence interval around each
estimate and therefore the rankings should be interpreted as indicative. Although the intervals at the 90% confidence level are not presented, they are available.
Columns sorted initially by percent uninsured and then alphabetically. Ties are not indicated.

b.

Under age 19 is includes those under age 6 (i.e., the first two columns are not mutually exclusive). See footnote 23 for the justification for these age categories.

CRS-20

The Uninsured by State and Congressional District

Table 7. Percentage Uninsured, by Income by State, 2009
Statea

Under 133% of the FPL

Between 133% - 400%
of the FPL

Greater than 400% of
the FPL

United States

27.7

17.6

5.4

Alabama

26.3

13.5

3.9

Alaska

33.9

27.4

11.7

Arizona

28.0

19.2

7.2

Arkansas

28.1

17.0

5.9

California

29.8

22.7

6.7

Colorado

33.6

18.8

5.2

Connecticut

18.8

13.0

3.7

Delaware

17.1

13.5

4.7

District of Columbia

8.3

11.0

4.0

Florida

35.0

23.4

7.6

Georgia

34.8

20.8

6.1

Hawaii

15.1

7.7

3.3

Idaho

30.5

18.0

5.8

Illinois

25.5

15.8

5.2

Indiana

27.9

15.3

4.4

Iowa

19.2

9.4

2.6

Kansas

28.0

14.2

3.8

Kentucky

26.5

14.8

3.7

Louisiana

28.0

19.0

7.1

Maine

15.2

12.9

4.8

Maryland

24.4

15.6

4.8

Massachusetts

7.6

6.2

1.9

Michigan

22.1

13.2

4.4

Minnesota

18.1

11.4

3.5

Mississippi

27.4

17.6

6.6

Missouri

25.6

14.0

4.4

Montana

29.5

20.2

7.5

Nebraska

25.6

12.9

3.3

Nevada

41.8

24.3

7.8

New Hampshire

23.0

13.2

4.5

New Jersey

25.7

18.4

5.4

New Mexico

31.1

21.3

7.3

New York

17.5

15.0

5.4

North Carolina

29.8

17.4

4.7

Congressional Research Service

21

The Uninsured by State and Congressional District

Statea

Under 133% of the FPL

Between 133% - 400%
of the FPL

Greater than 400% of
the FPL

North Dakota

22.0

10.5

3.4

Ohio

23.4

13.1

4.1

Oklahoma

31.7

19.7

7.0

Oregon

31.8

18.9

5.9

Pennsylvania

18.6

11.7

3.9

Rhode Island

19.7

14.3

5.5

South Carolina

28.7

18.2

5.6

South Dakota

27.3

13.4

3.6

Tennessee

24.8

14.9

4.8

Texas

39.7

26.8

7.9

Utah

30.1

15.0

5.6

Vermont

12.2

11.2

4.6

Virginia

26.5

15.6

3.9

Washington

25.7

16.8

4.9

West Virginia

23.5

14.1

5.5

Wisconsin

19.8

10.1

3.4

Wyoming

29.1

17.8

7.0

Source: CRS analysis of data from 2009 American Community Survey, U.S. Census Bureau.
a.

All figures are for the civilian non-institutionalized population – all ages. Each value in the table is an estimate
and there is a confidence interval around the estimate. While the intervals at the 90% confidence level are
not presented, they are available.

Congressional Research Service

22

The Uninsured by State and Congressional District

Table 8. Ranking of States by Percentage Uninsured by Income, 2009
(lowest to highest)
Under 133% of the FPLa
Ranking/State

Percent
(%)

Between 133% - 400% of the
FPL
Ranking/State

Percent
(%)

Greater than 400% of the FPL
Ranking/State

Percent
(%)

1. Massachusetts

7.6

1. Massachusetts

6.2

1. Massachusetts

1.9

2. District of Columbia

8.3

2. Hawaii

7.7

2. Iowa

2.6

3. Vermont

12.2

3. Iowa

9.4

3. Hawaii

3.3

4. Hawaii

15.1

4. Wisconsin

10.1

3. Nebraska

3.3

5. Maine

15.2

5. North Dakota

10.5

5. North Dakota

3.4

6. Delaware

17.1

6. District of
Columbia

11.0

5. Wisconsin

3.4

7. New York

17.5

7. Vermont

11.2

7. Minnesota

3.5

8. Minnesota

18.1

8. Minnesota

11.4

8. South Dakota

3.6

9. Pennsylvania

18.6

9. Pennsylvania

11.7

9. Connecticut

3.7

10. Connecticut

18.8

10. Maine

12.9

9. Kentucky

3.7

11. Iowa

19.2

10. Nebraska

12.9

11. Kansas

3.8

12. Rhode Island

19.7

12. Connecticut

13.0

12. Alabama

3.9

13. Wisconsin

19.8

13. Ohio

13.1

12. Pennsylvania

3.9

14. North Dakota

22.0

14. Michigan

13.2

12. Virginia

3.9

15. Michigan

22.1

14. New Hampshire

13.2

15. District of Columbia

4.0

16. New Hampshire

23.0

16. South Dakota

13.4

16. Ohio

4.1

17. Ohio

23.4

17. Alabama

13.5

17. Indiana

4.4

18. West Virginia

23.5

17. Delaware

13.5

17. Michigan

4.4

19. Maryland

24.4

19. Missouri

14.0

17. Missouri

4.4

20. Tennessee

24.8

20. West Virginia

14.1

20. New Hampshire

4.5

21. Illinois

25.5

21. Kansas

14.2

21. Vermont

4.6

22. Missouri

25.6

22. Rhode Island

14.3

22. Delaware

4.7

22. Nebraska

25.6

23. Kentucky

14.8

22. North Carolina

4.7

24. New Jersey

25.7

24. Tennessee

14.9

24. Maine

4.8

24. Washington

25.7

25. New York

15.0

24. Maryland

4.8

26. Alabama

26.3

25. Utah

15.0

24. Tennessee

4.8

27. Kentucky

26.5

27. Indiana

15.3

27. Washington

4.9

27. Virginia

26.5

28. Maryland

15.6

28. Colorado

5.2

29. South Dakota

27.3

28. Virginia

15.6

28. Illinois

5.2

30. Mississippi

27.4

30. Illinois

15.8

30. New Jersey

5.4

United States

27.7

31. Washington

16.8

30. New York

5.4

31. Indiana

27.9

32. Arkansas

17.0

United States

5.4

Congressional Research Service

23

The Uninsured by State and Congressional District

Under 133% of the FPLa
Ranking/State

Percent
(%)

