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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
Other key facts about the uninsured >>

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  • Pulling It Together: The “R” Word Is Back

    Perspective

    Longer ago than I care to admit, I got my start in health policy at M.I.T. when I wrote a book about health care regulation. The book was about a long forgotten attempt to rationalize the health care system through an elaborate health planning program set up in the seventies under the National Health Planning and Resources Development Act. It established a system of federal, state and regional planning bodies to control health care costs by limiting the supply of…

  • Explaining Health Care Reform: Questions About Health Insurance Exchanges

    Issue Brief

    The Patient Protection and Affordable Care Act (PPACA), signed into law in March 2010, made broad changes to the way health insurance will be provided and paid for in the United States. PPACA created a new mechanism for purchasing coverage called Exchanges, which are entities that will be set up in states to create a more organized and competitive market for health insurance by offering a choice of health plans, establishing common rules regarding the…

  • Topline: Kaiser Health Tracking Poll – June 2009

    Poll Finding

    This document contains the toplines from the June Health Tracking Poll. The survey was designed and analyzed by public opinion researchers at the Kaiser Family Foundation and was conducted June 1 through June 8, 2009, among a nationally representative random sample of 1,205 adults ages 18 and older. Telephone interviews conducted by landline (804) and cell phone (401, including 157 who had no landline telephone) were carried out in English and Spanish. The margin of…

  • 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…

  • Analysis: Prices for Many Brand-Name TrumpRx Drugs Are Cheaper than the Average Price in Other Wealthy Countries, But Are Almost as Likely To Be More Expensive

    News Release

    Consumers who buy brand-name prescription drugs without an available generic or biosimilar at the prices available through the new TrumpRx website are about as likely to pay more as pay less for those drugs relative to the publicly listed prices available in other comparatively wealthy countries, a new KFF analysis finds. The Trump administration has promoted the TrumpRx website as a way for consumers to get the lowest prices for prescription medications in the world, drawing on…

  • Five Key Questions And Answers About Section 1115 Medicaid Waivers

    Issue Brief

    This issue brief provides an overview of what Section 1115 Medicaid waivers are, how they are approved and financed, how states have used them, and how they are impacted by health reform. For many years, Section 1115 waivers have been used by states to test new coverage approaches not otherwise allowed under Medicaid program rules. Some waivers have also raised important policy issues. Since the passage of the health reform law, several states, including California,…

  • The Texas Health Care Landscape

    Fact Sheet

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

  • New Report Provides State-Level Data on Coverage Gains and Costs of the Medicaid Expansion in Health Reform

    News Release

    Analysis Projects Steep Decreases in Uninsured, With Federal Government Covering Vast Majority of CostsWASHINGTON -- The expansion of Medicaid under the new health reform law will significantly increase the number of people covered by the program and markedly reduce the uninsured in states across the country, with the federal government picking up the overwhelming majority of the cost, according to a state-by-state analysis released today by the Kaiser Family Foundation’s Commission on Medicaid and the Uninsured (KCMU).…

  • Uninsured Are Less Satisfied

    Perspective

    Given that people without health insurance have no protection from health care costs, it is not surprising that they are much less likely to say they are satisfied with costs than those with insurance (31 percent vs. 68 percent Majorities of both the uninsured and insured report being satisfied with the quality of care they receive, but the differences are still striking. Six in ten of the uninsured say they are satisfied with their quality…