The 10 Best States for Racial Equality in Health Insurance

About 88% of Americans between 2017 and 2021 reportedly had some form of health insurance, based on survey data from the Centers for Disease Control and Prevention.

Yet access to health care coverage varies among different racial and ethnic groups in the U.S. Over the same five-year period, for example, coverage rates for Hispanics (72.3%), Native Hawaiians and other Pacific Islanders (85.7%), and Black (87.0%) individuals were lower than rates for white (92.8%) and Asian (92.4%) people.

Breaking down the data further shows how gaps between racial and ethnic groups can persist and vary at the state level. As part of the Racial Equality in America project, U.S. News compared health insurance coverage rates of racial and ethnic groups in a state to the rate of the state’s overall population, measuring the average disparity between the two categories. States were ranked based on the size of their disparity, with higher values resulting in a worse ranking for racial equality in health care coverage. Disparities in coverage rates are reflected as an average absolute percentage-point difference.

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In Iowa, for instance, the overall health insurance enrollment rate was about 92.8%, though a large range between groups in the state – from Hispanic people at 64.1% to non-Hispanic white people at 94.7% – indicates a high level of disparity. Meanwhile, in Pennsylvania, the health insurance enrollment rate was also 92.8%, but smaller gaps between group rates and the overall rate on average amount to a lower level of disparity.

The U.S. News analysis notably encompasses a period in which Medicaid coverage surged during the COVID-19 pandemic. Millions of people have since lost coverage, with states removing people from Medicaid rolls following the expiration of the federal “continuous enrollment” policy earlier this year. At the same time, nearly all of the top states for racial equality in health care coverage have expanded Medicaid eligibility to more adults in recent years as permitted after passage of the Affordable Care Act.

These are the 10 best states for racial equality in health care coverage as assessed by U.S. News. Learn more about the Racial Equality in America project in our methodology.