Between 133% - 400% of the
FPL
Ranking/State

Percent
(%)

Greater than 400% of the FPL
Ranking/State

Percent
(%)

32. Arizona

28.0

33. North Carolina

17.4

32. Rhode Island

5.5

32. Kansas

28.0

34. Mississippi

17.6

32. West Virginia

5.5

32. Louisiana

28.0

United States

17.6

34. South Carolina

5.6

35. Arkansas

28.1

35. Wyoming

17.8

34. Utah

5.6

36. South Carolina

28.7

36. Idaho

18.0

36. Idaho

5.8

37. Wyoming

29.1

37. South Carolina

18.2

37. Arkansas

5.9

38. Montana

29.5

38. New Jersey

18.4

37. Oregon

5.9

39. California

29.8

39. Colorado

18.8

39. Georgia

6.1

39. North Carolina

29.8

40. Oregon

18.9

40. Mississippi

6.6

41. Utah

30.1

41. Louisiana

19.0

41. California

6.7

42. Idaho

30.5

42. Arizona

19.2

42. Oklahoma

7.0

43. New Mexico

31.1

43. Oklahoma

19.7

42. Wyoming

7.0

44. Oklahoma

31.7

44. Montana

20.2

44. Louisiana

7.1

45. Oregon

31.8

45. Georgia

20.8

45. Arizona

7.2

46. Colorado

33.6

46. New Mexico

21.3

46. New Mexico

7.3

47. Alaska

33.9

47. California

22.7

47. Montana

7.5

48. Georgia

34.8

48. Florida

23.4

48. Florida

7.6

49. Florida

35.0

49. Nevada

24.3

49. Nevada

7.8

50. Texas

39.7

50. Texas

26.8

50. Texas

7.9

51. Nevada

41.8

51. Alaska

27.4

51. Alaska

11.7

Source: CRS analysis of data from 2009 American Community Survey, U.S. Census Bureau.
a.

Rankings are for the civilian non-institutionalized population. While rankings are based on the point
estimates, there is a confidence interval around each estimate and therefore the rankings should be
interpreted as indicative. Although the intervals at the 90% confidence level are not presented, they are
available. Columns sorted initially by percent uninsured and then alphabetically.

Table 9. Percentage Uninsured by Marital and Employment Status by State, 2009
Single

Married

Employed Full
Timeb

Employed Part
Time

United States

28.2

13.6

14.3

26.5

Alabama

28.5

11.9

12.3

27.1

Alaska

38.3

15.1

18.0

33.4

Arizona

29.5

16.8

17.3

29.0

Arkansas

34.6

17.5

17.1

36.2

California

30.8

18.0

17.3

30.3

Colorado

28.6

13.4

14.1

26.8

Statea

Congressional Research Service

24

The Uninsured by State and Congressional District

Single

Married

Employed Full
Timeb

Employed Part
Time

Connecticut

18.6

6.8

7.8

16.9

Delaware

19.8

8.7

10.4

19.7

District of Columbia

10.8

4.6

6.8

11.5

Florida

37.0

20.1

21.6

36.1

Georgia

34.4

17.0

17.2

33.3

Hawaii

15.3

5.7

5.4

14.7

Idaho

33.6

16.8

15.8

32.8

Illinois

27.2

11.4

12.5

23.0

Indiana

28.2

11.7

12.1

25.1

Iowa

19.9

6.3

8.4

16.0

Kansas

26.4

10.8

12.3

24.9

Kentucky

29.5

13.3

12.8

28.1

Louisiana

34.5

15.1

19.0

32.0

Maine

21.7

8.4

11.2

21.0

Maryland

22.0

9.0

9.8

21.6

Massachusetts

8.9

2.8

4.0

8.0

Michigan

25.8

9.8

11.0

22.2

Minnesota

18.8

6.0

8.2

15.9

Mississippi

33.3

15.9

16.6

34.2

Missouri

26.8

10.9

12.2

24.2

Montana

33.7

15.4

19.2

28.5

Nebraska

25.8

9.4

17.4

21.9

Nevada

36.1

19.0

17.4

35.8

New Hampshire

21.7

7.9

8.9

20.9

New Jersey

25.4

10.3

12.2

21.5

New Mexico

34.6

19.8

21.8

32.1

New York

21.2

10.2

12.1

20.6

North Carolina

31.1

14.5

15.0

30.7

North Dakota

21.9

6.6

9.3

17.8

Ohio

25.6

8.7

10.3

21.8

Oklahoma

35.2

18.0

18.7

35.3

Oregon

32.1

14.5

14.7

29.0

Pennsylvania

20.6

7.4

8.8

18.4

Rhode Island

22.3

8.5

10.8

17.7

South Carolina

32.2

14.2

15.0

30.7

South Dakota

27.3

10.7

13.2

24.5

Tennessee

29.3

12.5

13.3

26.3

Texas

38.4

24.3

23.0

41.2

Statea

Congressional Research Service

25

The Uninsured by State and Congressional District

Single

Married

Employed Full
Timeb

Employed Part
Time

Utah

26.9

13.5

13.4

23.7

Vermont

19.2

6.0

9.9

17.0

Virginia

23.2

9.7

10.6

23.0

Washington

26.3

11.2

11.2

24.8

West Virginia

30.5

12.8

15.5

29.3

Wisconsin

21.0

6.1

8.5

16.0

Wyoming

30.0

13.7

14.1

30.4

Statea

Source: CRS analysis of data from 2009 American Community Survey, U.S. Census Bureau.
a.

All figures are for the civilian non-institutionalized population. Each value in the table is an estimate and
there is a confidence interval around the estimate. While the intervals at the 90% confidence level are not
presented, they are available.

b.

Full time is defined as working 30 or more hours a week for 50 or more weeks and part-time is defined as
working fewer than 30 hours a week or less than 50 weeks per year.

Table 10. Ranking of States by Percentage Uninsured by Marital Status, 2009
(lowest to highest)
Single
Rank

State

Married
Percent
Uninsured (%)

Rank

State

Percent
Uninsured (%)

1.

Massachusetts

8.9

1.

