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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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  • Are Uninsured Adults Who Could Gain Medicaid Coverage Working?

    Fact Sheet

    As additional states consider whether to implement the ACA Medicaid expansion, some have raised pursuing waiver authority to tie Medicaid eligibility for adults under the expansion to work requirements. This fact sheet profiles uninsured adults who could gain Medicaid coverage under the ACA by their relationship to the workforce and job-based coverage.

  • 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.

  • Kaiser Health Tracking Poll: March 2015

    Feature

    As the Affordable Care Act (ACA) marks its fifth anniversary, this month’s poll finds the gap between favorable and unfavorable opinions of the law has narrowed to the closest margin in over two years. Although the Supreme Court heard oral arguments for the King v. Burwell case in early March, the majority of the public continues to say they have heard only a little or nothing at all about the case. The survey also includes…

  • With More than Half of Medicaid Enrollees Awaiting their Renewal Process, New Report Highlights Lessons Learned that Can Inform State Efforts and Reduce Disenrollments for “Procedural” Reasons

    News Release

    At the beginning of 2024, nine months into states’ efforts to unwind the Medicaid continuous enrollment provision and reverify enrollees’ eligibility, states have completed renewals for less than half of all enrollees. To gain a better understanding of what challenges states are facing and the effects of different unwinding strategies, KFF interviewed state Medicaid officials in Arizona, Indiana, and Pennsylvania, as well as others involved, including representatives from Medicaid, managed care plans, legal aid organizations,…

  • Nearly a Quarter of People Who Say They Were Disenrolled from Medicaid During the Unwinding Are Now Uninsured   

    News Release

    Nearly a quarter (23%) of adults who say they were disenrolled from Medicaid since early 2023 report being uninsured now, finds a new KFF national survey examining how the unwinding affected enrollees.  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, while 30% already had another form…

  • The Uninsured Population and Health Coverage

    Feature

    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. Economic conditions, federal and state policy decisions, and major health crises like the COVID-19 pandemic influence the uninsured rate. While implementation of the Affordable Care Act, namely the expansion of Medicaid and availability of subsidized Marketplace coverage, led to a drop in the share of…

  • States with the Fastest Recent Growth in ACA Marketplace Coverage Started with High Uninsured Rates

    News Release

    The states with the fastest recent growth in ACA Marketplace signups also had among the highest uninsured rates previously, as enhanced subsidies helped to make coverage more affordable for many consumers, particularly in southern states that did not expand their Medicaid programs to cover low-income adults, a new KFF analysis finds. The enhanced premium subsidies were first provided in the American Rescue Plan Act in 2021 and then extended through 2025 in the Inflation Reduction Act.…

  • As States Prepare to “Unwind” the Medicaid Continuous Enrollment Provision, Past Patterns Show That Most People Who Are Disenrolled from Medicaid Become Uninsured for All or Part of the Next 12 Months

    News Release

    Roughly two-thirds (65%) of people who were disenrolled from Medicaid or the Children’s Health Insurance Program (CHIP) in a recent year became uninsured for all or part of the 12 months that followed, a new KFF analysis finds. The analysis of enrollment data from the 2016-2019 Medical Expenditure Panel Survey (MEPS) suggests that many of the millions of people across the U.S. who are expected to lose Medicaid following the end of the pandemic-era continuous…