Health Insurance: Uninsured by State, 2005-2007
Order Code 96-979
Updated September 5, 2008
Health Insurance: Uninsured
by State, 2005-2007
Chris L. Peterson and April Grady
Domestic Social Policy Division
Summary
Based on data from the Census Bureau’s Current Population Survey (CPS), an
estimated 45.7 million people lacked health insurance coverage in 2007, representing
15.3% of the civilian noninstitutionalized U.S. population.
When comparing state-level health insurance estimates, a three-year average is used
to increase their reliability. During 2005-2007, the estimated average percentage
uninsured was 15.5% nationally, ranging from a low of 8.3% in Massachusetts to a high
of 24.5% in Texas. States in the Midwest and Northeast generally had lower uninsured
rates than those in the South and West.
These state-level estimates must be interpreted with caution because they are based
on a sample of the population. When sampling variation is taken into account, the
uninsured rate in nine states is not statistically different from the national rate. The
uninsured rate in 28 states and the District of Columbia is statistically lower than the
national rate, and statistically higher in the remaining 13 states.
Estimates of Health Insurance Coverage, by State
During 2005-2007, the estimated average percentage uninsured was 15.5%
nationally. Table 1 shows that 2005-2007 average uninsured rates ranged from 8.3% in
Massachusetts to 24.5% in Texas. Eight states (Massachusetts, Hawaii, Minnesota,
Wisconsin, Iowa, Maine, Pennsylvania, and Connecticut) had three-year average
uninsured rates of less than 10.0%. Three states (Florida, New Mexico, and Texas) had
average uninsured rates of 20.0% or more. Generally, states with the lowest uninsured
rates were located in the Midwest and Northeast; states with the highest rates were in the
South and West (Figure 1).
CRS-2
Table 1 provides private health insurance,1 public health insurance,2 and uninsured
estimates with percentage rankings by state. The right side of the table indicates whether
a state’s three-year average uninsured rate is statistically lower (shown with a “-”),
statistically higher (shown with a “+”), or not statistically different (shown with a “x”)
than the national rate of 15.5%.3
Both private and public health insurance affect a state’s uninsured rate. For example,
as shown in Table 1, Minnesota and Maine have similarly low uninsured rates.4
However, Minnesota has the highest three-year average private coverage rate in the
country (79.7%) and a relatively low public coverage rate (24.0%). On the other hand,
Maine has a lower three-year average private coverage rate (69.5%) and the highest public
coverage rate (35.9%). Thus, even though there are differences regarding whether people
in Maine and Minnesota obtain private or public health insurance, the impact is that both
have similarly low uninsured rates.
States with the highest rankings for average percentage uninsured during 2005-2007,
led by Texas with nearly a quarter of its population, have some of the lowest rankings for
private coverage. All but two of the 10 states with the highest uninsured rates (shown in
the last 10 rows of Table 1) rank in the lowest 10 states for private coverage.
Estimates with 95% Confidence Intervals. The estimates in this report are
based on data from the March 2008 supplement to the Current Population Survey (CPS).5
The CPS is representative of the civilian noninstitutionalized population and is designed
to produce reliable estimates at the national, regional, and state levels.
The small sample sizes available from the CPS for many states make it prudent to
use a three-year average when comparing state-level estimates and to consider the
estimates in terms of a range of values. Like Table 1, Table 2 shows the best point
estimates, or single values, for the average number and percentage of people covered and
not covered by health insurance. It also reports a range of values — the 95% confidence
interval — for these estimates. The larger the confidence interval in relation to the size
of the estimate, the less reliable the estimate. The size of the range depends primarily on
the sample size. A 95% confidence interval means that if repeated samples were collected
under essentially the same conditions and their confidence intervals calculated, in the long
1 Coverage through an employer or union, all coverage from outside the home, and coverage
purchased directly from a private insurer.
2 Medicare, Medicaid, the State Children’s Health Insurance Program (SCHIP), and other
government-provided health insurance, as well as coverage related to employment in the military.
3 Statistical significance was tested at the 95% confidence level (also referred to as the 5%
significance level). This means that one can be 95% certain that the difference between a state’s
uninsured rate and the national rate is not zero (i.e., the state’s rate is statistically higher or lower)
or could be zero (i.e., the state’s rate is not statistically different).
4 Their uninsured rates are statistically lower than the national rate and are not statistically
different from each other.