Massachusetts

2.8

2.

District of Columbia

10.8

2.

District of Columbia

4.6

3.

Hawaii

15.3

3.

Hawaii

5.7

4.

Connecticut

18.6

4.

Minnesota

6.0

5.

Minnesota

18.8

4

Vermont

6.0

6.

Vermont

19.2

6.

Wisconsin

6.1

7.

Delaware

19.8

7.

Iowa

6.3

8.

Iowa

19.9

8.

North Dakota

6.6

9.

Pennsylvania

20.6

9.

Connecticut

6.8

10

Wisconsin

21.0

10

Pennsylvania

7.4

11.

New York

21.2

11.

New Hampshire

7.9

12.

Maine

21.7

12.

Maine

8.4

12.

New Hampshire

21.7

13.

Rhode Island

8.5

14.

North Dakota

21.9

14.

Delaware

8.7

15.

Maryland

22.0

14.

Ohio

8.7

16.

Rhode Island

22.3

16.

Maryland

9.0

17.

Virginia

23.2

17.

Nebraska

9.4

18.

New Jersey

25.4

18.

Virginia

9.7

19.

Ohio

25.6

19.

Michigan

9.8

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26

The Uninsured by State and Congressional District

Single
Rank

State

Married
Percent
Uninsured (%)

Rank

State

Percent
Uninsured (%)

20.

Michigan

25.8

20

New York

10.2

20.

Nebraska

25.8

21.

New Jersey

10.3

22.

Washington

26.3

22.

South Dakota

10.7

23.

Kansas

26.4

23.

Kansas

10.8

24.

Missouri

26.8

24.

Missouri

10.9

25.

Utah

26.9

25.

Washington

11.2

26.

Illinois

27.2

26.

Illinois

11.4

27.

South Dakota

27.3

27.

Indiana

11.7

United States

28.2

28.

Alabama

11.9

28.

Indiana

28.2

29.

Tennessee

12.5

29

Alabama

28.5

30.

West Virginia

12.8

30.

Colorado

28.6

31.

Kentucky

13.3

31.

Tennessee

29.3

32.

Colorado

13.4

32.

Arizona

29.5

33.

Utah

13.5

32.

Kentucky

29.5

United States

13.6

34.

Wyoming

30.0

34.

Wyoming

13.7

35.

West Virginia

30.5

35.

South Carolina

14.2

36.

California

30.8

36.

North Carolina

14.5

37.

North Carolina

31.1

36.

Oregon

14.5

38.

Oregon

32.1

38.

Louisiana

15.1

39

South Carolina

32.2

38

Alaska

15.1

40.

Mississippi

33.3

40.

Montana

15.4

41.

Idaho

33.6

41.

Mississippi

15.9

42.

Montana

33.7

42.

Arizona

16.8

43.

Georgia

34.4

42.

Idaho

16.8

44.

Louisiana

34.5

44.

Georgia

17.0

45.

Arkansas

34.6

45.

Arkansas

17.5

45.

New Mexico

34.6

46.

California

18.0

47.

Oklahoma

35.2

46.

Oklahoma

18.0

48.

Nevada

36.1

48.

Nevada

19.0

49

Florida

37.0

49

New Mexico

19.8

50.

Alaska

38.3

50.

Florida

20.1

51.

Texas

38.4

51.

Texas

24.3

Source: CRS analysis of data from 2009 American Community Survey, U.S. Census Bureau.

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The Uninsured by State and Congressional District

Notes: Rankings are for the civilian non-institutionalized population age 18-64. While rankings are based on the
point estimates, there is a confidence interval around each estimate and therefore the rankings should be
interpreted as indicative. Although the intervals at the 90% confidence level are not presented, they are available.
Columns sorted initially by percent uninsured and then alphabetically.

Table 11. Ranking of States by Percentage Uninsured by Employment Status, 2009
(lowest to highest)
Employed Full Time

Rank

State

Employed Part Time
Percent
Uninsured
(%)

Rank

State

Percent
Uninsured (%)

1.

Massachusetts

4.0

1.

Massachusetts

8.0

2.

Hawaii

5.4

2.

District of Columbia

11.5

3.

District of Columbia

6.8

3.

Hawaii

14.7

4.

Connecticut

7.8

4.

Minnesota

15.9

5.

Minnesota

8.2

5.

Iowa

16.0

6.

Iowa

8.4

5.

Wisconsin

16.0

7.

Wisconsin

8.5

7.

Connecticut

16.9

8.

Pennsylvania

8.8

8.

Vermont

17.0

9.

New Hampshire

8.9

9.

Rhode Island

17.7

10

North Dakota

9.3

10

North Dakota

17.8

11.

Maryland

9.8

11.

Pennsylvania

18.4

12.

Vermont

9.9

12.

Delaware

19.7

13.

Ohio

10.3

13.

New York

20.6

14.

Delaware

10.4

14.

New Hampshire

20.9

15.

Virginia

10.6

15.

Maine

21.0

16.

Rhode Island

10.8

16.

New Jersey

21.5

17.

Michigan

11.0

17.

Maryland

21.6

18.

Maine

11.2

18.

Ohio

21.8

18.

Washington

11.2

19.

Nebraska

21.9

20

Indiana

12.1

20

Michigan

22.2

20.

New York

12.1

21.

Illinois

23.0

22.

Missouri

12.2

21.

Virginia

23.0

22.

New Jersey

12.2

23.

Utah

23.7

24.

Alabama

12.3

24.

Missouri

24.2

24.

Kansas

12.3

25.

South Dakota

24.5

26.

Illinois

12.5

26.

Washington

24.8

27.

Kentucky

12.8

27.

Kansas

24.9

28.

South Dakota

13.2

28.

Indiana

25.1

29.

Tennessee

13.3

29.

Tennessee

26.3

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The Uninsured by State and Congressional District

Employed Full Time

Rank

State

Employed Part Time
Percent
Uninsured
(%)

30.

Utah

13.4

31.

Colorado

14.1

31.

Wyoming

Rank

State

Percent
Uninsured (%)

United States

26.5

30.

Colorado

26.8

14.1

31.

Alabama

27.1

United States

14.3

32.

Kentucky

28.1

33.

Oregon

14.7

33.

Montana

28.5

34.

North Carolina

15.0

34.

Arizona

29.0

34.

South Carolina

15.0

34.

