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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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  • Targeting Medicare Drug Benefits: Costs and Issues

    Report

    This report, written by Marilyn Moon and Matthew Storeygard of the Urban Institute, estimates the potential cost of targeting drug benefits to low-income Medicare beneficiaries and those with catastrophic drug expenses and discusses some of the key programmatic issues that could arise under this approach.

  • The Working Uninsured in California and the US

    Issue Brief

    This issue brief, prepared by Linda Blumberg and Len Nichols of the Urban Institute, examines the factors contributing to the disproportionately high rates of uninsurance among California's workers compared to the

  • Immigrant Health Care Conference Call

    Report

    Federal and state policymakers face a major challenge in addressing the health needs of an increasingly diverse population. That challenge can be even greater in the growing number of cities and states with large immigrant communities.

  • Employer-Sponsored Health Insurance in California: Current Trends, Future Outlook, and Coverage Expansions — Issue Brief

    Issue Brief

    A 4-page issue brief that looks at trends in employer-sponsored health insurance coverage in California. The brief also includes public and private sector strategies for expanding employment-based coverage, and discusses how other states have implemented incremental coverage expansions using public programs and financial incentives, with emphasis on New York State.

  • Medicaid’s Disabled Population and Managed Care

    Fact Sheet

    Medicaid's Disabled Population and Managed Care This fact sheet highlights the key facts about the Medicaid managed care programs that serve persons with disabilities. It describes the Medicaid disabled population and the role managed care plays in serving them.

  • Key Facts: Women and HIV/AIDS

    Report

    Women comprise a growing share of new cases of AIDS in the United States. In 1986, women only represented 7% of new cases of AIDS. By 1999 that share had risen to nearly one quarter.

  • Medicaid’s Role for the Disabled Population Under Age 65

    Fact Sheet

    Medicaid's Role for the Disabled Population Under Age 65 Defines the non-elderly disabled and summarizes Medicaid's role in their health care coverage. Includes a description of enrollment requirements, benefits, spending and managed care concerns for the population.

  • The Uninsured in Rural America

    Fact Sheet

    Summarizes the number of uninsured individuals in rural America, who they are, and the barriers to coverage they experience.

  • Immigrants’ Health Coverage and Access

    Report

    New and recent publications on immigrant health policy explore some of the complex problems the country faces in expanding health coverage to immigrants and provide basic statistics and facts on the current status of their health care.