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2025 KFF Marketplace Enrollees Survey

If the amount they pay in premiums doubled, about one in four enrollees in ACA Marketplace health plans say they would “very likely” go without insurance in 2026, finds a KFF survey of Marketplace enrollees fielded shortly after open enrollment began in the first weeks of November 2025. One in three say they would be “very likely” to look for a lower-premium Marketplace plan.

Health Coverage Among Community Health Center Patients, 2019-2024

Community Health Center Patients, Financing, and Services

Changes to Medicaid and the ACA Marketplace included in the 2025 reconciliation law and the expiration of ACA Marketplace enhanced premium tax credits at the end of 2025 are likely to increase the number of uninsured patients and patients who cannot afford out-of-pocket costs, placing new financial burdens on community health centers.

Data and analysis

The Uninsured Population 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?

This analysis estimates that 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 coverage ACA's Marketplaces affordable to them.

Key Facts about the Uninsured Population

The number of people ages 0-64 who were uninsured held steady at 25.3 million in 2023, although the number of uninsured children rose from 3.8 million to 4.0 million. Most uninsured people are in low-income families and have at least one worker in the family.

How the Unwinding Affected Enrollees

Over half who were disenrolled say they put off needed medical care while trying to renew Medicaid. Overall, 19% of adults who had Medicaid prior to the start of unwinding say they were disenrolled at some point in the past year. Of this group, a large majority (70%) were left at least temporarily uninsured.

The uninsured: How costs affect care and health, 2023

Latest Polling
8%

Percent of adults who reported not having health insurance
55%

Percent of uninsured adults who reported delaying or forgoing some form of health care due to cost
19%

Percent of uninsured adults who report that they or a family member had difficulty paying medical bills
38%

Percent of uninsured adults who reported not having a usual source of care (vs. 8% of insured adults)
Peterson-KFF Health System Tracker

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  • Medicaid Beneficiaries and Access to Care

    Fact Sheet

    The health reform law relies on a large expansion of Medicaid to reach many low-income uninsured people, many of them adults. This fact sheet summarizes Medicaid beneficiaries' experience in obtaining access to care, a subject that is of keen interest in view of the planned expansion of the program.

  • Additional Resources on Hurricane Katrina Relief

    Other Post

    U.S. Department of Health & Human Services (HHS)http://www.hhs.gov/katrina/index.html HHS Resources Targeting Minority Communitieshttp://www.os.dhhs.gov/news/press/2005pres/20050930a.html Congressional Hearings and Resources: Hearing: Hurricane Katrina: Community Rebuilding Needs and Effectiveness of Past Proposalshttp://finance.senate.gov/sitepages/hearing092805.htm Hearing: Assessing Public Health and the Delivery of Care in the Wake of Katrinahttp://energycommerce.house.gov/108/Hearings/09222005hearing1643/hearing.htm Senate Committee Reports and Other Information About Hurricane Katrinahttp://help.senate.gov/katrina.

  • Small Area Variations and the ACA’s Coverage Expansions

    From Drew Altman

    A new Kaiser analysis sheds light on how the country might react to the Affordable Care Act (ACA) when it is implemented.  It looks at how the benefits of the ACA's coverage expansions will vary around the country by census areas (technically, Public Use Microdata Areas, or PUMAs).

  • A Guide to the Supreme Court’s Decision on the ACA’s Medicaid Expansion

    Issue Brief

    On June 28, 2012, the U.S. Supreme Court issued its decision in the case challenging the Affordable Care Act (ACA). The Court upheld the constitutionality of the ACA's individual mandate, which requires most people to maintain a minimum level of health insurance coverage beginning in 2014.

  • NPR/Kaiser/Harvard Survey: Public Views on SCHIP Reauthorization: Chartpack

    Poll Finding

    This chartpack presents key findings from an October 2007 survey conducted jointly by NPR, the Kaiser Family Foundation, and the Harvard School of Public Health on the public’s views and opinions of the State Children’s Health Insurance Program and the pending legislation surrounding its reauthorization. Chartpack (.

  • Reports and Other Resources on Trends in Children’s Health Coverage

    Event Date:
    Event

    With Congress poised to reauthorize the State Children's Health Insurance Program (SCHIP) with a substantial increase in its federal funding, there are potentially new opportunities for reducing the estimated 9 million uninsured children nationwide.

  • National Health Insurance — A Brief History Of Reform Efforts In The U.S.

    Issue Brief

    This policy brief provides an overview of health reform efforts in the United States over much of the last century, from New Deal-era calls for government-subsidized health coverage to the creation of Medicare and Medicaid in the 1960s and the failed attempt at universal coverage in the early 1990s. Issue Brief (.