Oregon

29.0

36.

West Virginia

15.5

36.

West Virginia

29.3

37.

Idaho

15.8

37.

California

30.3

38.

Mississippi

16.6

38.

Wyoming

30.4

39

Arkansas

17.1

39

North Carolina

30.7

40.

Georgia

17.2

39.

South Carolina

30.7

41.

Arizona

17.3

41.

Louisiana

32.0

41.

California

17.3

42.

New Mexico

32.1

43.

Nebraska

17.4

43.

Idaho

32.8

43.

Nevada

17.4

44.

Georgia

33.3

45.

Alaska

18.0

45.

Alaska

33.4

46.

Oklahoma

18.7

46.

Mississippi

34.2

47.

Louisiana

19.0

47.

Oklahoma

35.3

48.

Montana

19.2

48.

Nevada

35.8

49

Florida

21.6

49

Florida

36.1

50.

New Mexico

21.8

50.

Arkansas

36.2

51.

Texas

23.0

51.

Texas

41.2

Source: CRS analysis of data from 2009 American Community Survey, U.S. Census Bureau.
Notes: Rankings are for the civilian non-institutionalized population age 18-64. While rankings are based on the
point estimates, there is a confidence interval around each estimate and therefore the rankings should be
interpreted as indicative. Although the intervals at the 90% confidence level are not presented, they are available.
Columns sorted initially by percent uninsured and then alphabetically.

The Uninsured: Characteristics by Congressional
District (111th Congress)
Of the 435 congressional districts, 245 had fewer uninsureds in 2009, as a proportion of their
population, than the national average of 15.1% and more than 80 congressional districts had
fewer then 10% of their populations uninsured in 2009. Of the 10 congressional districts with the
lowest proportion of uninsureds, nine were in Massachusetts. The 4th congressional district in

Congressional Research Service

29

The Uninsured by State and Congressional District

Massachusetts, an area west and south of Boston, had the lowest proportion of uninsureds in the
country with just 3.2% of its population uninsured. The fifth congressional district in Wisconsin,
north and west of Milwaukee, was the only non-Massachusetts district among the ten districts
with the lowest proportion of uninsureds.
There were 12 congressional districts in 2009 where more than 30% of their populations were
uninsured: six in Texas (32, 18, 28, 30, 9, and 29), three in California (47, 34, and 31), two in
Florida (23 and 17) and one in Arizona (4). California’s 31st congressional district, covering parts
of Los Angeles, had the highest proportion of uninsureds of any congressional district with 38.5%
uninsured.
In the appendix that follows, two tables are presented for each state and the District of Columbia.
The first table presents the proportion uninsured in 2009 by gender, age, income, and marital and
employment status. The second table presents the proportion of uninsured, estimated by the
Census Bureau, for each congressional district in 2009. Both sets of estimates were generated by
the Census Bureau based on the 2009 American Community Survey.

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The Uninsured by State and Congressional District

Appendix. State and Congressional District
Data Tables
Alabama
Table A-1. Alabama: Characteristics of the Uninsured, 2009

Total Populationa
(in thousands)
Total Population

Number
Uninsured (in
thousands)

Percent
Uninsured

Above (+), At
(x), or Below (-)
National
Averageb

4,616

637

13.8

-

Male

2,400

301

12.5

-

Female

2,216

336

15.2

-

Under Age 6

373

17

4.5

-

Under Age 19

1,194

74

6.2

-

Under Age 26

1,640

216

13.2

-

Age 19 through 21

206

64

31.0

x

Age 21 through 64

2,660

518

19.5

-

Age 65 and over

624

3

0.5

-

Poverty Status

4,570

≤133% FPL

1,140

300

26.3

-

>133 to <400% FPL

2,067

279

13.5

-

≥400% + FPL

1,363

53

3.9

-

Total Population
Age 18-64

2,868

Singlec

1,360

388

28.5

x

Married

1,508

179

11.9

-

Employed Full Timed

1,448

178

12.3

-

Employed Part Timee

431

117

27.1

x

Source: U.S. Census Bureau, 2009 American Community Survey.
a.

Total population figures are for the civilian non-institutionalized population. Each value in the table is an
estimate with an associated confidence interval around it. While the confidence intervals are not presented,
they are available.

b.

Above (below) the national level means that subgroup at the state level, has, with a 90% confidence level, a
statistically significant higher (lower) likelihood of being uninsured than the same subgroup at the national
level. If a subgroup is at the national level, there is no statistical difference between the proportion of
individuals uninsured in the subgroup at the state level as compared to the subgroup at the national level.

c.

Never married, separated, divorced, or widowed.

d.

Working 30 or more hours for 50 or more weeks a year.

e.

Working fewer than 30 hours a week for fewer than 50 weeks a year.

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The Uninsured by State and Congressional District

Table A-2. Alabama: Number and Percentage of People Without Health Insurance,
by State and Congressional District (111th), 2009

Congressional District
Alabama

Total Population
(in thousands)a

Number
Uninsured (in
thousands)

Percent
Uninsured

Above (+), At
(x), or Below (-)
National
Averageb

4,616

637

13.8

Congressional District 1

684

107

15.6

+

Congressional District 2

661

91

13.7

-

Congressional District 3

661

97

14.6

-

Congressional District 4

652

100

15.4

+

Congressional District 5

703

90

12.8

-

Congressional District 6

735

68

9.2

-

Congressional District 7

612

97

15.9

+

Source: U.S. Census Bureau, 2009 American Community Survey (ACS).
a.

Total population figures are for the civilian non-institutionalized population. Each value in the table is an
estimate and there is a confidence interval around the estimate. While the intervals at the 90% confidence
level are not presented, they are available.

b.

No statistical test of this difference was performed.

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The Uninsured by State and Congressional District

Alaska
Table A-3. Alaska: Characteristics of the Uninsured, 2009

Total Populationa
(in thousands)
Total Population

Number
Uninsured (in
thousands)

Percent
Uninsured

Above (+), At
(x), or Below (-)
National
Averageb

678

143

21.1

+

Male

334

63

19.0

+

Female

344

80

23.1

+

Under Age 6

64

9

13.7

+

Under Age 19

198

29

14.6

+

Under Age 26

273

58

21.2

+

Age 19 through 21

34

12

36.5

+

Age 21 through 64

406

105

26.0

+

Age 65 and over

51

0.4

0.7

x

Poverty Status

669

≤133% FPL

91

31

33.9

+

>133 to <400% FPL

276

76

27.4

+

≥400% + FPL

303

35

11.7

+

Total Population
Age 18-64

444

Singlec

219

84

38.3

+

Married

225

34

15.1

x

Employed Full Timed

212

38

18.0

+

Employed Part Timee

105

35

33.4

+

Source: U.S. Census Bureau, 2009 American Community Survey.
a.