5 Because the supplement is now fielded from February through April, it has been officially
renamed the Annual Social and Economic supplement (ASEC) to the CPS, though many analysts
continue to refer to it by its traditional name.
CRS-3
run about 95% of those intervals would contain the true number of people with (or
without) health insurance.
Reasons for Differences in the Percentage Uninsured
Figure 1 indicates that people in the South and West are more likely to lack health
insurance, and that residents of the Midwest and Northeast are more likely to be covered.
Various characteristics of a state’s population may account for these differences.
Nationwide, the uninsured rate is related to age, race and ethnicity, employment, and a
number of other factors.6 The prevalence of particular population and employer
characteristics may account for some of the regional or state variation in uninsured rates.
The percentage of a state’s population that is uninsured may also be affected by state
policies, such as eligibility criteria for the state’s Medicaid program or its State Children’s
Health Insurance Program (SCHIP).
6 For more information, see CRS Report 96-891, Health Insurance Coverage: Characteristics
of the Insured and Uninsured Populations in 2007, by Chris L. Peterson and April Grady.
CRS-4
Table 1. Health Insurance Coverage Estimates with Rankings, by State,
2005-2007 Average
(sorted by percentage uninsured ranking, numbers in thousands)
Public health insurance
Private health insurance
(including military)
Uninsured
Percent
Percent
Percent
State
Total population
Number
Value
Rank
Number
Value
Rank
Number
Value
Rank
United States
296,588
201,616
68.0%
NA
81,171
27.4%
NA
45,822
15.5% NA
NA
Massachusetts
6,334
4,731
74.7%
9
1,768
27.9%
25
527
8.3%
-
1
Hawaii
1,267
945
74.6%
12
404
31.9%
10
105
8.3%
-
2
Minnesota
5,156
4,110
79.7%
1
1,238
24.0%
45
438
8.5%
-
3
Wisconsin
5,465
4,218
77.2%
5
1,413
25.9%
36
480
8.8%
-
4
Iowa
2,933
2,290
78.1%
3
778
26.5%
35
274
9.4%
-
5
Maine
1,316
915
69.5%
29
472
35.9%
1
125
9.5%
-
6
Pennsylvania
12,313
9,356
76.0%
7
3,380
27.5%
29
1,203
9.8%
-
7
Connecticut
3,475
2,657
76.4%
6
892
25.7%
38
344
9.9%
-
8
Rhode Island
1,051
761
72.4%
21
321
30.6%
15
108
10.3%
-
9
New Hampshire
1,308
1,040
79.5%
2
279
21.4%
48
138
10.5%
-
10
Michigan
9,960
7,418
74.5%
13
2,738
27.5%
28
1,075
10.8%
-
11
Vermont
619
435
70.4%
28
204
33.0%
5
68
11.0%
-
12
Ohio
11,318
8,307
73.4%
15
3,076
27.2%
31
1,249
11.0%
-
13
North Dakota
619
482
77.9%
4
152
24.5%
42
68
11.1%
-
14
South Dakota
776
579
74.6%
11
221
28.5%
22
87
11.2%
-
15
District of Columbia
564
373
66.2%
36
180
32.0%
8
64
11.4%
-
16
Kansas
2,713
2,026
74.7%
10
739
27.3%
30
320
11.8%
-
17
Delaware
