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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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  • Legislative Summary: State Children’s Health Insurance Program

    Fact Sheet

    This Fact Sheet summarizes eligibility, benefits and cost-sharing, and financing rules of the State Children's Health Insurance Program as well as other child-related Medicaid provisions from the Balanced Budget Act of 1997. Fact Sheet Fact Sheet

  • Talking with Voters About the Uninsured

    Report

    Ten focus groups were conducted with voters April through July 2001, prior to the tragedies of September 11th and broad public recognition of an economic slowdown. The report, Effective Language and Themes for Talking About the Uninsured, finds that at that time: voters were still surprised by basic facts about the uninsured; voters seemed ready for messages about the uninsured that focus on the health and financial consequences of being uninsured, especially those centered on…

  • Study on the Consequences of Uninsurance Featured in a New Journal Supplement

    Other Post

    A June 2003 supplement of Medical Care Research and Review presents a compelling case that health insurance does lead to improved health and better access to care. The supplement, with Thomas Rice as guest editor, includes four commentaries on the topic by John Ayanian, Stuart Butler, Karen Davis, and Richard Kronick. The supplement, published by Sage Publications and supported by the Kaiser Commission on Medicaid and the Uninsured (KCMU), features Jack Hadley s exhaustive review…

  • Participation in Welfare and Medicaid Enrollment

    Report

    This paper examines Medicaid enrollment and its relation to the rise and fall of enrollment in Aid to Families with Dependent Children (AFDC) or Temporary Assistance to Needy Families (TANF) programs. Issue Paper Issue Paper

  • Summary of Findings: Privatization of Public Hospitals

    Poll Finding

    This Summary presents background, findings, and data from the Economic and Social Research Institute's (ESRI) full report, Privatization of Public Hospitals. Section I provides background about public hospital conversions, including the role of public hospitals, reasons for conversion, the mechanisms of conversion and new ownership entities, and analysis of national and regional public hospital data. Section II provides a discussion of the five case studies of public hospital conversions and the key findings from the…

  • Retiree Health Trends and Implications of Possible Medicare Reforms

    Other Post

    Background Health care benefits had been offered to active employees for a long period of time before health coverage became a retiree benefit offered by employers. The key event that made employer-sponsored retiree health care a possible benefit for retirees was the enactment of Medicare in 1965. It was then felt possible to provide a widely desired benefit at a relatively low cost, since the Medicare program would pay the majority of the costs. Millions…

  • Striving to Make Ends Meet:  Low-Income Families’ Finances and Health Coverage

    Other Post

    Striving to Make Ends Meet: Low-Income Families’ Finances and Health Coverage The Kaiser Commission on Medicaid and the Uninsured released new reports and held a policy briefing on the challenges and tradeoffs low-income families face when dealing with their budgets and the implications for health coverage. Challenges and Tradeoffs in Low-Income Family Budgets: Implications for Health CoverageFaces of Medicaid Webcast of April 20, 2004 Policy Briefing

  • Health Care Agenda for the New Congress – Toplines

    Poll Finding

    This document includes the complete toplines from a survey of the public's attitudes regarding the health care agenda for Bush's second term and the new Congress in 2005. It assesses the relative priority placed on health-care concerns by the American public and also provides insight into public opinion on key issues likely to face the new Congress, such as implementing the Medicare drug law, controlling health care costs, reducing the nation’s uninsured population and reforming…

  • The State of Retiree Health Benefits: Historical Trends and Future Uncertainties

    Event

    Tricia Neuman, Vice President and Director of the Medicare Policy Project for the Kaiser Family Foundation, testified on Monday, May 17, at a U.S. Senate Committee on Aging hearing on issues relating to retiree health coverage, "Access to Adequate Health Insurance: How Does the Equal Employment Opportunity Commission's Recent Rule Affect Retiree Health Benefits?" Testimony (.pdf) Webcast of Hearing

  • Addressing the Health Care Impact of Hurricane Katrina

    Issue Brief

    This issue paper is an effort to begin an assessment of health care needs in the wake of Hurricane Katrina and to review some of the policy options available to the federal government to ensure access to health care for those affected by Katrina. The brief begins with a summary of the implications for the health of the population and its access to needed care. It then outlines the implications for affected states – those…