Uninsured

New and noteworthy

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

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  • Survey: Assisters Help Estimated 5.3 Million During 2016 ACA Open Enrollment, Down 10 Percent from Prior Year

    News Release

    During the third Affordable Care Act open enrollment period, assistance programs helped an estimated 5.3 million people -- a number that was 10 percent lower than the prior year and that included a higher share of people renewing coverage, finds a new Kaiser Family Foundation survey of assister programs and brokers. Both assisters and brokers report a shift toward more return customers among those who sought assistance during the 2016 ACA open enrollment period, which…

  • A Final Look: California’s Previously Uninsured after the ACA’s Third Open Enrollment Period

    Report

    The Kaiser Family Foundation California Longitudinal Panel Survey is a series of surveys that, over time, tracked the experiences and views of a representative, randomly selected sample of Californians who were uninsured prior to the major coverage expansions under the Affordable Care Act (ACA). The initial baseline survey was conducted with a representative sample of 2,001 nonelderly uninsured Californian adults in summer 2013, prior to the ACA’s initial open enrollment period. After each enrollment period…

  • Health Care in Puerto Rico and the U.S. Virgin Islands: A Six-Month Check-Up After the Storms (Event)

    Event Date:
    Event

    Six months after Hurricanes Irma and Maria battered Puerto Rico and the U.S. Virgin Islands, the U.S. territories continue to struggle with crippled infrastructure, faltering economies and an exodus of their populations to the continental U.S.  On Monday, March 19, 2018, the Kaiser Family Foundation held a public briefing to examine the status of the recovery on the islands, with a focus on how their health care systems are doing and the likely impact of…

  • Poll: Survey of the Non-Group Market Finds Most Say the Individual Mandate Was Not a Major Reason They Got Coverage in 2018, And Most Plan to Continue Buying Insurance Despite Recent Repeal of the Mandate Penalty 

    News Release

    Very Few Say They Would Want to Purchase a Short-Term Plan, A Regulation Being Drafted By The Trump Administration Nine in 10 enrollees in the non-group market say they intend to continue buying their own insurance even after being told that Congress has repealed the individual mandate penalty for not having coverage as of 2019, according to a new survey by the Kaiser Family Foundation. The survey finds the mandate, part of the Affordable Care…

  • If Health Insurance Subsidies Are Struck Down, States Will Need Time

    From Drew Altman

    In this column for The Wall Street Journal's Think Tank, Drew Altman explores a practical timetable for state action if the Supreme Court rules in favor of the plaintiffs in King V. Burwell and ponders what Republicans in Congress might do.

  • 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…

  • Americans’ Views on the Affordable Care Act Hold Steady, with 43% Now Viewing It Favorably and 42% Unfavorably

    News Release

    Few Report Seeing Comparative Information about Health Care Prices and Quality, and Less Than 10% Use It Pocketbook and Consumer Issues Top Public's List of Priorities for the President and Congress, Ahead of Several ACA-Related Issues This month's Kaiser Health Tracking Poll finds public opinion on the health care law holding steady and closely divided. The share expressing a favorable view (43%) exceeds the share with an unfavorable view (42%) for the first time since…

  • Briefing on the ACA in CA: Year One & Beyond

    Event Date:
    Event

    Continuing an effort to explore Affordable Care Act (ACA) implementation in the states, the Kaiser Family Foundation and the Blue Shield of California Foundation examined ACA implementation in California (CA) at a Sacramento, Calif. briefing and panel discussion on May 28. A state official, experts and advocates discussed issues and challenges related to implementation of the law, and the practical impact of providing coverage to roughly 4.5 million Californians who have coverage via the state…

  • Coverage Expansions and the Remaining Uninsured: A Look at California During Year One of ACA Implementation

    Report

    California is a bellwether state for understanding the impact of the Affordable Care Act (ACA). Much attention has been paid to enrollment in California's new coverage options, such as the Medicaid expansion (Medi-Cal) and plans sold through ACA marketplaces (Covered California), and to changes in the uninsured from 2013 to 2014. However, less is known about how this coverage has affected people’s access to care and financial security, and why others remain uninsured. This report,…