856
625
73.0%
19
239
27.9%
26
101
11.8%
-
18
Nebraska
1,762
1,326
75.2%
8
438
24.8%
41
212
12.0%
-
19
Washington
6,359
4,604
72.4%
22
1,796
28.2%
23
770
12.1%
-
20
Indiana
6,247
4,584
73.4%
16
1,522
24.4%
43
766
12.3%
-
21
Missouri
5,767
4,093
71.0%
26
1,617
28.0%
24
723
12.5%
-
22
New York
19,041
12,649
66.4%
35
5,893
30.9%
13
2,551
13.4%
-
23
Virginia
7,559
5,414
71.6%
24
2,091
27.7%
27
1,031
13.6%
-
24
Maryland
5,582
4,158
74.5%
14
1,339
24.0%
46
761
13.6%
-
25
Illinois
12,647
9,182
72.6%
20
3,056
24.2%
44
1,735
13.7%
-
26
Kentucky
4,122
2,750
66.7%
34
1,282
31.1%
11
569
13.8%
-
27
Tennessee
5,979
3,859
64.5%
40
1,985
33.2%
4
830
13.9%
-
28
Alabama
4,542
3,113
68.5%
32
1,391
30.6%
14
632
13.9%
-
29
Wyoming
515
370
71.9%
23
139
27.0%
32
73
14.3%
x
30
Idaho
1,473
1,039
70.5%
27
375
25.5%
39
216
14.7%
x
31
West Virginia
1,803
1,155
64.1%
41
623
34.6%
2
268
14.8%
x
32
New Jersey
8,647
6,337
73.3%
17
1,785
20.6%
49
1,318
15.2%
x
33
Utah
2,573
1,880
73.1%
18
510
19.8%
51
399
15.5%
x
34
Montana
933
631
67.7%
33
273
29.3%
20
150
16.1%
x
35
South Carolina
4,264
2,759
64.7%
39
1,278
30.0%
17
705
16.5%
x
36
North Carolina
8,865
5,776
65.2%
37
2,603
29.4%
19
1,469
16.6%
+
37
Colorado
4,773
3,406
71.3%
25
980
20.5%
50
799
16.7%
x
38
Oregon
3,702
2,554
69.0%
30
953
25.7%
37
621
16.8%
x
39
Alaska
664
421
63.3%
42
206
31.1%
12
115
17.3%
+
40
Arkansas
2,774
1,699
61.2%
46
888
32.0%
9
485
17.5%
+
41
Georgia
9,295
6,031
64.9%
38
2,469
26.6%
34
1,658
17.8%
+
42
Nevada
2,517
1,726
68.6%
31
549
21.8%
47
452
18.0%
+
43
Oklahoma
3,516
2,177
61.9%
45
1,131
32.2%
7
640
18.2%
+
44
California
36,148
22,650
62.7%
44
9,651
26.7%
33
6,720
18.6%
+
45
Mississippi
2,883
1,660
57.6%
50
971
33.7%
3
543
18.8%
+
46
Louisiana
4,166
2,538
60.9%
47
1,240
29.8%
18
807
19.4%
+
47
Arizona
6,228
3,768
60.5%
48
1,876
30.1%
16
1,219
19.6%
+
48
Florida
18,007
11,355
63.1%
43
5,216
29.0%
21
3,698
20.5%
+
49
New Mexico
1,943
1,095
56.4%
51
637
32.8%
6
425
21.9%
+
50
Texas
23,253
13,590
58.4%
49
5,911
25.4%
40
5,687
24.5%
+
51
Source: CRS analysis of data from the March 2008 Current Population Survey (CPS).
Notes: People may have both private and public coverage. On the right side of the table, “-” indicates that a state’s uninsured rate
is statistically lower than the national rate, “+” indicates that it is statistically higher, and “x” indicates that it is not statistically
different. Statistical significance was tested at the 95% confidence level (see text for more information).
CRS-5
Table 2. Health Insurance Coverage Estimates with 95% Confidence Intervals,
by State, 2005-2007 Average
(numbers in thousands)
Public health insurance
Private health insurance
(including military)
Uninsured
State
Number
