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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 >>

Data and analysis

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.

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 tax credits that would make ACA coverage affordable to them.

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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  • What Are Some Policy Options for Reaching the 2.2 Million Uninsured People in the ACA’s “Coverage Gap”?

    News Release

    A new KFF issue brief explores several potential policy options that would help close the Affordable Care Act’s "coverage gap," including providing further new incentives for states to expand Medicaid, creating a new "public option" or extending ACA Marketplace premium subsidies to low-income people who don’t currently qualify for federal help. At stake is affordable health coverage for 2.2 million uninsured people with incomes below the federal poverty level ($12,880 annually for an individual in…

  • Federal Policy May Temporarily Close the Coverage Gap, But Long-term Coverage May Fall Back to States

    Policy Watch

    Recent policy attention has focused on closing the coverage gap for roughly 2.2 million individuals living in the 12 states that have not adopted Medicaid expansion included in the Affordable Care Act (ACA). These individuals do not qualify for Medicaid and have incomes below poverty, making them ineligible for premium subsidies in the ACA Marketplace. Pending federal legislation may temporarily provide coverage to individuals in the coverage gap, but providing a permanent pathway to coverage may fall back…

  • How Could the Build Back Better Act Affect Uninsured Children?

    Issue Brief

    This brief examines characteristics of uninsured children in 2020 and discusses how current policy proposals, including outreach efforts, continuous eligibility requirements, and closing the coverage gap, could affect children’s health coverage. Recent efforts to expand coverage for adults could benefit children’s coverage, especially for children in non-expansion states if the coverage gap is filled as proposed by the Build Back Better Act (BBBA).

  • More Than 6 in 10 of the Remaining 27.4 Million Uninsured People in the U.S. are Eligible for Subsidized ACA Marketplace Coverage, Medicaid or the Children’s Health Insurance Program

    News Release

    Recent policy attention has focused on efforts to reduce the number of uninsured people in the U.S. by expanding eligibility for coverage assistance, including enhanced premium subsidies in the Affordable Care Act (ACA) Marketplace and filling the Medicaid “coverage gap.” A new KFF analysis shows that a majority of the 27.4 million people who remained uninsured in 2020 already are eligible for financial assistance for coverage through Medicaid/CHIP or the Marketplace, suggesting that policies in…

  • Health Insurance Coverage in 2013: Gains in Public Coverage Continue to Offset Loss of Private Insurance

    Issue Brief

    The recession accelerated the long-standing decline in employer-sponsored health insurance and through 2013 most of the recovery in the uninsured rate was due to increased enrollment in public insurance, primarily Medicaid and the Children’s Health Insurance Program (CHIP). With the exception of young adults ages 19 to 25, who are able to remain on their parents’ health plan until age 26 under the ACA, ESI coverage rates for adults and children continued to decrease between…

  • How the Midterms Factor Into Medicaid Expansion

    From Drew Altman

    In this column for The Wall Street Journal’s Think Tank, Drew Altman discusses how Democratic victories in several close gubernatorial races on Tuesday could revive efforts to expand Medicaid.

  • Early Impacts of the Medicaid Expansion for the Homeless Population

    Issue Brief

    This analysis provides an early look at the impact of the expansion for homeless providers and the patients they serve. It is based on focus groups conducted with administrators, providers, and enrollment workers at four sites serving homeless individuals in states that have expanded Medicaid (Albuquerque, NM; Baltimore, MD; Chicago, IL; and Portland, OR) and one site in a state that has not expanded (Jacksonville, FL), as well as administrative data collected from the sites.

  • Challenges to Forecasting Obamacare Enrollment for 2015

    News Release

    In his latest column for The Wall Street Journal’s Think Tank, Drew Altman explains why 2015 enrollment in the Affordable Care Act’s marketplaces is very hard to predict. All previous columns by Drew Altman are available online.