Highest uninsured rate, US counties
US counties ranked by the share of residents without health insurance (2024 ACS). Oglala Lakota County, South Dakota leads at 44.6%. 3,144 counties qualify in total. Texas carries 14 of the top 25 entries. The median across all 3,144 is 7.8%. Biggest climber in the top 100 since 2020: Platte County, WY, up 1,275 places to #79.
UPDATED 2026-09-11 · DATA: US CENSUS BUREAU ACS 5-YEAR ESTIMATES
Frequently asked
Which county has the highest uninsured?
Oglala Lakota County, South Dakota ranks #1 with 44.6% (2024 American Community Survey).
What are the top 5 counties by uninsured?
Oglala Lakota County, South Dakota, LaGrange County, Indiana, Buffalo County, South Dakota, Holmes County, Ohio, Scotland County, Missouri.
How many counties are in this ranking?
3,144 counties qualify after filtering for population minimums and data availability. The ranking covers 2024 ACS 5-year data.
How is uninsured measured?
Share of residents without health insurance. Source: US Census Bureau, American Community Survey 5-year estimates (2024).