Percent
Number
Percent
Number
Percent
United States
201,616 +/- 509
68.0% +/- 0.2% 81,171 +/- 529
27.4% +/- 0.2% 45,822 +/- 429 15.5% +/- 0.1%
Alabama
3,113 +/- 65
68.5% +/- 1.5%
1,391 +/-
69
30.6% +/- 1.5%
632 +/-
52 13.9% +/- 1.1%
Alaska
421 +/- 10
63.3% +/- 1.7%
206 +/-
11
31.1% +/- 1.7%
115 +/-
9 17.3% +/- 1.4%
Arizona
3,768 +/- 86
60.5% +/- 1.5%
1,876 +/-
87
30.1% +/- 1.4%
1,219 +/-
76 19.6% +/- 1.2%
Arkansas
1,699 +/- 43
61.2% +/- 1.7%
888 +/-
44
32.0% +/- 1.6%
485 +/-
36 17.5% +/- 1.3%
California
22,650 +/- 207
62.7% +/- 0.6%
9,651 +/- 205
26.7% +/- 0.6%
6,720 +/- 180 18.6% +/- 0.5%
Colorado
3,406 +/- 68
71.3% +/- 1.6%
980 +/-
67
20.5% +/- 1.4%
799 +/-
61 16.7% +/- 1.3%
Connecticut
2,657 +/- 47
76.4% +/- 1.5%
892 +/-
53
25.7% +/- 1.5%
344 +/-
36
9.9% +/- 1.0%
Delaware
625 +/- 12
73.0% +/- 1.6%
239 +/-
13
27.9% +/- 1.6%
101 +/-
10 11.8% +/- 1.1%
District of Columbia
373 +/- 10
66.2% +/- 1.8%
180 +/-
10
32.0% +/- 1.8%
64 +/-
7 11.4% +/- 1.2%
Florida
11,355 +/- 138
63.1% +/- 0.8%
5,216 +/- 140
29.0% +/- 0.8%
3,698 +/- 125 20.5% +/- 0.7%
Georgia
6,031 +/- 96
64.9% +/- 1.1%
2,469 +/-
96
26.6% +/- 1.0%
1,658 +/-
84 17.8% +/- 0.9%
Hawaii
945 +/- 17
74.6% +/- 1.4%
404 +/-
19
31.9% +/- 1.5%
105 +/-
12
8.3% +/- 0.9%
Idaho
1,039 +/- 21
70.5% +/- 1.6%
375 +/-
22
25.5% +/- 1.5%
216 +/-
18 14.7% +/- 1.2%
Illinois
9,182 +/- 108
72.6% +/- 0.9%
3,056 +/- 112
24.2% +/- 0.9%
1,735 +/-
90 13.7% +/- 0.7%
Indiana
4,584 +/- 73
73.4% +/- 1.3%
1,522 +/-
77
24.4% +/- 1.2%
766 +/-
59 12.3% +/- 0.9%
Iowa
2,290 +/- 40
78.1% +/- 1.5%
778 +/-
46
26.5% +/- 1.6%
274 +/-
30
9.4% +/- 1.0%
Kansas
2,026 +/- 39
74.7% +/- 1.5%
739 +/-
43
27.3% +/- 1.6%
320 +/-
31 11.8% +/- 1.1%
Kentucky
2,750 +/- 63
66.7% +/- 1.6%
1,282 +/-
66
31.1% +/- 1.6%
569 +/-
49 13.8% +/- 1.2%
Louisiana
2,538 +/- 65
60.9% +/- 1.7%
1,240 +/-
66
29.8% +/- 1.6%
807 +/-
57 19.4% +/- 1.4%
Maine
915 +/- 21
69.5% +/- 1.7%
472 +/-
24
35.9% +/- 1.8%
125 +/-
14
9.5% +/- 1.1%
Maryland
4,158 +/- 69
74.5% +/- 1.4%
1,339 +/-
74
24.0% +/- 1.3%
761 +/-
59 13.6% +/- 1.1%
Massachusetts
4,731 +/- 72
74.7% +/- 1.2%
1,768 +/-
80
27.9% +/- 1.3%
527 +/-
49
8.3% +/- 0.8%
Michigan
7,418 +/- 92
74.5% +/- 1.0%
2,738 +/- 101
27.5% +/- 1.0%
1,075 +/-
70 10.8% +/- 0.7%
Minnesota
4,110 +/- 59
79.7% +/- 1.3%
1,238 +/-
69
24.0% +/- 1.3%
438 +/-
45
8.5% +/- 0.9%
Mississippi
1,660 +/- 45
57.6% +/- 1.7%
971 +/-
46
33.7% +/- 1.6%
543 +/-
38 18.8% +/- 1.3%
Missouri
4,093 +/- 73
71.0% +/- 1.4%
1,617 +/-
78
28.0% +/- 1.4%
723 +/-
58 12.5% +/- 1.0%
Montana
631 +/- 14
67.7% +/- 1.6%
273 +/-
15
29.3% +/- 1.6%
150 +/-
12 16.1% +/- 1.3%
Nebraska
1,326 +/- 24
75.2% +/- 1.5%
438 +/-
27
24.8% +/- 1.5%
212 +/-
20 12.0% +/- 1.1%
Nevada
1,726 +/- 38
68.6% +/- 1.7%
