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

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  • State Variation and Health Reform: A Chartbook

    Report

    This chartbook pulls together data related to state variation in key areas such as major industry types, poverty and unemployment rates and fiscal conditions; health coverage and the uninsured; Medicaid and CHIP eligibility and enrollment; Medicaid spending and financing; access to Health Care; health care costs; and insurance markets.

  • The Role of Health Coverage for Communities of Color

    Issue Brief

    The current health reform debate in this country focuses heavily on providing access to affordable health coverage for the millions of people who are uninsured. Any effort to expand coverage, alter current public programs, and/or create new public programs will have important consequences for the health of communities of color, who are more likely than Whites to be enrolled in public programs or be uninsured. This issue brief highlights variations in coverage by race and…

  • A Foundation for Health Reform: Findings of An Annual 50-State Survey of Eligibility Rules, Enrollment and Renewal Procedures and Cost-Sharing Practices in Medicaid and CHIP for Children and Parents During 2009

    Report

    In 2009, despite the bleakest economic picture in years, states managed to safeguard and in some cases expand health coverage for children and parents in their Medicaid and Children's Health Insurance Programs, according to the Kaiser Family Foundation's annual 50-state survey of Medicaid and CHIP eligibility rules, enrollment and renewal procedures and cost-sharing Practices. That was in large part due to the substantial help that states received through the congressional reauthorization of CHIP and the…

  • Aging Out of Medicaid: What is the Risk of Becoming Uninsured?

    Issue Brief

    This policy brief uses the most recent available data to examine the patterns of health coverage for young adults after they turn 19 and typically are no longer eligible for Medicaid or the Children's Health Insurance Program (CHIP). Medicaid is a key source of coverage for children in the U.S., providing insurance to about 29 million at some point during the year. After turning 19, however, in many cases they lose their eligibility for Medicaid…

  • State Adoption of Coverage and Enrollment Options in The Children’s Health Insurance Reauthorization Act of 2009

    Fact Sheet

    The Children's Health Insurance Reauthorization Act of 2009 (CHIPRA) extended and expanded the Children's Health Insurance Program (CHIP), which was originally enacted in 1997. Together Medicaid and CHIP cover more than 32 million children, providing them access to needed care, including ongoing preventive and primary care that is key for children's health and development and financial protections for their families. CHIPRA added $33 billion in federal funds for children's coverage through 2013 and included provisions…

  • The Massachusetts Health Care Landscape

    Fact Sheet

    This fact sheet summarizes the Massachusetts health care landscape, including data on demographics, population health, the uninsured and the state Medicaid program. Fact Sheet (.pdf)

  • How Five Leading Safety-Net Hospitals Are Preparing For The Challenges and Opportunities of Health Care Reform

    Report

    This study, published in the journal Health Affairs, examines how five leading safety-net hospitals are preparing for major changes expected to result from the Affordable Care Act (ACA), including less government support for uncompensated care and the need to compete for newly insured people. The hospitals studied are Bellevue Hospital Center in New York City; Denver Health Medical Center in Colorado; Parkland Health and Hospital System in Dallas; San Francisco General Hospital in California; and…

  • Visualizing Health Policy: Health Coverage Under the Affordable Care Act (ACA)

    Report

    Related Resources Study Highlights Role of Geography and Plan Shopping Under Medicare Premium Support System Medicare Part D: A First Look at Part D Plan Offerings in 2013 The Medicare Prescription Drug Benefit - An Updated Fact Sheet Online Consumer Guide to Medicare   The latest Visualizing Health Policy infographic is a flowchart illustrating the mechanisms by which people will get health coverage beginning in 2014. Medicare's Role and Future Challenges << Previous Visualizing Health…

  • The Uninsured and Their Health Care Needs: How Have They Changed Since the Recession?

    Issue Brief

    This analysis uses the Center for Studying Health System Change's (HSC) 2010 Health Tracking Household Survey, the 2007 HSC Health Tracking Household Survey and the 2003 HSC Community Tracking Household Survey to describe the uninsured population and how it has changed over the past decade, especially between 2007 and 2010 when the recession caused many with previously stable coverage to become uninsured. It finds that although the uninsured population remains disproportionately made up of younger…

  • Faces of the Medicaid Expansion: How Obtaining Medicaid Coverage Impacts Low-Income Adults

    Report

    The Affordable Care Act (ACA) seeks to fill the longstanding gap in Medicaid coverage for low-income adults by expanding eligibility to a minimum floor of 138% of the federal poverty level (FPL), or $24,344 for a family of 3 in 2012. However, the Supreme Court ruling on the ACA effectively made implementation of the Medicaid expansion a state choice. If a state does not expand Medicaid, poor uninsured adults in that state will not gain…