Total population figures are for the civilian non-institutionalized population. Each value in the table is an
estimate with an associated confidence interval around it. While the confidence intervals are not presented,
they are available.

b.

Above (below) the national level means that subgroup at the state level, has, with a 90% confidence level, a
statistically significantly higher (lower) likelihood of being uninsured than the same subgroup at the national
level. If a subgroup is at the national level, there is no statistical difference between the proportion of
individuals uninsured in the subgroup at the state level as compared to the subgroup at the national level.

c.

Never married, separated, divorced, or widowed.

d.

Working 30 or more hours for 50 or more weeks a year.

e.

Working fewer than 30 hours a week for fewer than 50 weeks a year.

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The Uninsured by State and Congressional District

Table A-4. Alaska: Number and Percentage of People Without Health Insurance,
by State and Congressional District (111th), 2009

Congressional
District

Total Population
(in thousands)a

Number
Uninsured (in
thousands)

Percent
Uninsured

Alaska

678

143

21.1

At Large Alaska

678

143

21.1

Above (+), At (x),
or Below (-)
National
Averageb

+

Source: U.S. Census Bureau, 2009 American Community Survey.
a.

Total population figures are for the civilian non-institutionalized population. Each value in the table is an
estimate and there is a confidence interval around the estimate. While the intervals at the 90% confidence
level are not presented, they are available.

b.

No statistical test of this difference was performed.

Congressional Research Service

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The Uninsured by State and Congressional District

Arizona
Table A-5. Arizona: Characteristics of the Uninsured, 2009

Total Populationa
(in thousands)

Number
Uninsured (in
thousands)

Percent
Uninsured

Above (+), At
(x), or Below (-)
National
Averageb

6,502

1,127

17.3

+

Male

3,269

497

15.2

+

Female

3,233

629

19.5

+

Under Age 6

616

62

10.0

+

Under Age 19

1,821

232

12.7

+

Under Age 26

2,428

437

18.0

+

Age 19 through 21

260

88

33.9

+

Age 21 through 64

3,653

827

22.6

+

Age 65 and over

854

11

1.3

+

Total Population

Poverty Status

6,459

≤133% FPL

1,519

425

28.0

x

>133 to <400% FPL

2,853

547

19.2

+

≥400% + FPL

2,087

150

7.2

+

Total Population
Age 18-64

3,918

Singlec

1,964

579

29.5

+

Married

1,953

329

16.8

+

Employed Full Timed

2,006

348

17.3

+

Employed Part Timee

651

189

29.0

+

Source: U.S. Census Bureau, 2009 American Community Survey.
a.

Total population figures are for the civilian non-institutionalized population. Each value in the table is an
estimate with an associated confidence interval around it. While the confidence intervals are not presented,
they are available.

b.

Above (below) the national level means that subgroup at the state level, has, with a 90% confidence level, a
statistically significantly higher (lower) likelihood of being uninsured than the same subgroup at the national
level. If a subgroup is at the national level, there is no statistical difference between the proportion of
individuals uninsured in the subgroup at the state level as compared to the subgroup at the national level.

c.

Never married, separated, divorced, or widowed.

d.

Working 30 or more hours for 50 or more weeks a year.

e.

Working fewer than 30 hours a week for fewer than 50 weeks a year.

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The Uninsured by State and Congressional District

Table A-6. Arizona: Number and Percentage of People Without Health Insurance,
by State and Congressional District (111th), 2009

Congressional
District
Arizona

Total Population
(in thousands)a

Number
Uninsured (in
thousands)

Percent
Uninsured

Above (+), At
(x), or Below (-)
National
Averageb

6,502

1,127

17.3

Congressional District 1

758

130

17.1

+

Congressional District 2

957

144

15.0

-

Congressional District 3

758

121

16.0

+

Congressional District 4

761

234

30.7

+

Congressional District 5

726

107

14.7

-

Congressional District 6

974

137

14.1

-

Congressional District 7

892

187

20.9

+

Congressional District 8

768

84

10.9

-

Source: U.S. Census Bureau, 2009 American Community Survey.
a.

Total population figures are for the civilian non-institutionalized population. Each value in the table is an
estimate and there is a confidence interval around the estimate. While the intervals at the 90% confidence
level are not presented, they are available.

b.

No statistical test of this difference was performed.

Congressional Research Service

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The Uninsured by State and Congressional District

Arkansas
Table A-7. Arkansas: Characteristics of the Uninsured, 2009

Total Populationa
(in thousands)
Total Population

Number
Uninsured (in
thousands)

Percent
Uninsured

Above (+), At
(x), or Below (-)
National
Averageb

2,833

483

17.0

+

Male

1,457

233

16.0

+

Female

1,376

250

18.1

+

Under Age 6

242

12

5.1

-

Under Age 19

750

53

7.0

-

Under Age 26

1,017

158

15.5

x

Age 19 through 21

121

46

38.4

+

Age 21 through 64

1,611

396

24.6

+

Age 65 and over

392

2

0.5

-

Poverty Status

2,798

≤133% FPL

758

213

28.1

x

1,308

222

17.0

x

≥400% + FPL

732

43

5.9

x

Total Population
Age 18-64

1,735

>133 to <400% FPL

Singlec

776

269

34.6

+

Married

959

168

17.5

+

Employed Full Timed

901

154

17.1

+

Employed Part Timee

276

100

36.2

+

Source: U.S. Census Bureau, 2009 American Community Survey.
a.

Total population figures are for the civilian non-institutionalized population. Each value in the table is an
estimate with an associated confidence interval around it. While the confidence intervals are not presented,
they are available.

b.

Above (below) the national level means that subgroup at the state level, has, with a 90% confidence level, a
statistically significantly higher (lower) likelihood of being uninsured than the same subgroup at the national
level. If a subgroup is at the national level, there is no statistical difference between the proportion of
individuals uninsured in the subgroup at the state level as compared to the subgroup at the national level.

c.

