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Quote from KFF President and CEO Drew Altman reads, "when it comes to the “affordability crisis” driving the national discussion of health care today, the chronically ill, and most of all the chronically ill uninsured, are the tip of the spear."

The Group that Struggles the Most in American Health Care

In a new column, Dr. Drew Altman, KFF’s Founding President and CEO, previews findings about the chronically ill uninsured from a large KFF survey of 25,000 Americans focusing on the cost and access challenges facing the chronically ill, which will be released tomorrow. He writes: “There are more than enough needs to go around in American health care, but if I had to pick the one group that struggles the most with costs and access, it would be people with chronic illnesses who are also uninsured.”

Other “Beyond the Data” columns >>

Key Facts about the Uninsured Population

The number and share of people without insurance grew in 2024, increasing for the first time since 2019, according to KFF’s analysis of data from the American Community Survey (ACS). This issue brief describes trends in health coverage in 2024, examines the characteristics of the uninsured population , and summarizes the access and financial implications of not having coverage.

Data and analysis

The coverage gap exists because some states did not expand Medicaid under the ACA to cover adults under age 65 without dependent children with incomes at/below 138% of the federal poverty level (FPL)

How Many Uninsured Are in the Coverage Gap?

An estimated 1.4 million uninsured individuals in the 10 states without Medicaid expansion, including many working adults, people of color, and those with disabilities, remain in the "coverage gap," ineligible for Medicaid or for ACA tax credits that would make coverage affordable.

The Uninsured and Health Coverage

This Health Policy 101 chapter examines the share of the United States population who are uninsured, highlighting their demographics and the challenges they face because of the lack of coverage.

Key Facts on Health Coverage of Immigrants

This fact sheet provides an overview of health coverage for immigrants based on data from the 2023 KFF/LA Times Survey of Immigrants. As of 2023, half of likely undocumented immigrant adults and one in five lawfully present immigrant adults reported being uninsured.

Who was uninsured in 2024?

Latest Polling
9.8%

The share of people under age 65 without insurance
62%

The share of uninsured adults who said they were uninsured because coverage is not affordable
59%

The share of uninsured adults who said they or someone living with them had problems paying for health care
39%

The share of uninsured adults who reported delaying or not getting needed care or medication due to cost
Other key facts about the uninsured >>

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  • Behind the Challenges to Universal Health Coverage

    From Drew Altman

    In this column for The Wall Street Journal's Think Tank, Drew Altman discusses why political reality and the diverse makeup of the remaining uninsured population mean that the likeliest path to universal coverage is a multi-step approach.

  • Medicare-for-All vs. Single Payer: The Impact of Labels

    News Release

    In his latest column for The Wall Street Journal’s Think Tank, “Medicare-for-All vs. Single Payer: The Impact of Labels”, Drew Altman uses new polling on a Medicare-for-all or single payer health system to explain how what you call a health reform plan can substantially affect the public’s response. All previous Drew Altman columns are online.

  • Medicaid Expansion Waivers: What Will We Learn?

    Issue Brief

    Section 1115 waivers authorize research and demonstration projects that, in the view of the Health and Human Services (HHS) Secretary, further the purposes of the Medicaid program. The ACA implemented new requirements for these waivers, including that states must have a publicly available, approved evaluation strategy. This brief examines some of the major research questions and hypotheses relevant to the federal and state evaluations of Medicaid expansion Section 1115 waivers and explores key challenges that…

  • The Affordable Care Act After Six Years

    From Drew Altman

    In this column for The Wall Street Journal’s Think Tank, Drew Altman examines the role of the Affordable Care Act in the health system on its sixth anniversary, and how the hot debate about the law may have created an exaggerated impression of the good and the bad it can do.

  • Analysis: Nearly 12 Million People Who Remain Uninsured Are Eligible for Financial Help Under the Affordable Care Act, About Half Through Medicaid and Half Through the Marketplaces

    News Release

    As the Nov. 1 start of the Affordable Care Act’s fourth open enrollment period approaches, a new Kaiser Family Foundation analysis estimates that 11.7 million people who remain without health insurance are eligible for Medicaid in their state or for tax credits to purchase health insurance through their state’s Affordable Care Act marketplace. While millions of people have gained coverage under the ACA and the nation’s uninsured rate has fallen to a record low, the…

  • Nearly Half of the Uninsured, or 15.7 Million People, Are Eligible for Medicaid or Subsidized Affordable Care Act Coverage, Analysis Finds

    News Release

    State-Level Numbers Provide Estimates of How Many Could Be Reached During Third ACA Open Enrollment Period Weeks away from the Affordable Care Act’s third open enrollment period, a new Kaiser Family Foundation analysis finds nearly half (49% or 15.7 million) of the 32.3 million nonelderly people in the United States without health insurance at the beginning of 2015 are eligible for Medicaid or subsidized coverage through an ACA marketplace. On a state level, the share…

  • Estimates of Eligibility for ACA Coverage among the Uninsured by Race and Ethnicity

    Issue Brief

    This analysis provides national estimates of eligibility for ACA coverage options by race/ethnicity, including Whites, Blacks, and Hispanics. We estimate coverage and eligibility as of early 2015, which is prior to the end of the 2015 Marketplace open enrollment period. Overall, this analysis finds that more than half (55%) of the total 32.3 million nonelderly uninsured are people of color, including 34% who identify as Hispanic, 14% who identify as Black, and 8% who identify…