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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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  • How Accessible is Individual Health Insurance for Consumers in Less-Than Perfect Health?

    Report

    This report documents the findings of a study examining access to health insurance coverage in the individual market for people with health problems. Seven hypothetical consumers with varying health conditions were defined and insurers and HMOs in eight different markets around the country were asked to consider them as though they were real consumers applying for coverage. Renewed debate over proposals to expand coverage for the uninsured using tax credits for the purchase of individual…

  • How Private Insurance Works: A Primer

    Report

    This primer, prepared by Gary Claxton of the Institute for Health Care Research and Policy at Georgetown University, examines the structure and operation of private health insurance including the types of organizations that provide it, how managed care is delivered, and how risk pools work and describes how private health insurance coverage is regulated under state and federal laws. The primer explains how the current nature of private insurance relates to key issues facing federal…

  • Urban Indian Health

    Report

    More than half (57%) of the 2.5 million people who identify themselves solely as American Indian and Alaska Native in the 2000 Census live in metropolitan areas. This issue brief describes the large and growing urban Indian population, their health status, and the major federal health programs and federal-state programs that are available to improve Native Americans' access to needed health services. Report Introductory Letter  

  • Health Centers: An Overview and Analysis of Their Experiences With Private Health Insurance

    Report

    This policy brief provides an overview of health centers, with a special focus on the relationship between health centers and private health insurance. The analysis of 10 years of national data reveals that health centers do not receive adequate reimbursement from private insurers to cover the costs of treating commercially insured patients. The cumulative shortfalls jeopardize the ability of health centers to fulfill their mission of providing access to care for low-income patients. Issue Brief…

  • Medicaid, SCHIP and Economic Downturn: Policy Challenges and Policy Responses

    Report

    Medicaid, SCHIP and Economic Downturn: Policy Challenges and Policy Responses A new analysis conducted for the Kaiser Family Foundation's Commission on Medicaid and the Uninsured examines the implications of a downturn for health coverage and state programs and projects the impact of one percentage point rise in the national unemployment rate on Medicaid and SCHIP and the number of uninsured individuals. The analysis also documents how federal fiscal relief during the last economic downturn of…

  • Medicare: Holes in the Safety Net

    Other Post

    Medicare: Holes in the Safety Net This report discusses findings from focus groups that consisted of those individuals who interact with the Medicare program, including beneficiaries, health professionals, caretakers, and program management staff. A press release summarizing the findings of 15 focus groups conducted nationwide on public attitudes toward and understanding of the Medicare system in the United States is available. Note: This publication is no longer in circulation. However, a few copies may still…

  • What Shapes Lawmakers’ Views: A Survey of Members of Congress and Key Staff on Health Care Reform

    Report

    A report summarizing the findings of in-depths interviews conducted with Members of Congress and their staff who were actively involved in the health care reform debate about their opinions about what factors influenced the debate and shaped their views. The report finds that, among media sources, talk radio had the greatest influence in the debate and that public opinion trailed only Administration failures in terms of perceived influence on the debate's outcome. REPORT Download

  • Protection in Managed Care Plans: A Side-by-Side Comparison of Proposal Federal Legislation

    Other Post

    Part I: Congressional Budget Reconciliation Proposals A. Entities Regulated Issue H.R. 2015--House Budget Bill(Medicare) S. 947--Senate Budget Bill(Medicare) H.R. 2015--House Budget Bill(Medicaid) S. 947--Senate Budget Bill(Medicaid) Establishes new Medicare managed care program, "MedicarePlus;" MedicarePlus plan options include coordinated care plans (HMOs, PPOs), MSA plans (exceptions for MSA plans from some requirements). (Medicare eligibles can still choose the traditional fee-for-service program.) Medicare; established new "Medicare Choice" program. Medicare Choice plan options include fee-for-service, PPOs, point-of-service plans,…

  • Covering the Low-Income Uninsured: Assessing the Alternatives

    Report

    This issue brief describes and analyzes expansions of Medicaid and SCHIP, tax credits for individually-purchased insurance, and tax credits for employment-based health insurance as options to expand health coverage of the low-income population. Issue Paper