This week’s annual release of Census Bureau insurance data tells us that, once again, all states are not equal. Over 90 percent of women aged 18 to 64 in states like Massachusetts and Minnesota are insured. But, again this year, Texas leads the nation in the proportion of women without health insurance, with nearly one-third of women going without health coverage.

Here is the sad list of the worst states for women’s health insurance coverage:


Percentage of Women

without Insurance

1. Texas

28 percent

2. Florida

26 percent

3. Nevada

26 percent

4. New Mexico

25 percent

5. Georgia

25 percent

6. Mississippi

24 percent

7. Oklahoma

24 percent

8. Louisiana

23 percent

9. Arkansas

23 percent

10. Idaho

22 percent

Luckily, governors have an immediate option available to get their states off this list.

This list reflects insurance rates for 2013, before the full implementation of the Affordable Care Act (ACA). In the future, the list of states with lowest insurance rates of women is likely to look substantially different. The governors of Nevada, New Mexico, and Arkansas have already accepted federal funds to expand eligibility for their Medicaid programs and are providing new health coverage for low-income women and families in their state. Although not reflected in this data, many low-income residents of these states (and the other 25 states, including the District of Columbia, that have expanded Medicaid coverage) are already newly insured. Next year, these three states won’t be at the bottom anymore.

But, the other seven states on this list (Texas, Florida, Georgia, Mississippi, Oklahoma, Louisiana, and Idaho) have failed to take action to cover low income women in their states, even though the ACA gives them the tools they need. Without state action to expand Medicaid coverage, women with lower incomes fall into a ‘coverage gap.’ In other words, they will not get any help towards the cost of health insurance.

In the future this list should look very different – particularly if these governors accept the federal money to expand Medicaid coverage and get their states off this shameful list. 

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