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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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  • 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)

  • Low-Income Parents’ Access to Medicaid Five Years After Welfare Reform

    Issue Brief

    This policy brief examines health coverage for low-income parents after the 1996 welfare law broke the historical connection between Medicaid coverage and welfare. Many states have altered their rules and some have expanded coverage for low-income working parents. Policy Brief

  • Medicare+Choice in California: Lessons and Insights

    Report

    Thirty-five percent of all California Medicare beneficiaries are enrolled in a M+C plan, far in excess of the 14 percent rate nationwide. This report seeks to identify what lessons for the nation can be drawn from the California M+C experience, as Congress debates the implications of major withdrawals from the M+C program and potential policy changes aimed at reversing this trend. The report is based largely on analysis of M+C data on plan participation, withdrawals,…

  • 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.

  • Barriers to Medi-Cal Enrollment and Ideas for Improving Enrollment: Findings from Eight Focus Groups in California with Parents of Potentially Eligible Children

    Issue Brief

    This report presents the results of eight focus groups conducted in several languages throughout California to explore the knowledge and opinions of parents of potentially eligible children about the Medi-Cal program, California's Medicaid program. The study found that participants were confused about eligibility requirements, found the enrollment process onerous and demeaning, and had suggestions about how they could be better educated about the program. Policy Brief: Medi-Cal Eligibility And Enrollment (.pdf)   Report: Barriers to…

  • External Review of Health Plan Decisions — Policy Brief

    Issue Brief

    An 8-page policy brief on the external review of health plan decisions to inform the policy debate in California and nationally. The policy brief covers external review systems in other states and the Medicare program, the current status of external review in California, and issues regarding the design and implementation of external review. Policy Brief: External Review of Health Plan Decisions Policy Brief: External Review of Health Plan Decisions