WASHINGTON, D.C. -- For the fifth straight year, Texas has the highest uninsured rate in the country -- the 28.8% of adult Texans lacking healthcare coverage in 2012 is the highest for any state since Gallup and Healthways started tracking insurance coverage in January 2008. This widens the gap between Texas and the state with the second-highest uninsured rate in the country, Louisiana (24.0%), to 4.8 percentage points -- the largest number separating these two spots on record. Massachusetts continues to have the lowest uninsured rate in the U.S., at 4.5%.
The gap between Texas and the state with the second-highest uninsured rate -- which has varied from year to year -- has increased from 3.5 points or less in 2008, 2009, and 2010.
These state-level data are based on daily surveys conducted as part of the Gallup-Healthways Well-Being Index from January through December 2012 and include at least 900 residents in every state.
An average of 16.9% of all adults reported lacking health insurance last year, similar to the 17.1% in 2011, but still much higher than the 14.8% in 2008. In most states, the uninsured rate was unchanged in 2012 compared with 2011. The percentage of uninsured adults increased statistically significantly in eight states last year: New Jersey, Pennsylvania, Wisconsin, Minnesota, Louisiana, Texas, California, and Arizona.
The uninsured rates in 24 states remained statistically higher in 2012 than they were in 2008. And four states have seen at least marginal increases in their uninsured rates every year since 2008: Rhode Island, New Jersey, California, and New York. No state has recorded consistent year-over-year declines in the uninsured rate during the past five years.
(For the full data on each state since 2008, visit the State of the States interactive or see page 2.)
States with the lowest uninsured rates continue to cluster in the East and upper Midwest. Uninsured rates are highest in the South and the West.
The high uninsured rates in Texas and other states, including California and Florida, are likely related, at least in part, to the large Hispanic populations in those states -- a demographic group that Gallup finds has the highest uninsured rate in the country, at 40.1% in 2012.
Bottom Line
Uninsured rates in about half the U.S. remained higher in 2012 than in 2008. Just four states, though, show year-over-year increases every year since 2008 -- Rhode Island, New Jersey, California, and New York. And Texas -- the state with the highest adult uninsured rate in the country for five years in a row -- continues to widen the gap between it and the state with the second-highest uninsured rate in the U.S.
For the most part, the geographic distribution of uninsured rates has been relatively unchanged over the past five years, with Eastern states tending to have fewer uninsured residents and Southern and Western states having more.
Nationwide, the most significant change Gallup has found in health insurance trends since the passage of the 2010 Affordable Care Act is that more young adults have gained coverage. It is unclear, at this point, whether a particular state's age makeup has played a role in the changes in uninsured rates over the past two years. The bulk of the law goes into effect in 2014, meaning Gallup should begin to see more significant changes across states in its midyear 2014 state reporting.
Gallup's "State of the States" series reveals state-by-state differences on political, economic, and well-being measures Gallup tracks each day.
About the Gallup-Healthways Well-Being Index
The Gallup-Healthways Well-Being Index tracks well-being in the U.S. and provides best-in-class solutions for a healthier world. To learn more, please visit well-beingindex.com.
Survey Methods
Results are based on telephone interviews conducted as part of the Gallup-Healthways Well-Being Index survey Jan. 1-Dec. 31, 2012, with a random sample of 353,564 adults, aged 18 and older, living in all 50 U.S. states and the District of Columbia, selected using random-digit-dial sampling.
For results based on the total sample of national adults, one can say with 95% confidence that the maximum margin of sampling error is ±1 percentage point.
The margin of sampling error for most states is ±1 to ±2 percentage points, but is as high as ±4 points for states with smaller population sizes such as Alaska, Rhode Island, Vermont, Wyoming, North Dakota, South Dakota, Delaware, and Hawaii.
Interviews are conducted with respondents on landline telephones and cellular phones, with interviews conducted in Spanish for respondents who are primarily Spanish-speaking. Each sample includes a minimum quota of 400 cell phone respondents and 600 landline respondents per 1,000 national adults, with additional minimum quotas among landline respondents by region. Landline telephone numbers are chosen at random among listed telephone numbers. Cell phone numbers are selected using random-digit-dial methods. Landline respondents are chosen at random within each household on the basis of which member had the most recent birthday.
Samples are weighted by gender, age, race, Hispanic ethnicity, education, region, adults in the household, and phone status (cell phone only/landline only/both, cell phone mostly, and having an unlisted landline number). Demographic weighting targets are based on the March 2012 Current Population Survey figures for the aged 18 and older non-institutionalized population living in U.S. telephone households. All reported margins of sampling error include the computed design effects for weighting.
In addition to sampling error, question wording and practical difficulties in conducting surveys can introduce error or bias into the findings of public opinion polls.
For more details on Gallup's polling methodology, visit www.gallup.com.
