19 of 20 US counties with lowest health insurance coverage located in Texas
AUSTIN (KXAN) — A recent study found some individuals may be forgoing health insurance and instead making the tradeoff for their financial well-being.
SmartAsset, a financial technology company, said it ranked U.S. counties based on the rate of people under age 65 who were insured in 2024. Of the top 20, 19 counties with the least health insurance coverage were in Texas.
“In 2024, the average annual premium for a single individual was nearly $9,000 – and an estimated $25,500 for a family of four,” SmartAsset said.
According to the study, several Texas counties had the lowest health insurance coverage rates nationwide.
“More than any other county, 32.0% of residents in Hidalgo County don’t have health insurance,” SmartAsset said. “Cameron County (30.1% uninsured), Webb County (29.7%), Starr County (29.0%), Ector County (25.3%), Potter County (24.4%), Dallas County (24.2%), Harris County (23.8%) and El Paso County (23.5%) are also among the top 10 uninsured counties nationwide.”
The data showed one Texas county also had the lowest rate of primary care physicians.
According to the study, Orange County, Texas, ranked 84th overall for the lowest rate of health insurance, with 6,053 residents for every primary care physician. Smart Asset said that was more than any other county studywide.
Another Texas county also saw the largest drop in insurance coverage year over year, according to the study.
SmartAsset found Tom Green County, Texas, which was ranked as having the 25th highest number of uninsured residents, saw a drop from 17.5% uninsured in 2023 to 20.2% uninsured in 2024.
Top 20 counties with the highest rates of uninsured people
No. 1 - Hidalgo County, Texas
- People under 65 that are uninsured, 2024: 32.05%
- Population per primary care physician: 2,158
- Population per mental health care professional: 1,199
- Children under 19 who are uninsured, 2024: 12.57%
No. 2 - Cameron County, Texas
- People under 65 that are uninsured, 2024: 30.08%
- Population per primary care physician: 2,034
- Population per mental health care professional: 1,128
- Children under 19 who are uninsured, 2024: 13.65%
No. 3 - Webb County, Texas
- People under 65 that are uninsured, 2024: 29.69%
- Population per primary care physician: 3,268
- Population per mental health care professional: 1,913
- Children under 19 who are uninsured, 2024: 12.28%
No. 4 - Starr County, Texas
- People under 65 that are uninsured, 2024: 29%
- Population per primary care physician: 3,885
- Population per mental health care professional: 4,695
- Children under 19 who are uninsured, 2024: 12.46%
No. 5 - Ector County, Texas
- People under 65 that are uninsured, 2024: 25.26%
- Population per primary care physician: 1,751
- Population per mental health care professional: 1,962
- Children under 19 who are uninsured, 2024: 18.56%
No. 6 - Potter County, Texas
- People under 65 that are uninsured, 2024: 24.44%
- Population per primary care physician: 1,143
- Population per mental health care professional: 385
- Children under 19 who are uninsured, 2024: 13.36%
No. 7 - Dallas County, Texas
- People under 65 that are uninsured, 2024: 24.15%
- Population per primary care physician: 1,387
- Population per mental health care professional: 487
- Children under 19 who are uninsured, 2024: 14.88%
No. 8 - Harris County, Texas
- People under 65 that are uninsured, 2024: 23.76%
- Population per primary care physician: 1,717
- Population per mental health care professional: 613
- Children under 19 who are uninsured, 2024: 13.93%
No. 9 - El Paso County, Texas
- People under 65 that are uninsured, 2024: 23.52%
- Population per primary care physician: 2,014
- Population per mental health care professional: 810
- Children under 19 who are uninsured, 2024: 10.09%
No. 10 - Whitfield County, Georgia
- People under 65 that are uninsured, 2024: 23.43%
- Population per primary care physician: 1,870
- Population per mental health care professional: 742
- Children under 19 who are uninsured, 2024: 10.12%
No. 11 - Liberty County, Texas
- People under 65 that are uninsured, 2024: 23.24%
- Population per primary care physician: 4,649
- Population per mental health care professional: 3,643
- Children under 19 who are uninsured, 2024: 12.51%
No. 12 - Bastrop County, Texas
- People under 65 that are uninsured, 2024: 22.81%
- Population per primary care physician: 4,252
- Population per mental health care professional: 1,455
- Children under 19 who are uninsured, 2024: 14.94%
No. 13 - Jefferson County, Texas
- People under 65 that are uninsured, 2024: 22.68%
- Population per primary care physician: 2,097
- Population per mental health care professional: 758
- Children under 19 who are uninsured, 2024: 11.51%
No. 14 - Angelina County, Texas
- People under 65 that are uninsured, 2024: 22.52%
- Population per primary care physician: 1,518
- Population per mental health care professional: 593
- Children under 19 who are uninsured, 2024: 13.25%
No. 15 - Gregg County, Texas
- People under 65 that are uninsured, 2024: 22.01%
- Population per primary care physician: 1,099
- Population per mental health care professional: 451
- Children under 19 who are uninsured, 2024: 12.65%
No. 16 - Nacogdoches County, Texas
- People under 65 that are uninsured, 2024: 21.99%
- Population per primary care physician: 1,406
- Population per mental health care professional: 721
- Children under 19 who are uninsured, 2024: 11.64%
No. 17 - Henderson County, Texas
- People under 65 that are uninsured, 2024: 21.69%
- Population per primary care physician: 2,789
- Population per mental health care professional: 1,432
- Children under 19 who are uninsured, 2024: 12.11%
No. 18 - Smith County, Texas
- People under 65 that are uninsured, 2024: 21.18%
- Population per primary care physician: 1,014
- Population per mental health care professional: 593
- Children under 19 who are uninsured, 2024: 11.74%
No. 19 - Nueces County, Texas
- People under 65 that are uninsured, 2024: 21.16%
- Population per primary care physician: 1,266
- Population per mental health care professional: 648
- Children under 19 who are uninsured, 2024: 9.83%
No. 20 - Wise County, Texas
- People under 65 that are uninsured, 2024: 20.88%
- Population per primary care physician: 2,656
- Population per mental health care professional: 1,702
- Children under 19 who are uninsured, 2024: 12.98%