Medicaid covers one in three New Mexico residents, compared with one in nine in Utah
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About one in five Americans has Medicaid or another means-tested public health plan, but the share ranges from one in three in New Mexico to about one in nine in Utah, according to the U.S. Census Bureau's 2020-2024 American Community Survey.
New Mexico has the highest share, at 33.5 percent of residents, followed by Louisiana (31.3 percent), New York (28.1 percent), Kentucky (27.6 percent), and California (26.9 percent). Utah has the lowest, at 10.9 percent, with Wyoming, North Dakota, New Hampshire, and South Dakota close behind.
| Rank | State | Share with Medicaid |
|---|---|---|
| 1 | New Mexico | 33.5% |
| 2 | Louisiana | 31.3% |
| 3 | New York | 28.1% |
| 4 | Kentucky | 27.6% |
| 5 | California | 26.9% |
| 6 | West Virginia | 26.5% |
| 7 | Arkansas | 26.4% |
| 8 | District of Columbia | 24.9% |
| 9 | Mississippi | 24.1% |
| 10 | Oregon | 23.6% |
| 11 | Alaska | 23.4% |
| 12 | Michigan | 23.1% |
| 13 | Massachusetts | 23.0% |
| T14 | Rhode Island | 22.7% |
| T14 | Vermont | 22.7% |
| 16 | Connecticut | 22.0% |
| 17 | Ohio | 21.1% |
| 18 | Oklahoma | 21.0% |
| 19 | Pennsylvania | 20.8% |
| 20 | Montana | 20.6% |
| 21 | Delaware | 20.5% |
| 22 | Washington | 20.4% |
| T23 | Arizona | 20.3% |
| T23 | Indiana | 20.3% |
| 25 | Maine | 20.2% |
| 26 | Alabama | 20.0% |
| T27 | Nevada | 19.9% |
| T27 | Iowa | 19.9% |
| 29 | Hawaii | 19.7% |
| T30 | Tennessee | 19.6% |
| T30 | South Carolina | 19.6% |
| 32 | Illinois | 19.5% |
| 33 | Maryland | 19.3% |
| 34 | North Carolina | 18.9% |
| 35 | Idaho | 18.6% |
| 36 | Minnesota | 18.3% |
| 37 | Georgia | 18.2% |
| 38 | New Jersey | 18.1% |
| 39 | Colorado | 18.0% |
| 40 | Wisconsin | 17.8% |
| 41 | Florida | 17.4% |
| T42 | Texas | 16.2% |
| T42 | Missouri | 16.2% |
| 44 | Virginia | 16.0% |
| 45 | Nebraska | 15.4% |
| 46 | Kansas | 14.2% |
| 47 | South Dakota | 13.6% |
| 48 | New Hampshire | 12.9% |
| 49 | North Dakota | 12.5% |
| 50 | Wyoming | 11.7% |
| 51 | Utah | 10.9% |
The counties with the highest shares
Among counties with at least 50,000 residents, McKinley County, New Mexico, has the highest share, at 57.4 percent. The Bronx is second at 52.5 percent, followed by Imperial County, California (49.8 percent), Tulare County, California (45.7 percent), and Apache County, Arizona (44.8 percent). California's Central Valley appears repeatedly, with Merced and Kern counties also above 40 percent.
Among cities of 100,000 or more, Detroit has the highest share, 52.1 percent, followed by Springfield, Massachusetts (51.4 percent), New Bedford, Massachusetts (48.6 percent), and Waterbury, Connecticut (47.3 percent).
The lowest shares are in suburban counties. Forsyth County, Georgia, north of Atlanta, has the lowest share of any county with 50,000 or more residents, at 5.9 percent. Johnson County, Kansas, outside Kansas City, is at 6.7 percent, and Collin County, Texas, Douglas County, Colorado, and Williamson County, Tennessee, are each at 6.8 percent.
What the numbers measure
The figures count people who have Medicaid or other means-tested public coverage at the time of the survey, alone or together with another plan. The survey question asks about Medicaid, Medical Assistance, or any kind of government-assistance plan for people with low incomes or a disability. Because the survey covers five years, the 2020-2024 figures include the pandemic period, when a federal rule kept most people enrolled in Medicaid without the usual eligibility checks. That rule ended in March 2023.
How Americans get coverage overall, from employer plans to Medicare, is covered in how Americans get health insurance, and county uninsured rates in our report on county uninsured rates. The full county list is at counties with the highest Medicaid coverage.
Sources
Figures are from the U.S. Census Bureau's 2020-2024 American Community Survey 5-year estimates, table S2704 (public health insurance coverage by type), for the civilian noninstitutionalized population. "Medicaid" here means Medicaid, medical assistance, or any kind of government-assistance plan for people with low incomes or a disability, alone or in combination with other coverage. The county list is limited to counties with at least 50,000 residents and the city list to cities with at least 100,000.
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Which state has the most people on Medicaid?
By share of residents, New Mexico, where 33.5 percent have Medicaid or other means-tested public coverage, according to the 2020-2024 American Community Survey. Louisiana is second at 31.3 percent and New York third at 28.1 percent.
Which state has the lowest Medicaid enrollment rate?
Utah, where 10.9 percent of residents have Medicaid or similar coverage. Wyoming (11.7 percent), North Dakota (12.5 percent), New Hampshire (12.9 percent), and South Dakota (13.6 percent) are next.
What share of Americans are on Medicaid?
About one in five, based on state figures from the Census Bureau's 2020-2024 American Community Survey. The count includes people with Medicaid alone or combined with other insurance, such as Medicare.
