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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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  • Health Insurance Coverage Of Low-Income Women

    Fact Sheet

    Low-income women's high rate of health problems and limited economic resources make access to health care and adequate health insurance coverage particularly important. Health coverage, whether through the private sector or publicly through Medicaid, has been demonstrated to improve access to care for low-income women. However, obtaining coverage is not easy or even possible for many women. Job-based insurance is not always an option for low-income women, despite their high workforce participation. Assistance is available…

  • Prescription Drug Coverage for Medicare Beneficiaries: A Side-by-Side Comparison

    Other Post

    This document, prepared by Health Policy Alternatives, Inc., provides a side-by-side comparison of five major federal proposals under consideration to provide outpatient prescription drug coverage to Medicare beneficiaries. It includes both a summary and a detailed comparison of the following major proposals: S. 357, The Medicare Preservation and Improvement Act of 2001 (Breaux/Frist I), S. 358, The Medicare Prescription Drug and Modernization Act of 2001 (Breaux-Frist II), H.R. 4680, The Medicare Rx 2000 Act (passed…

  • Is Immigration Responsible for the Growth in the Number of the Uninsured?

    Report

    This issue paper analyzes the role of immigrants in the growth of the number uninsured people in America. Results show that recent immigrants are not the reason for the growth in the number of the uninsured from 1994 to 1998 despite their high rates of uninsurance. Issue Paper

  • Medicaid: Purchasing Prescription Drugs

    Issue Brief

    Medicaid: Purchasing Prescription Drugs A policy brief explaining how Medicaid purchases outpatient drugs and outlining the policy tools available to states to limit the rate of growth in spending on prescription drugs. Policy Brief (28 pages)

  • Medicare Beneficiaries and Their Assets: Implications for Low-Income Programs

    Report

    This report, prepared by Marilyn Moon of The Urban Institute and Robert Friedland and Lee Shirey of Georgetown University's Center on an Aging Society, reviews the income and assets of the current Medicare population, provides an overview of asset tests used to determine eligibility for programs assisting low-income Medicare beneficiaries, and considers how alternative policy options would affect eligibility for these programs. The authors find that beneficiaries with low incomes tend to have minimal assets.…

  • Disability, Health Coverage, and Welfare Reform

    Report

    This report analyzes data from a survey of 42 low-income families with children with moderate or severe disabilities to better understand the impact of welfare reform on health coverage for these families. Report

  • Small Employers and Health Insurance and State Reforms of Small Group Health Insurance – Fact Sheet

    Fact Sheet

    State Reforms of Small Group Health Insurance Between 1989 and 1995, 45 states enacted laws to make health insurance more accessible and attractive to small businesses. The small group market was targeted for reform because about half of all uninsured workers are either self-employed or working in firms with fewer than 25 employees (EBRI, 1996). The problem is that only about half of all small firms offer health insurance (Figure 1). In 1995, 53% of…

  • Is There Room for Conscience without Compromising Access? Are Affiliations Between Religious and Secular Health Care Organizations Threatening Access?

    Fact Sheet

    These resources were prepared for a briefing held for journalists in New York City on November 4, 1997 in New York City as part of a joint program by The Alan Guttmacher Institute, The Kaiser Family Foundation and the National Press Foundation. This program focused on mergers, acquisitions, consolidations, joint ventures, and other affiliations between Catholic and non-Catholic hospitals and health systems and the effect these affiliations have on access to reproductive health services.