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Uninsured

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.

New and noteworthy

Affordability Is the Issue Now, But Look for the Uninsured to Make a Comeback

A new column on the uninsured from President and CEO Dr. Drew Altman explains: “The uninsured is not the most politically salient problem in health care now, that’s affordability, nor is it the non-problem some say it is. But it’s coming back. And the problem of the chronically ill uninsured is glaring.” Read more.

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.

More on the uninsured population >>

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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  • Expanding Medicaid to Low-Income Childless Adults Under Health Reform: Key Lessons From State Experiences

    Issue Brief

    The health reform law will expand Medicaid to millions of low-income adults, including many childless adults who have historically been ineligible for the program, necessitating one of the largest enrollment efforts in the program's history. This report, based on interviews with officials in seven states and the District of Columbia and national experts, examines lessons learned from past state experience covering childless adults through waiver and state-funded programs and profiles the programs included in the…

  • 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 Health Reform Law’s Medicaid Expansion: A Guide to the Supreme Court Arguments

    Issue Brief

    One significant element of the pending U.S. Supreme Court case challenging the Affordable Care Act is the constitutionality of the law's Medicaid expansion. This provision of the law requires states that choose to participate in the Medicaid program to cover nearly all adults under age 65 with household incomes at or below 133% of the federal poverty level as of January 2014. A ruling on the Medicaid expansion could have far-reaching impacts on the present…

  • Using Data and Technology to Drive Process Improvement in Medicaid and CHIP: Lessons From South Carolina

    Fact Sheet

    In the past year, there has been a notable trend of states increasingly utilizing data and technology to modernize, streamline, and gain efficiencies in their Medicaid and CHIP programs. The expanded use of data and technology is not only helping states deal with current budget pressures and decreased administrative resources, but also lays important groundwork for the coverage expansions and new coordinated, streamlined, and technology-driven enrollment process that will go into effect in 2014 under…

  • Immigrants’ Access to Health Care

    Issue Brief

    Immigrants account for 20 percent of the uninsured. There are many reasons for immigrants' lack of coverage, but the welfare reform law of 1996 was significant in restricting Medicaid eligibility for certain immigrant populations. The Kaiser Commission on Medicaid and the Uninsured has produced new reports on immigrant health care: a chart pack highlighting statistics and a policy brief discussing the legal status of Medicaid eligibility. An issue paper summarizing the findings of immigrant focus…

  • Express Lane Eligibility: How to Enroll Large Groups of Eligible Children in Medicaid and CHIP

    Report

    This issue paper explores the potential for increasing enrollment in children's health insurance programs through "Express Lane Eligibility." Express Lane Eligibility is the accelerated enrollment of low-income uninsured children already participating in other income-comparable publicly funded programs, such as WIC or school lunch, into Medicaid or CHIP. The paper reviews Express Lane Eligibility's potential impact on Medicaid and CHIP enrollment, analyzes different models, discusses key challenges with implementation, and suggests steps states and localities can…

  • 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. Fact Sheet

  • SCHIP Managed Care Contracting

    Report

    The fourth in a series of reports on implementation issues and challenges in the first year of S-CHIP finds that states have been able to enter arrangements with plans for their S-CHIP population fairly easily. REPORT Download

  • Sicker and Poorer: The Consequences of Being Uninsured

    Report

    Sicker and Poorer: The Consequences of Being Uninsured A new report by the Kaiser Commission on Medicaid and the Uninsured synthesizes the major findings of the past 25 years of health services research assessing the most important effects of health insurance. The report evaluates thousands of citations and 230 research articles to assess the consequences of being uninsured for health status and economic opportunity and concludes that the weight of this large body of research…