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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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  • Pulling It Together: Critical Path To Health Reform: Stage One

    Perspective

    Will there be a big debate about health reform in the general election? If there is it will elevate the issue further, engage the public, and create momentum and a mandate for action by a new President and Congress. If, however, the debate about health is tepid or health is eclipsed by other issues such as the economy and Iraq, momentum could falter. One measure of the level of debate will be whether or not…

  • The Decline in the Uninsured in 2007: Why Did It Happen and Can It Last?

    Issue Brief

    This policy brief examines the underlying shifts in health insurance coverage in 2007, which resulted in a 1.5 million decrease in the number of uninsured people under age 65, due to increased public coverage. This includes about 300,000 in Massachusetts, which implemented its comprehensive health reform that year. The brief also projects that the current economic downturn and rising unemployment rate likely will cause the number of uninsured to grow by at least 2 million…

  • Pulling it Together from Drew Altman: Multiple Agendas for Controlling Health Care Costs

    Perspective

    In what would be a domestic policy trifecta, we may be headed for interconnected big debates about economic recovery, entitlement programs and health reform. A core issue in the entitlement and health reform debates is the problem of rising health care costs. President Obama, now apparently fully briefed on the economic, budget and health reform realities he faces, is talking conspicuously about hard choices that may lie ahead. In a short period of time the…

  • Pulling it Together: The Health Care Industry’s Second Voluntary Effort

    Perspective

    The announcement that health care industry groups plan to put on the table voluntarily a package of proposals to shave $2 trillion off the rate of increase in health spending over the next ten years immediately conjures up the image of the Voluntary Effort or VE launched with similar fanfare in the Carter administration.  Back then the industry used the VE to fend off Jimmy Carter's efforts to aggressively control the costs of hospital care…

  • Pulling it Together: The Experts vs. The Public on Health Reform

    Perspective

    In repeated Kaiser polls, we see a divide between what experts believe and what the public believes about some of the key issues in health reform. They don’t disagree on everything; far from it. But there is a wide gulf on basic beliefs about what is behind the problems in the health care system and key elements of reform, especially delivery reform. Experts believe the health care system is full of unnecessary care and troubling…

  • Putting Children on the Express Lane to Health Insurance: Streamlining Enrollment and Renewal of Children in Medicaid and CHIP Through Express Lane Eligibility

    Issue Brief

    Express Lane Eligibility (ELE) is a new tool available to states to streamline enrollment and renewal of children in Medicaid and CHIP. It allows state Medicaid and CHIP agencies to utilize data and eligibility findings from other public need-based programs, such as Head Start or Food Stamps, and/or tax return data to identify, enroll and recertify children rather than requiring them to re-analyze and determine eligibility under their own rules. A primary goal of this…

  • Key Findings: Kaiser Health Tracking Poll — November 2009

    Poll Finding

    This document contains the key findings from the November Health Tracking Poll. The survey was designed and analyzed by public opinion researchers at the Kaiser Family Foundation and was conducted November 5 through November 12, 2009, among a nationally representative random sample of 1,203 adults ages 18 and older. Telephone interviews conducted by landline (802) and cell phone (401, including 112 who had no landline telephone) were carried out in English and Spanish. The margin…

  • State High-Risk Pools: An Overview

    Issue Brief

    Health reform bills passed in the House and Senate would create a national high-risk pool insurance program to offer health coverage to otherwise uninsurable individuals during the interim period between the enactment of legislation and the implementation of broader health care reform. This issue brief discusses the structure, operation, benefits and challenges of state high-risk pool programs and describes how temporary national high-risk pool would be created as part of health reform. Issue Brief (.pdf)

  • Pulling It Together: The Message from Massachusetts

    Perspective

    The Massachusetts special election has roiled the political world and profoundly affected the prospects for health reform just when it looked like passage was a lock.  Efforts are underway to put health reform legislation back together again on Capitol Hill, but not since powerful Ways and Means Chair Wilbur Mills fell into the Tidal Basin with Fanne Foxe in 1974, halting momentum on a deal on health reform that seemed ready to happen, has something this unexpected so affected…

  • Mental Health Financing in the United States: A Primer

    Report

    This primer provides an overview of behavioral health care, reviews the sources of financing for such care, assesses the interaction between different payers, and highlights recent policy debates in mental health. It also discusses the role of Medicaid, currently the largest source of financing for behavioral health services in the nation, covering a quarter of all expenditures. This comprehensive resource serves as a guide for those who want to understand the complex system of behavioral…