A map of Massachusetts
Most Americans had health insurance at least part of the year in 2023, but coverage varies widely from market to market. This variability is a result of different policies, economic conditions and local job markets, according to an analysis by Visual Capitalist.
The report said 305 million Americans had health insurance in 2023, representing about 92% of the population. The metro area with the largest share of residents with health insurance was Amherst Town-Northampton, Massachusetts, where 98.4% of the population was covered.
In fact, Massachusetts had five metros among the top 11 in Visual Capitalist’s ranking, which may be related to its high median income and highly educated population, a factor that has been tied to health insurance coverage, said the report. Pittsfield ranked second with 98.2% of the population covered by health insurance. The Boston-Cambridge-Newton, Massachusetts/New Hampshire market ranked fourth with 97.4% of residents covered, and Worcester and Barnstable Town were among three markets tied for fifth place with 97.3% coverage.
Outside of Massachusetts, Midwest markets also had high levels of health insurance coverage among residents. Grand Forks, North Dakota, ranked third with 97.7% of its residents having health insurance coverage. Other markets with high rates of health insurance coverage were Decatur, Illinois, at 97.3% and Sandusky, Ohio; Glen Falls, New York; and Jackson and Ann Arbor, Michigan, in a four-way tie with 97.1% coverage.
Meanwhile, all but one of the bottom markets for health insurance coverage were in Texas in 2023, the report found. Border cities Laredo, McAllen and Brownsville represented the bottom three with 70.7%, 74.7% and 76.5% coverage, respectively. Other Texas cities that ranked toward the bottom of the list were Odessa (77.2%), El Paso (78.2%), Eagle Pass (79.9%), Beaumont (80.8%), Houston (81.9%) and Sherman (82.9%).
The report noted that Texas is one of ten states that did not expand Medicaid under the Affordable Care Act (ACA) and has some of the highest health care insurance costs in the country, both of which may contribute to a relatively lower share of insured residents.
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