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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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  • Child Health Facts:  National and State Profiles of Coverage

    Other Post

    Child Health Facts: National and State Profiles of Coverage Appendix 2 Medicaid Enhanced Matching Rate Matching Rate Alabama 69.3% 78.5% Alaska 59.8% 71.9% Arizona 65.3% 75.7% Arkansas 72.8% 81.0% California 51.2% 65.9% Colorado 52.0% 66.4% Connecticut 50.0% 65.0% Delaware 50.0% 65.0% District of Columbia 70.0% 79.0% Florida 55.7% 69.0% Georgia 60.8% 72.6% Hawaii 50.0% 65.0% Idaho 69.6% 78.7% Illinois 50.0% 65.0% Indiana 61.4% 73.0% Iowa 63.8% 74.6% Kansas 59.7% 71.8% Kentucky 70.4% 79.3% Louisiana 70.0%…

  • Low-Income Adults in New Orleans in 2008: Who Are They and How Are They Faring?

    Poll Finding

    Based on data from Kaiser's Second Post-Katrina Survey, this Survey Brief profiles low-income adults in New Orleans in 2008, examining their demographics, personal recovery from the aftermath of Hurricane Katrina, worries and concerns, and financial and health care challenges. It finds that low-income adults in New Orleans are more likely than other adults in the city to still be dealing with recovery from the aftermath of Hurricane Katrina and facing financial and health care challenges.…

  • Medicaid Spending Growth and the Great Recession, 2007-2009

    Fact Sheet

    This fact sheet examines how the recent recession drove up Medicaid enrollment as millions of Americans lost jobs and income, and how that increase in enrollment has been the primary cause of the increase in overall Medicaid spending. Fact Sheet (.pdf)

  • Health Coverage for the Unemployed

    Issue Brief

    This policy brief outlines the challenges facing the unemployed as they seek to remain insured after losing jobs and employer-sponsored health coverage. In May 2011, 13.9 million people in the U.S. were unemployed. Of these, 6.2 million had been unemployed for six months or more and faced limited options to remain insured. The brief examines potential sources of insurance, including through a spouse's plan, COBRA, the non-group insurance market and public programs. It also discusses…

  • Medicaid Coverage and Care for the Homeless Population: Key Lessons to Consider for the 2014 Medicaid Expansion

    Report

    Beginning in 2014, the Affordable Care Act ACA provides for a significant Medicaid expansion uninsured, low-income adults. Given their low incomes and high uninsured rate, individuals experiencing homelessness could significantly benefit from this expansion. However, it will be important to address the barriers they face to enrolling in coverage and accessing needed care. This report, based on eight focus group discussions with administrators and frontline workers serving the homeless population in four cities, identifies enrollment…

  • Variations in State Medicaid Buy-in Practices for Low-Income Medicare Beneficiaries: A 1999 Update

    Report

    This report updates a 1997 Foundation report to assess how states are implementing financial protections for the 16 million Medicare beneficiaries who are low-income. These protections, generally referred to as "buy-in programs," help low-income Medicare beneficiaries meet Medicare's cost-sharing requirements by using state Medicaid programs to pay either all or some portion of premiums, deductibles, and coinsurance amounts. Using information collected through a survey of state Medicaid directors and consumer advocates, the update seeks to…

  • Insurance Market Reforms and the Individual Insurance Marketplace: Implications for Coverage Expansions

    Report

    Proposals that attempt to expand coverage in the private individual insurance market will only work if private insurance is available and affordable. This paper describes how the current individual marketplace will affect the ability of such proposals to assure equitable access to affordable coverage. This paper is part of the Kaiser Incremental Health Reform Project. Issue Paper

  • Medicaid Managed Care’s Impact On Safety-Net Clinics In California

    Fact Sheet

    Medicaid Managed Care's Impact On Safety-Net Clinics In California Medicaid Managed Care's Impact On Safety-Net Clinics In California was published in the January/February 2000 issue of the journal Health Affairs. The report provides an overview of Medi-Cal Managed Care in California, and its effects on community health clinics, and related issues. In order to better understand the impact that the Medi-Cal managed care program has had on California safety-net providers, the Kaiser Family Foundation supported…

  • Long-Term Care:  Medicaid’s Role and Challenges

    Issue Brief

    Long-Term Care: Medicaid's Role and Challenges This Policy Brief examines Medicaid's role in providing long-term care services. It describes long-term care services, the population that needs these services, and how people get long-term care services. It provides an overview of health insurance coverage of persons with long-term care needs and describes both Medicare's and Medicaid's role in providing these services. It also examines some of the policy issues and challenges involved in providing long-term care…

  • A Risky Proposition?  Risk-Bearing and Solvency in California’s Medical Groups — Policy Brief

    Issue Brief

    A Risky Proposition? Risk-Bearing and Solvency in California's Medical Groups -- Policy Brief A Risky Proposition? Risk-Bearing and Solvency in California's Medical Groups is an 8-page policy brief to provide information about medical groups in California, including a discussion on risk-bearing, solvency, and proposed regulatory approaches. The brief includes a variety of perspectives presented by speakers at a California Health Policy Roundtable held in Sacramento, California on July 20, 1999. Roundtable