Never married, separated, divorced, or widowed.

d.

Working 30 or more hours for 50 or more weeks a year.

e.

Working fewer than 30 hours a week for fewer than 50 weeks a year.

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The Uninsured by State and Congressional District

Table A-8. Arkansas: Number and Percentage of People Without Health Insurance,
by State and Congressional District (111th), 2009

Congressional District
Arkansas

Total Population
(in thousands)a

Number
Uninsured (in
thousands)

Percent
Uninsured

Above (+), At
(x), or Below (-)
National
Averageb

2,833

483

17.0

Congressional District 1

679

115

16.9

+

Congressional District 2

737

108

14.7

-

Congressional District 3

819

150

18.3

+

Congressional District 4

655

120

18.3

+

Source: U.S. Census Bureau, 2009 American Community Survey.
a.

Total population figures are for the civilian non-institutionalized population. Each value in the table is an
estimate and there is a confidence interval around the estimate. While the intervals at the 90% confidence
level are not presented, they are available.

b.

No statistical test of this difference was performed.

Congressional Research Service

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The Uninsured by State and Congressional District

California
Table A-9.California: Characteristics of the Uninsured, 2009
Total
Populationa (in
thousands)
Total Population

Number
Uninsured (in
thousands)

Percent
Uninsured

Above (+), At
(x), or Below
(-) National
Averageb

36,377

6,559

18.0

+

Male

18,305

2,914

15.9

+

Female

18,072

3,645

20.2

+

Under Age 6

3,246

228

7.0

x

Under Age 19

9,985

997

10.0

+

Under Age 26

13,603

2,311

17.0

+

Age 19 through 21

1,591

544

34.2

+

Age 21 through 64

21,300

5,137

24.1

+

Age 65 and over

4,024

73

1.8

+

Poverty Status

36,089

≤133% FPL

7,542

2,249

29.8

+

>133 to <400% FPL

14,788

3,360

22.7

+

≥400% + FPL

13,759

924

6.7

+

Total Population Age 18-64

22,930

Singlec

11,435

3,523

30.8

+

Married

11,495

2,073

18.0

+

Employed Full Timed

11,503

1,992

17.3

+

Employed Part Timee

4,249

1,286

30.3

+

Source: U.S. Census Bureau, 2009 American Community Survey.
a.

Total population figures are for the civilian non-institutionalized population. Each value in the table is an
estimate with an associated confidence interval around it. While the confidence intervals are not presented,
they are available.

b.

Above (below) the national level means that subgroup at the state level, has, with a 90% confidence level, a
statistically significantly higher (lower) likelihood of being uninsured than the same subgroup at the national
level. If a subgroup is at the national level, there is no statistical difference between the proportion of
individuals uninsured in the subgroup at the state level as compared to the subgroup at the national level.

c.

Never married, separated, divorced, or widowed.

d.

Working 30 or more hours for 50 or more weeks a year.

e.

Working fewer than 30 hours a week for fewer than 50 weeks a year.

Congressional Research Service

39

The Uninsured by State and Congressional District

Table A-10.California: Number and Percentage of People Without Health Insurance,
by State and Congressional District (111th), 2009

Congressional District
California

Total Population
(in thousands)a

Number
Uninsured (in
thousands)

Percent
Uninsured

Above (+), At
(x), or Below (-)
National
Averageb

36,377

6,559

18.0

Congressional District 1

695

104

14.9

-

Congressional District 2

713

117

16.4

+

Congressional District 3

760

90

11.8

-

Congressional District 4

769

81

10.5

-

Congressional District 5

703

112

15.9

+

Congressional District 6

649

79

12.1

-

Congressional District 7

672

106

15.7

+

Congressional District 8

675

85

12.6

-

Congressional District 9

649

94

14.5

-

Congressional District 10

703

74

10.5

-

Congressional District 11

760

89

11.7

-

Congressional District 12

644

59

9.1

-

Congressional District 13

650

82

12.6

-

Congressional District 14

656

68

10.3

-

Congressional District 15

681

74

10.8

-

Congressional District 16

686

106

15.5

+

Congressional District 17

653

127

19.4

+

Congressional District 18

714

149

20.9

+

Congressional District 19

751

133

17.7

+

Congressional District 20

724

187

25.8

+

Congressional District 21

767

150

19.6

+

Congressional District 22

763

116

15.2

+

Congressional District 23

662

130

19.6

+

Congressional District 24

677

89

13.2

-

Congressional District 25

819

134

16.4

+

Congressional District 26

700

97

13.8

-

Congressional District 27

674

138

20.4

+

Congressional District 28

669

182

27.2

+

Congressional District 29

658

115

17.5

+

Congressional District 30

644

63

9.8

-

Congressional District 31

630

242

38.5

+

Congressional District 32

645

152

23.6

+

Congressional Research Service

40

The Uninsured by State and Congressional District

Congressional District

Total Population
(in thousands)a

Number
Uninsured (in
thousands)

Percent
Uninsured

Above (+), At
(x), or Below (-)
National
Averageb

Congressional District 33

644

183

28.4

+

Congressional District 34

646

223

34.5

+

Congressional District 35

673

179

26.6

+

Congressional District 36

677

116

17.2

+

Congressional District 37

644

146

22.6

+

Congressional District 38

639

161

25.2

+

Congressional District 39

657

156

23.8

+

Congressional District 49

676

129

19.1

+

Congressional District 41

783

131

16.7

+

Congressional District 42

668

77

11.5

-

Congressional District 43

721

195

27.0

+

Congressional District 44

825

151

18.3

+

Congressional District 45

898

198

22.0

+

Congressional District 46

656

84

12.8

-

Congressional District 47

639

213

33.3

+

Congressional District 48

724

76

10.5

-

Congressional District 49

777

148

19.0

+

Congressional District 50

752

99

13.2

-

Congressional District 51

732

169

23.1

+

Congressional District 52

674

86

12.7

-

Congressional District 53

638

126

19.7

+

Source: U.S. Census Bureau, 2009 American Community Survey.
a.

Total population figures are for the civilian non-institutionalized population. Each value in the table is an
estimate and there is a confidence interval around the estimate. While the intervals at the 90% confidence
level are not presented, they are available.

b.

No statistical test of this difference was performed.

