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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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  • Toplines — The Public’s Health Care Agenda for the New President and Congress

    Poll Finding

    Toplines -- The Public's Health Care Agenda for the New President and Congress This document contains the detailed toplines from The Public's Health Care Agenda for the New President and Congress poll. The poll involved a nationally representative random sample of 1,628 adults ages 18 and older who were interviewed by telephone between December 4 and 14, 2008. The margin of sampling error for the full sample is plus or minus 3 percentage points. For…

  • Challenges of Providing Health Coverage for Children and Parents in a Recession: A 50 State Update on Eligibility Rules, Enrollment and Renewal Procedures, and Cost-Sharing Practices in Medicaid and SCHIP in 2009

    Report

    Overall, more than one-third of the states (19 states) took steps last year to increase access to health coverage for low-income children, pregnant women and parents –- including 15 states that authorized or implemented coverage expansions. At the same time, 10 states enacted at least one measure to restrict access. The report also examines trends in parental coverage and state outreach efforts, including the use of technology to facilitate enrollment. Full Report (.pdf) Data Tables…

  • CHIP TIPS: Medicaid Performance Bonus

    Issue Brief

    This brief, the first in a series, examines the new federal "performance bonus" available to states that do an especially good job of signing up eligible children for Medicaid. The bonus, created by a provision in the Children's Health Insurance Program Reauthorization Act of 2009, is designed to help states cover the added costs that result when states are very successful in enrolling eligible children in Medicaid above target levels specified in the law. It…

  • Today’s Topics In Health Disparities: The Effect of the Economic Downturn on the Health of Communities of Color

    Event Date:
    Event

    Transcript (.pdf) On Wednesday, March 25, the Kaiser Family Foundation held a live, interactive webcast to examine the economic downturn’s impact on health care in communities of color as part of its Today's Topics In Health Disparities series. Rising unemployment has left many families uninsured and increasingly strained family finances are prompting some Americans to cut back on medications and forgo preventive care. The panel discussed these and other potential implications of the economic crisis,…

  • Children’s Health Coverage: Medicaid, CHIP, and Next Steps

    Event Date:
    Event

    The Alliance for Health Reform and the Robert Wood Johnson Foundation co-sponsored this briefing to examine the factors which influence children's coverage. Questions addressed include:What are the trends in private sector coverage? How well are the enrollment simplification and outreach tools that are included in this year’s CHIP reauthorization helping to reach those children who are eligible but unenrolled? How much does a child’s coverage depend on where he or she lives? For more information,…

  • Health Care In New Orleans: Progress and Remaining Challenges

    Event Date:
    Event

    On Dec. 3, 2009, Diane Rowland, the Foundation Executive Vice President and Executive Director of the Kaiser Commission on Medicaid and the Uninsured, delivered this testimony on the post-Katrina recovery efforts to restore health care to the New Orleans area before the U.S.House Committee on Oversight and Government Reform. Testimony (.pdf)

  • Explaining Health Reform: Questions About the Temporary High-Risk Pool

    Issue Brief

    The health reform law creates a temporary national high-risk pool to provide health coverage to people with pre-existing medical conditions who have been uninsured for six months. It is a temporary measure designed to bridge the gap until the implementation of other coverage provisions in the law that will take effect in January 2014. This summary provides answers to basic questions about the high-risk pool program. Brief (.pdf)

  • Article and Policy Forum Examine Medicare, Health Reform and the Challenges Facing People With Disabilities

    Event Date:
    Event

    Wednesday, Sept. 8, the Foundation held a policy workshop examining Medicare, health reform and the challenges facing people with disabilities. Younger Medicare beneficiaries with disabilities are much more likely than seniors in the program to report problems accessing and paying for needed medical services, Kaiser Family Foundation researchers report in this Health Affairs article. Based on a national random-sample survey of people on Medicare, the study finds that half of nonelderly disabled beneficiaries report problems…

  • The Role of Medicare and Beneficiaries in the Deficit-Reduction Debate

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    Event

    This Kaiser Family Foundation briefing examined how Medicare reform options now under consideration might work and their implications for beneficiaries and taxpayers. As context for understanding the potential effects of reforms, the briefing looked at the current and projected income and assets of people on Medicare, out-of pocket health care spending and the ability of Medicare beneficiaries to absorb rising costs. The Foundation also released a new report and video profiling Medicare families and the…

  • Briefing, Survey Examine 2012 Data From 50-State Survey of Medicaid and CHIP Eligibility and Enrollment Policies

    Event Date:
    Event

    Despite continued tight state budgets, a requirement in the Affordable Care Act (ACA) that states maintain eligibility in Medicaid and Children’s Health Insurance Programs was central in preserving coverage during 2011. In addition, more than half of states (29) made improvements in their programs, often using technology to increase program efficiency and streamline enrollment. These and other findings appear in the Kaiser Commission on Medicaid and the Uninsured report, "Performing Under Pressure: Annual Findings of…