AUSTIN (KXAN) — A recent study found some individuals may be forgoing health insurance and instead making the tradeoff for their financial well-being. SmartAsset, a financial technology company, said it ranked U.S. counties based on the rate of people under age 65 who were insured in 2024. Of the top 20, 19 counties with the least health insurance coverage were in Texas. “In 2024, the average annual premium for a single individual was nearly $9,000 – and an estimated $25,500 for a family of four,” SmartAsset said. According to the study, several Texas counties had the lowest health insurance coverage rates nationwide. “More than any other county, 32.0% of residents in Hidalgo County don’t have health insurance,” SmartAsset said. “Cameron County (30.1% uninsured), Webb County (29.7%), Starr County (29.0%), Ector County (25.3%), Potter County (24.4%), Dallas County (24.2%), Harris County (23.8%) and El Paso County (23.5%) are also among the top 10 uninsured counties nationwide.” The data showed one Texas county also had the lowest rate of primary care physicians. According to the study, Orange County, Texas, ranked 84th overall for the lowest rate of health insurance, with 6,053 residents for every primary care physician. Smart Asset said that was more than any other county studywide. Another Texas county also saw the largest drop in insurance coverage year over year, according to the study. SmartAsset found Tom Green County, Texas, which was ranked as having the 25th highest number of uninsured residents, saw a drop from 17.5% uninsured in 2023 to 20.2% uninsured in 2024. Top 20 counties with the highest rates of uninsured people No. 1 - Hidalgo County, Texas People under 65 that are uninsured, 2024: 32.05% Population per primary care physician: 2,158 Population per mental health care professional: 1,199 Children under 19 who are uninsured, 2024: 12.57% No. 2 - Cameron County, Texas People under 65 that are uninsured, 2024: 30.08% Population per primary care physician: 2,034 Population per mental health care professional: 1,128 Children under 19 who are uninsured, 2024: 13.65% No. 3 - Webb County, Texas People under 65 that are uninsured, 2024: 29.69% Population per primary care physician: 3,268 Population per mental health care professional: 1,913 Children under 19 who are uninsured, 2024: 12.28% No. 4 - Starr County, Texas People under 65 that are uninsured, 2024: 29% Population per primary care physician: 3,885 Population per mental health care professional: 4,695 Children under 19 who are uninsured, 2024: 12.46% No. 5 - Ector County, Texas People under 65 that are uninsured, 2024: 25.26% Population per primary care physician: 1,751 Population per mental health care professional: 1,962 Children under 19 who are uninsured, 2024: 18.56% No. 6 - Potter County, Texas People under 65 that are uninsured, 2024: 24.44% Population per primary care physician: 1,143 Population per mental health care professional: 385 Children under 19 who are uninsured, 2024: 13.36% No. 7 - Dallas County, Texas People under 65 that are uninsured, 2024: 24.15% Population per primary care physician: 1,387 Population per mental health care professional: 487 Children under 19 who are uninsured, 2024: 14.88% No. 8 - Harris County, Texas People under 65 that are uninsured, 2024: 23.76% Population per primary care physician: 1,717 Population per mental health care professional: 613 Children under 19 who are uninsured, 2024: 13.93% No. 9 - El Paso County, Texas People under 65 that are uninsured, 2024: 23.52% Population per primary care physician: 2,014 Population per mental health care professional: 810 Children under 19 who are uninsured, 2024: 10.09% No. 10 - Whitfield County, Georgia People under 65 that are uninsured, 2024: 23.43% Population per primary care physician: 1,870 Population per mental health care professional: 742 Children under 19 who are uninsured, 2024: 10.12% No. 11 - Liberty County, Texas People under 65 that are uninsured, 2024: 23.24% Population per primary care physician: 4,649 Population per mental health care professional: 3,643 Children under 19 who are uninsured, 2024: 12.51% No. 12 - Bastrop County, Texas People under 65 that are uninsured, 2024: 22.81% Population per primary care physician: 4,252 Population per mental health care professional: 1,455 Children under 19 who are uninsured, 2024: 14.94% No. 13 - Jefferson County, Texas People under 65 that are uninsured, 2024: 22.68% Population per primary care physician: 2,097 Population per mental health care professional: 758 Children under 19 who are uninsured, 2024: 11.51% No. 14 - Angelina County, Texas People under 65 that are uninsured, 2024: 22.52% Population per primary care physician: 1,518 Population per mental health care professional: 593 Children under 19 who are uninsured, 2024: 13.25% No. 15 - Gregg County, Texas People under 65 that are uninsured, 2024: 22.01% Population per primary care physician: 1,099 Population per mental health care professional: 451 Children under 19 who are uninsured, 2024: 12.65% No. 16 - Nacogdoches County, Texas People under 65 that are uninsured, 2024: 21.99% Population per primary care physician: 1,406 Population per mental health care professional: 721 Children under 19 who are uninsured, 2024: 11.64% No. 17 - Henderson County, Texas People under 65 that are uninsured, 2024: 21.69% Population per primary care physician: 2,789 Population per mental health care professional: 1,432 Children under 19 who are uninsured, 2024: 12.11% No. 18 - Smith County, Texas People under 65 that are uninsured, 2024: 21.18% Population per primary care physician: 1,014 Population per mental health care professional: 593 Children under 19 who are uninsured, 2024: 11.74% No. 19 - Nueces County, Texas People under 65 that are uninsured, 2024: 21.16% Population per primary care physician: 1,266 Population per mental health care professional: 648 Children under 19 who are uninsured, 2024: 9.83% No. 20 - Wise County, Texas People under 65 that are uninsured, 2024: 20.88% Population per primary care physician: 2,656 Population per mental health care professional: 1,702 Children under 19 who are uninsured, 2024: 12.98%