never fully compensated public and private hospitals for the full cost of care mandated by emtala. in fact, more than half of all emergency care in the u.s. now goes uncompensated. according to some analyses, emtala is an unfunded mandate that has contributed to financial pressures on hospitals in the last 20 years, causing them to consolidate and close facilities, and contributing to emergency room overcrowding. according to the institute of medicine, between 1993 and 2003, emergency room visits in the u.s. grew by 26%, while in the same period, the number of emergency departments declined by 425. hospitals bill uninsured patients directly under the fee-for-service model, often charging much more than insurers would pay, and patients may become bankrupt when hospitals file lawsuits to collect. mentally ill patients present a unique challenge for emergency departments and hospitals. in accordance with emtala, mentally ill patients who enter emergency rooms are evaluated for emergency medical conditions. once mentally ill patients are medically stable, regional mental health agencies are contacted to evaluate them. patients are evaluated as to whether they are a danger to themselves or others. those meeting this criterion are admitted to a mental health facility to be further evaluated by a psychiatrist. typically, mentally ill patients can be held for up to 72 hours, after which a court order is required. uninsured rates by state percent uninsured (under age 65) by state (2014) 3.8% - 6% 6% - 8% 8% - 9.9% 9.9% - 11.2% 11.2% - 13.7% 13.7% - 15.7% 15.7% - 19% 19% - 21.4% the united states census bureau regularly conducts the current population survey (cps), which includes estimates on health insurance coverage in the united states. the data is published annually in the annual social and economic supplement (asec). the data from 1999 to 2014 are reproduced below.as of 2012, the five states with the highest estimated percentage of uninsured are, in order, texas, nevada, new mexico, florida, and alaska. the five states/territories with the lowest estimated percentage of uninsured for the same year are, in order, massachusetts, vermont, hawaii, washington, d.c., and connecticut. these rankings for each year are highlighted below. percent uninsured (all persons) by state, 1999–2014 division1999200020012002200320042005200620072008200920102011201220132014 united states 13.613.113.513.914.614.314.615.214.714.916.116.315.715.414.511.7 alabama 12.012.512.412.212.512.014.015.111.711.516.415.513.014.813.612.1 alaska 18.317.414.818.017.515.316.916.417.619.617.218.118.219.018.517.2 arizona 19.416.416.716.416.416.219.120.817.819.118.919.117.318.017.113.6 arkansas 13.914.116.416.517.215.917.218.615.717.619.018.517.518.416.011.8 california 19.017.518.016.517.317.518.017.817.518.119.319.419.717.917.212.4 colorado 14.112.914.614.515.315.216.216.516.015.414.512.915.713.714.110.3 connecticut 7.38.98.28.69.410.310.18.78.69.411.111.28.68.19.46.9 delaware 9.78.58.59.29.613.111.611.910.610.713.011.310.010.89.17.8 district of columbia 14.012.812.313.012.712.012.410.99.39.412.412.88.47.96.75.3 florida 17.416.216.915.617.018.319.520.319.819.421.720.719.821.520.016.6 georgia 14.213.914.714.615.215.717.917.317.217.120.519.519.219.218.815.8 hawaii 9.27.98.28.88.68.58.17.96.97.37.47.77.87.76.75.3 idaho 18.215.415.716.917.714.514.415.113.615.415.119.116.915.916.213.6 illinois 11.912.011.812.413.812.513.213.513.012.214.214.814.713.612.79.7 indiana 8.910.110.111.512.212.413.111.311.011.313.713.412.013.414.011.9 iowa 7.88.16.89.010.48.88.19.98.89.010.812.210.010.18.16.2 kansas 11.29.69.89.410.110.610.012.112.411.812.812.613.512.612.310.2 kentucky 12.912.711.612.713.713.911.715.213.415.715.914.814.415.714.38.5 louisiana 20.916.817.817.219.017.016.921.118.019.514.519.820.818.316.68.5 maine 9.210.410.210.49.69.39.88.98.510.210.09.310.09.511.210.1 maryland 10.09.011.011.712.211.913.113.212.711.413.312.813.812.410.27.9 massachusetts 7.87.16.99.510.19.88.69.64.95.04.35.53.44.13.73.3 michigan 9.07.89.09.89.310.29.510.110.811.513.013.012.510.911.08.5 minnesota 6.68.06.97.98.78.37.68.98.08.28.09.79.28.38.25.9 mississippi 15.713.217.016.217.516.916.520.318.417.717.321.016.215.317.114.5 missouri 6.68.69.710.89.911.011.413.112.212.414.613.914.913.313.011.7 montana 17.316.113.814.318.917.515.516.915.015.715.118.218.318.116.514.2 nebraska 9.07.97.99.310.110.39.812.013.011.111.113.212.313.311.39.7 nevada 18.315.714.518.417.618.216.518.616.918.120.621.422.623.520.715.2 new hampshire 7.77.99.78.89.38.79.110.89.910.19.810.112.512.010.79.2 new jersey 11.110.211.612.012.812.613.714.814.613.214.515.615.414.013.210.9 new mexico 24.023.019.620.021.319.320.222.721.822.820.921.419.621.918.614.5 new york 14.414.513.914.014.311.812.113.412.313.414.115.112.211.310.78.7 north carolina 12.512.113.315.916.714.214.517.416.215.117.817.116.317.215.613.1 north dakota 10.29.88.09.710.310.010.811.89.511.610.313.49.111.510.47.9 ohio 9.99.89.910.411.110.311.09.611.111.213.813.613.712.311.08.4 oklahoma 15.417.417.216.719.118.717.718.817.613.817.917.316.917.217.715.4 oregon 14.211.612.714.316.015.415.317.516.215.917.316.013.815.414.79.7 pennsylvania 7.87.68.410.210.010.19.39.49.19.610.910.910.812.09.78.5 rhode island 5.96.97.78.110.410.010.78.110.511.012.011.512.012.311.67.4 south carolina 14.810.711.111.113.114.916.315.315.915.516.820.519.014.315.813.6 south dakota 10.110.88.310.810.611.011.511.59.912.213.113.113.014.411.39.8 tennessee 9.310.710.19.812.212.413.413.214.014.515.014.613.313.913.912.0 texas 21.122.022.424.523.623.622.923.924.724.525.524.623.824.622.119.1 utah 11.910.813.812.111.512.815.516.712.212.014.113.814.614.414.012.5 vermont 10.17.48.88.98.49.811.29.810.19.39.49.38.67.07.25.0 virginia 11.39.69.811.811.513.012.312.514.211.812.614.013.412.512.310.9 washington 12.213.113.312.314.812.512.511.511.012.012.613.914.513.614.09.2 west virginia 14.913.412.913.816.815.716.513.313.714.513.713.414.914.614.08.6 wisconsin 9.77.17.38.69.810.38.88.08.09.28.99.410.49.79.17.3 wyoming 14.514.714.114.814.812.314.414.213.213.315.417.217.815.413.412.0 assisting programs for uninsured people without health insurance in the united states may receive benefits from patient-assistance programs such as partnership for prescription assistance. uninsured patients can also use a medical bill negotiation service, which can audit the medical bill for overcharges and errors. on april 3, 2020, president donald trump announced that the federal government would use funds from the cares act to pay hospitals for treatment of uninsured patients infected with the virus that causes coronavirus disease 2019.