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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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  • 2016 Survey of Health Insurance Marketplace Assister Programs and Brokers

    Report

    In its third year, the survey tracks the experiences of assistance programs signing people up for Affordable Care Act coverage during open enrollment and, for consumers who qualify, during special enrollment periods. This year, for the second time, the survey includes health insurance brokers who helped people apply for non-group coverage in an ACA marketplace.

  • Connecting the Justice-Involved Population to Medicaid Coverage and Care: Findings from Three States

    Issue Brief

    This brief provides an overview of initiatives to connect the justice-involved population to Medicaid coverage and care in the community in three states—Arizona, Connecticut, and Massachusetts—based on interviews with key stakeholders. These states are leading efforts in these areas and provide key lessons about how to coordinate across health care and corrections and the potential of such initiatives to better link individuals to the physical and behavioral services they need. Each of the case study states is connecting individuals to coverage at multiple points within the justice system. The study states also connect individuals to care in the community as they are released from jail or prison. Stakeholders and data indicate that these approaches have increased coverage, facilitated access to care, and contributed to administrative efficiencies and state savings. However, more data and time are needed to examine the effects on health and criminal justice outcomes, including recidivism rates.

  • 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.

  • Measuring Changes in Insurance Coverage Under the Affordable Care Act

    Issue Brief

    This data note discusses the details and timing of some of the private and federal surveys that will be used to look at how coverage has changed due to the Affordable Care Act. Different surveys offer different information and insight into coverage under the ACA, and we discuss the contributions and challenges in each type of effort.

  • Health Coverage and Care in the South: A Chartbook

    Report

    The South has faced longstanding disparities in health and health care, although significant variation exists between southern states. As a group, compared to those in other regions, Southerners are more likely to be uninsured, less likely to have access to needed health services, and more likely to experience a number of chronic health conditions. This chartbook provides key data on the demographic and economic characteristics of the southern population as well as their health status, health insurance coverage, and access to care today.

  • If Health Insurance Subsidies Are Struck Down, States Will Need Time

    From Drew Altman

    In this column for The Wall Street Journal's Think Tank, Drew Altman explores a practical timetable for state action if the Supreme Court rules in favor of the plaintiffs in King V. Burwell and ponders what Republicans in Congress might do.

  • The Health-Care Enrollment Story Is in the States

    From Drew Altman

    In this column for The Wall Street Journal's Think Tank, Drew Altman examines the variation among states beneath the national Affordable Care Act’s Marketplace enrollment numbers released by the Department of Health and Human Services.

  • Which Path for Health-Care Politics in 2015?

    From Drew Altman

    This was published as a Wall Street Journal Think Tank column on January 6, 2015. Yogi Berra said that when you come to a fork in the road, take it. It will be that kind of year for health-care politics. The status quo is not an option.