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How Many Uninsured Are in the Coverage Gap?

This analysis estimates that 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 tax credits that would make coverage ACA's Marketplaces affordable to them.

Key Facts about the Uninsured Population

The number of people ages 0-64 who were uninsured held steady at 25.3 million in 2023, although the number of uninsured children rose from 3.8 million to 4.0 million. Most uninsured people are in low-income families and have at least one worker in the family.

How the Unwinding Affected Enrollees

Over half who were disenrolled say they put off needed medical care while trying to renew Medicaid. Overall, 19% of adults who had Medicaid prior to the start of unwinding say they were disenrolled at some point in the past year. Of this group, a large majority (70%) were left at least temporarily uninsured.

The uninsured: How costs affect care and health, 2023

Latest Polling
8%

Percent of adults who reported not having health insurance
55%

Percent of uninsured adults who reported delaying or forgoing some form of health care due to cost
19%

Percent of uninsured adults who report that they or a family member had difficulty paying medical bills
38%

Percent of uninsured adults who reported not having a usual source of care (vs. 8% of insured adults)
Peterson-KFF Health System Tracker

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  • Addressing Health and Social Needs of California’s Immigrant Families: Lessons Learned from Local Responses and Future Priorities

    Event Date:
    Event

    A flurry of federal activity on immigration rules and policies is affecting health care and coverage for both lawfully residing immigrants and undocumented immigrants in the country, ranging from deportation policies, a revised “public charge” rule, and a new proclamation from President Trump requiring health insurance for entry via immigrant visas.

  • ANALYSIS: More than Half of Uninsured People Eligible for Marketplace Insurance Could Pay Less for Health Plan than Individual Mandate Penalty

    News Release

    A new Kaiser Family Foundation analysis finds that more than half (54% or 5.9 million) of the 10.7 million people who are uninsured and eligible to purchase an Affordable Care Act marketplace plan in 2018 could pay less in premiums for health insurance than they would owe as an individual mandate tax penalty for lacking coverage.

  • Kaiser Health Tracking Poll – October 2017: Experiences of the Non-Group Marketplace Enrollees

    Feature

    The start of the open enrollment period for non-group insurance in 2018 is less than one month away, and the majority of individuals who are targets for enrollment – those who currently purchase their own insurance and those who are uninsured – are unaware of the key dates of the next open enrollment period. This report, focusing on enrollees in the non-group market, compares the experiences of individuals who purchase their own insurance through an ACA marketplace with the current health insurance market to those who get their insurance through their employer. Overall, the experiences of marketplace enrollees are more similar than different than those with employer coverage when it comes to costs and choices. However, marketplace enrollees are more likely to express worry about their future ability to afford insurance and health care services.

  • The Language of Health Care Reform

    Perspective

    Published in the Jan. 19 edition of JAMA, this article from KFF Executive Vice President for Health Policy Larry Levitt lays out the major health policy challenges that will confront President-elect Biden and potential approaches to major reform.

  • Community Health Centers’ Role in Delivering Care to the Nation’s Underserved Populations During the Coronavirus Pandemic

    Issue Brief

    In the midst of the coronavirus pandemic, community health centers are serving as public health responders, especially for medically underserved populations. Health centers are a national network of safety net primary care providers who provided care to nearly 30 million patients in 2019, and disproportionately serve patients who are low-income, persons of color, uninsured, or publicly insured – groups that have been especially hard hit by the pandemic. This brief examines how health centers have adapted their service delivery models during the pandemic response and the current challenges they face continuing to meet patients’ needs.

  • How Has the Pandemic Affected Health Coverage in the U.S.?

    Policy Watch

    Findings from administrative data suggest that the decline in enrollment among employer-sponsored insurance was far less than overall declines in employment as of September, and that many who did lose their job-based coverage likely found a safety net in coverage through Medicaid or the ACA marketplaces.

  • Millions of Uninsured Americans are Eligible for Free ACA Health Insurance

    Policy Watch

    Amid the ongoing pandemic and high unemployment, this poste xamines how many uninsured people would be eligible for free health insurance during in a typical year, including those who qualify for Medicaid or for tax credits that cover the full cost of an ACA Marketplace plan.

  • The Uninsured and the ACA: A Primer – Key Facts about Health Insurance and the Uninsured amidst Changes to the Affordable Care Act

    Report

    The Uninsured and the ACA: A Primer provides information on how insurance has changed under the ACA and more recent policy changes, how many people remain uninsured, who they are, and why they lack health coverage. It also summarizes what we know about the impact that a lack of insurance can have on the health outcomes and personal finances and the difference health insurance can make in people’s lives.