Congressional Research Service

41

The Uninsured by State and Congressional District

Colorado
Table A-11.Colorado: Characteristics of the Uninsured, 2009
Number
Uninsured (in
thousands)

Percent
Uninsured

Above (+), At
(x), or Below (-)
National
Averageb

4,930

778

15.8

+

Male

2,473

339

13.7

x

Female

2,457

439

17.8

+

Under Age 6

433

35

8.2

+

Under Age 19

1,299

138

10.6

+

Under Age 26

1,781

292

16.4

+

Age 19 through 21

206

60

29.1

x

Age 21 through 64

2,979

596

20.0

x

Age 65 and over

517

5

1.0

x

Total
Populationa (in
thousands)
Total Population

Poverty Status

4,892

≤133% FPL

889

298

33.6

-

>133 to <400% FPL

1,978

372

18.8

+

≥400% + FPL

2,025

105

5.2

x

Total Population Age 18-64

3,188

Singlec

1,453

415

28.6

x

Married

1,735

233

13.4

x

Employed Full Timed

11,503

248

14.1

x

Employed Part Timee

4,249

161

26.8

x

Source: U.S. Census Bureau, 2009 American Community Survey.
a.

Total population figures are for the civilian non-institutionalized population. Each value in the table is an
estimate with an associated confidence interval around it. While the confidence intervals are not presented,
they are available.

b.

Above (below) the national level means that subgroup at the state level, has, with a 90% confidence level, a
statistically significantly higher (lower) likelihood of being uninsured than the same subgroup at the national
level. If a subgroup is at the national level, there is no statistical difference between the proportion of
individuals uninsured in the subgroup at the state level as compared to the subgroup at the national level.

c.

Never married, separated, divorced, or widowed.

d.

Working 30 or more hours for 50 or more weeks a year.

e.

Working fewer than 30 hours a week for fewer than 50 weeks a year.

Congressional Research Service

42

The Uninsured by State and Congressional District

Table A-12.Colorado: Number and Percentage of People Without Health Insurance,
by State and Congressional District (111th), 2009
Above (+), At
(x), or Below (-)
National
Averageb

Total Population
(in thousands)a

Number
Uninsured (in
thousands)

Percent
Uninsured

4,930

778

15.8

Congressional District 1

671

133

19.9

+

Congressional District 2

732

105

14.4

-

Congressional District 3

700

139

19.8

+

Congressional District 4

731

117

16

+

Congressional District 5

708

100

14.1

-

Congressional District 6

808

63

7.8

-

Congressional District 7

676

136

20.1

+

Congressional
District
Colorado

Source: U.S. Census Bureau, 2009 American Community Survey.
a.

Total population figures are for the civilian non-institutionalized population. Each value in the table is an
estimate and there is a confidence interval around the estimate. While the intervals at the 90% confidence
level are not presented, they are available.

b.

No statistical test of this difference was performed.

Congressional Research Service

43

The Uninsured by State and Congressional District

Connecticut
Table A-13.Connecticut: Characteristics of the Uninsured, 2009
Number
Uninsured (in
thousands)

Percent
Uninsured

Above (+), At
(x), or Below (-)
National
Averageb

3,457

305

8.8

-

Male

1,778

125

7.0

-

Female

1,679

180

10.7

-

Under Age 6

250

9

3.7

-

Under Age 19

860

35

4.0

-

Under Age 26

1,181

101

8.6

-

Age 19 through 21

154

27

17.8

-

Age 21 through 64

2,030

249

12.3

-

Age 65 and over

460

3

0.7

-

Total
Populationa (in
thousands)
Total Population

Poverty Status

3,404

≤133% FPL

438

83

18.8

-

>133 to <400% FPL

1,191

155

13.0

-

≥400% + FPL

1,774

66

3.7

-

Total Population Age 18-64

2,190

Singlec

1,034

193

18.6

-

Married

1,156

79

6.8

-

Employed Full Timed

1,207

94

7.8

-

Employed Part Timee

423

71

16.9

-

Source: U.S. Census Bureau, 2009 American Community Survey.
a.

Total population figures are for the civilian non-institutionalized population. Each value in the table is an
estimate with an associated confidence interval around it. While the confidence intervals are not presented,
they are available.

b.

Above (below) the national level means that subgroup at the state level, has, with a 90% confidence level, a
statistically significantly higher (lower) likelihood of being uninsured than the same subgroup at the national
level. If a subgroup is at the national level, there is no statistical difference between the proportion of
individuals uninsured in the subgroup at the state level as compared to the subgroup at the national level.

c.

Never married, separated, divorced, or widowed.

d.

Working 30 or more hours for 50 or more weeks a year.

e.

Working fewer than 30 hours a week for fewer than 50 weeks a year.

Congressional Research Service

44

The Uninsured by State and Congressional District

Table A-14.Connecticut: Number and Percentage of People Without Health
Insurance, by State and Congressional District (111th), 2009

Congressional
District
Connecticut

Total Population
(in thousands)a

Number
Uninsured (in
thousands)

Percent
Uninsured

Above (+), At
(x), or Below (-)
National
Averageb

3,457

305

8.8

Congressional District 1

698

59

8.5

-

Congressional District 2

721

50

6.9

-

Congressional District 3

698

62

8.9

-

Congressional District 4

696

76

10.9

-

Congressional District 5

705

63

9.0

-

Source: U.S. Census Bureau, 2009 American Community Survey.
a.

Total population figures are for the civilian non-institutionalized population. Each value in the table is an
estimate and there is a confidence interval around the estimate. While the intervals at the 90% confidence
level are not presented, they are available.

b.

No statistical test of this difference was performed.

Congressional Research Service

45

The Uninsured by State and Congressional District

Delaware
Table A-15.Delaware: Characteristics of the Uninsured, 2009
Total
Populationa (in
thousands)

Number
Uninsured (in
thousands)

Percent
Uninsured

Above (+), At
(x), or Below
(-) National
Averageb

869

89

10.2

-

Male

451

38

8.5

x

Female

418

51

12.1

-

Under Age 6

70

3

4.6

-

Under Age 19

222

12

5.6

-

Under Age 26

298

31

10.3

-

Age 19 through 21

34

7

21.8

-

Age 21 through 64

504

71

14.2

-

Age 65 and over

121

1

0.6

x

Total Population

Poverty Status

856

≤133% FPL

137

24

17.1

-

>133 to <400% FPL

357

48

13.5

-

≥400% + FPL

362

17

4.7

x

Total Population Age 18-64

541

Singlec

269

53

19.8

-

Married

272

24

8.7

-

Employed Full Timed

298

31

10.4

-

Employed Part Timee

94

19

19.7

-

Source: U.S. Census Bureau, 2009 American Community Survey.
a.

