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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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1,121-1,130 of 1,313 results

  • Pulling It Together: What Do We Want Health Insurance To Be?

    Perspective

    Trends in the health insurance marketplace show substantial growth in high deductible health plans, especially among smaller firms, where 35% of workers are now covered by plans with a deductible of $1,000 or more. That's according to our recently released employer health benefits survey, which we have been conducting now for ten years. The majority of these plans are simply high deductible health plans; only a minority are so-called "consumer driven" plans with savings accounts.…

  • 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…

  • Community Health Centers in an Era of Health System Reform and Economic Downturn: Prospects and Challenges

    Issue Brief

    This issue brief reviews the role of community health centers in the nation's health care safety net. The centers provided comprehensive primary care to 16.1 million patients in 2007, many of them from lower-income families and medically underserved communities. The role of the centers is even more critical during an economic recession when families are more vulnerable to economic loss and unmet health needs. Issue Brief (.pdf)

  • 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…

  • Express Lane Eligibility Efforts: Lessons Learned from Early State Cross-Program Enrollment Initiatives

    Issue Brief

    The Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA) provides states new options to reach and enroll eligible but uninsured low-income children into Medicaid and CHIP. The law's Express Lane Eligibility (ELE) provisions enable state Medicaid and CHIP agencies to identify, enroll and recertify children by relying on eligibility findings from other programs, such as Head Start or Food Stamps, rather than having to re-analyze eligibility under their own rules. Further, CHIPRA authorizes greater…

  • 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,…

  • 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)

  • Coverage of Low-Income Children: Key Issues to Consider in Health Reform

    Issue Brief

    A key element of health reform will be meeting the needs of low-income children. Overall, a major goal of proposals is to expand coverage by building on Medicaid, providing subsidies to low- and moderate-income individuals to buy coverage through new health insurance exchanges, and requiring individuals to obtain coverage. Current proposals also could significantly change coverage for some children already eligible for Medicaid and CHIP. This issue brief examines several key issues to consider about…

  • 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)

  • 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…