549 +/-
37
21.8% +/- 1.5%
452 +/-
34 18.0% +/- 1.4%
New Hampshire
1,040 +/- 17
79.5% +/- 1.4%
279 +/-
19
21.4% +/- 1.4%
138 +/-
14 10.5% +/- 1.1%
New Jersey
6,337 +/- 87
73.3% +/- 1.1%
1,785 +/-
87
20.6% +/- 1.0%
1,318 +/-
77 15.2% +/- 0.9%
New Mexico
1,095 +/- 34
56.4% +/- 1.9%
637 +/-
34
32.8% +/- 1.8%
425 +/-
30 21.9% +/- 1.6%
New York
12,649 +/- 142
66.4% +/- 0.8%
5,893 +/- 150
30.9% +/- 0.8%
2,551 +/- 111 13.4% +/- 0.6%
North Carolina
5,776 +/- 94
65.2% +/- 1.2%
2,603 +/-
98
29.4% +/- 1.1%
1,469 +/-
80 16.6% +/- 0.9%
North Dakota
482 +/-
8
77.9% +/- 1.5%
152 +/-
9
24.5% +/- 1.5%
68 +/-
7 11.1% +/- 1.1%
Ohio
8,307 +/- 99
73.4% +/- 0.9%
3,076 +/- 108
27.2% +/- 1.0%
1,249 +/-
76 11.0% +/- 0.7%
Oklahoma
2,177 +/- 55
61.9% +/- 1.7%
1,131 +/-
58
32.2% +/- 1.6%
640 +/-
48 18.2% +/- 1.4%
Oregon
2,554 +/- 57
69.0% +/- 1.7%
953 +/-
58
25.7% +/- 1.6%
621 +/-
50 16.8% +/- 1.3%
Pennsylvania
9,356 +/- 99
76.0% +/- 0.9%
3,380 +/- 113
27.5% +/- 0.9%
1,203 +/-
75
9.8% +/- 0.6%
Rhode Island
761 +/- 16
72.4% +/- 1.6%
321 +/-
18
30.6% +/- 1.7%
108 +/-
12 10.3% +/- 1.1%
South Carolina
2,759 +/- 65
64.7% +/- 1.6%
1,278 +/-
67
30.0% +/- 1.6%
705 +/-
54 16.5% +/- 1.3%
South Dakota
579 +/- 10
74.6% +/- 1.4%
221 +/-
11
28.5% +/- 1.5%
87 +/-
8 11.2% +/- 1.0%
Tennessee
3,859 +/- 78
64.5% +/- 1.4%
1,985 +/-
83
33.2% +/- 1.4%
830 +/-
61 13.9% +/- 1.0%
Texas
13,590 +/- 172
58.4% +/- 0.8%
5,911 +/- 164
25.4% +/- 0.7%
5,687 +/- 161 24.5% +/- 0.7%
Utah
1,880 +/- 33
73.1% +/- 1.4%
510 +/-
32
19.8% +/- 1.3%
399 +/-
29 15.5% +/- 1.1%
Vermont
435 +/- 10
70.4% +/- 1.7%
204 +/-
11
33.0% +/- 1.7%
68 +/-
7 11.0% +/- 1.2%
Virginia
5,414 +/- 81
71.6% +/- 1.2%
2,091 +/-
88
27.7% +/- 1.2%
1,031 +/-
67 13.6% +/- 0.9%
Washington
4,604 +/- 77
72.4% +/- 1.3%
1,796 +/-
84
28.2% +/- 1.3%
770 +/-
61 12.1% +/- 1.0%
West Virginia
1,155 +/- 26
64.1% +/- 1.5%
623 +/-
27
34.6% +/- 1.5%
268 +/-
21 14.8% +/- 1.1%
Wisconsin
4,218 +/- 66
77.2% +/- 1.3%
1,413 +/-
74
25.9% +/- 1.4%
480 +/-
48
8.8% +/- 0.9%
Wyoming
370 +/-
8
71.9% +/- 1.7%
139 +/-
8
27.0% +/- 1.7%
73 +/-
7 14.3% +/- 1.3%
Source: CRS analysis of data from the March 2008 Current Population Survey (CPS).
Notes: People may have both private and public coverage. The 95% confidence interval is a measure of an estimate’s variability
(see text for more information).
CRS-6
Figure 1. Percentage Uninsured, by State, 2005-2007 Average
Source: CRS analysis of data from the March 2008 Current Population Survey (CPS).
Note: States in the 14.3%-16.8% category are not statistically different from the national rate, except for North Carolina (which is statistically higher). Others are statistically higher
(more than 16.8% category) or lower (less than 14.3% category)