Total population figures are for the civilian non-institutionalized population. Each value in the table is an
estimate with an associated confidence interval around it. While the confidence intervals are not presented,
they are available.

b.

Above (below) the national level means that subgroup at the state level, has, with a 90% confidence level, a
statistically significantly higher (lower) likelihood of being uninsured than the same subgroup at the national
level. If a subgroup is at the national level, there is no statistical difference between the proportion of
individuals uninsured in the subgroup at the state level as compared to the subgroup at the national level.

c.

Never married, separated, divorced, or widowed.

d.

Working 30 or more hours for 50 or more weeks a year.

e.

Working fewer than 30 hours a week for fewer than 50 weeks a year.

Congressional Research Service

46

The Uninsured by State and Congressional District

Table A-16.Delaware: Number and Percentage of People Without Health Insurance,
by State and Congressional District (111th), 2009

Congressional
District

Total Populationa
(in thousands)1

Number
Uninsured (in
thousands)

Percent
Uninsured

Delaware

869

89

10.2

At Large Delaware

869

89

10.2

Above (+), At (x),
or Below (-)
National
Averageb

-

Source: U.S. Census Bureau, 2009 American Community Survey.
a.

Total population figures are for the civilian non-institutionalized population. Each value in the table is an
estimate and there is a confidence interval around the estimate. While the intervals at the 90% confidence
level are not presented, they are available.

b.

No statistical test of this difference was performed.

Congressional Research Service

47

The Uninsured by State and Congressional District

District of Columbia
Table A-17.District of Columbia: Characteristics of the Uninsured, 2009
Total
Populationa (in
thousands)

(in thousands)

Percent
Uninsured

Above (+), At
(x), or Below
(-) National
Averageb

589

41

7.0

-

Male

314

17

5.3

-

Female

276

25

9.0

-

Under Age 6

43

1

1.7

-

Under Age 19

126

4

3.4

-

Under Age 26

200

13

6.8

-

Age 19 through 21

32

3

9.7

-

Age 21 through 64

373

35

9.4

-

Age 65 and over

66

0

0.7

x

Total Population

Number
Uninsured

Poverty Status

568

≤133% FPL

131

11

8.3

-

>133 to <400% FPL

180

20

11.0

-

≥400% + FPL

257

10

4.0

-

Total Population Age 18-64

410

Singlec

306

33

10.8

-

Married

104

5

4.6

-

Employed Full Timed

221

15

6.8

-

Employed Part Timee

58

7

11.5

-

Source: U.S. Census Bureau, 2009 American Community Survey.
a.

Total population figures are for the civilian non-institutionalized population. Each value in the table is an
estimate with an associated confidence interval around it. While the confidence intervals are not presented,
they are available.

b.

Above (below) the national level means that subgroup at the state level, has, with a 90% confidence level, a
statistically significantly higher (lower) likelihood of being uninsured than the same subgroup at the national
level. If a subgroup is at the national level, there is no statistical difference between the proportion of
individuals uninsured in the subgroup at the state level as compared to the subgroup at the national level.

c.

Never married, separated, divorced, or widowed.

d.

Working 30 or more hours for 50 or more weeks a year.

e.

Working fewer than 30 hours a week for fewer than 50 weeks a year.

Congressional Research Service

48

The Uninsured by State and Congressional District

Table A-18.District of Columbia; Number and Percentage of People Without Health
Insurance, by State and Congressional District (111th), 2009

Congressional
District

Total Populationa
(in thousands)

Number
Uninsured (in
thousands)

Percent
Uninsured

District of
Columbia

589

41

7.0

At Large District of
Columbia

589

41

7.0

Above (+), At (x),
or Below (-)
National
Averageb

-

Source: U.S. Census Bureau, 2009 American Community Survey.
a.

Total population figures are for the civilian non-institutionalized population. Each value in the table is an
estimate and there is a confidence interval around the estimate. While the intervals at the 90% confidence
level are not presented, they are available.

b.

No statistical test of this difference was performed.

Congressional Research Service

49

The Uninsured by State and Congressional District

Florida
Table A-19.Florida: Characteristics of the Uninsured, 2009
Total
Populationa (in
thousands)
Total Population

Number
Uninsured (in
thousands)

Percent
Uninsured

Above (+), At
(x), or Below (-)
National
Averageb

18,193

3,795

20.9

+

Male

9,336

1,750

18.7

+

Female

8,857

2,045

23.1

+

Under Age 6

1,364

165

12.1

+

Under Age 19

4,294

659

15.3

+

Under Age 26

5,924

1,321

22.3

+

Age 19 through 21

730

292

40.0

+

Age 21 through 64

10,299

2,910

28.3

+

Age 65 and over

3,118

40

1.3

+

Poverty Status

18,070

≤133% FPL

3,950

1,382

35.0

+

>133 to <400% FPL

8,389

1,964

23.4

+

≥400% + FPL

5,731

435

7.6

+

Total Population Age 18-64

11,024

Singlec

5,561

2,056

37.0

+

Married

5,463

1,099

20.1

+

Employed Full Timed

5,759

1,241

21.6

+

Employed Part Timee

1,775

641

36.1

+

Source: U.S. Census Bureau, 2009 American Community Survey.
a.

Total population figures are for the civilian non-institutionalized population. Each value in the table is an
estimate with an associated confidence interval around it. While the confidence intervals are not presented,
they are available.

b.

Above (below) the national level means that subgroup at the state level, has, with a 90% confidence level, a
statistically significantly higher (lower) likelihood of being uninsured than the same subgroup at the national
level. If a subgroup is at the national level, there is no statistical difference between the proportion of
individuals uninsured in the subgroup at the state level as compared to the subgroup at the national level.

c.

Never married, separated, divorced, or widowed.

d.

Working 30 or more hours fo

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Source: Frix Law Library, https://www.frixlaw.com/law-library/documents/crs%3AR41621. Public record. Not legal advice.