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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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  • Testimony on the National Governors’ Association Proposal on Medicaid – Report

    Report

    Hearing before the United States House of Representatives Committee on Commerce on the National Governors Association Proposal on Medicaid Testimony of Diane Rowland, Sc.D., Executive Director, Kaiser Commission on the Future of Medicaid and Senior Vice President, Henry J. Kaiser Family Foundation March 6, 1996 Thank you, Mr. Chairman and members of the Committee, for this opportunity to provide some perspective on the recent proposal of the National Governors Association for Medicaid reform and its…

  • Risk Selection Issues Under Medicare Reform Proposals

    Report

    This report compares the provisions designed to guard against risk selection among the Medicare population in both the Congressional Balanced Budget Act of 1995 and in the President's budget plan released in December 1995. The report also explores provisions in both that may exacerbate the potential for risk selection. Report:

  • Medicaid and the Elderly – Policy Brief

    Issue Brief

    Medicaid and the Elderly September 1995 Medicaid is a crucial health financing program for the elderly population, providing assistance to over 1 in 10 Americans age 65 or older. Nearly four million elderly people receive Medicaid assistance with medical and long-term care expenses. Medicaid's coverage helps low-income elderly people gain access to health care services, eases financial burdens for medical expenses, and provides a safety net for long-term care coverage. Medicaid plays three essential roles…

  • Medicaid and the Elderly

    Other Post

    Long-Term Care Spending In 1993, Medicaid spent $25.5 billion for long-term care services for elderly beneficiaries (Figure 5). This represents 58 percent of the $44 billion Medicaid spent on long-term care services for all population groups. The majority of spending was for care delivered in nursing facilities (84 percent) and ICFs-MR (2 percent). The remaining 14 percent of Medicaid long-term care spending went towards community-based care, including 3 percent for mental health services and 11…

  • The California Single-Payer Debate, The Defeat of Proposition 186

    Report

    A report summarizing the campaigns of proponents and opponents to the California Health Security Act (Proposition 186) of 1994. The report includes findings from research commissioned by the Kaiser Family Foundation on the potential financial and administrative impact of the Act on California, as well as an analysis of the paid media campaigns on the issue (see also #1026, Statewide Surveys of Californians on Public Attitudes Toward the Single Payer Ballot Initiatives (Proposition 186), #1027,…

  • National Survey of Public Knowledge of the Medicare Program and Public Support for Medicare Policy Proposals

    Other Post

    New Survey finds most Americans oppose slowing the growth of Medicare to balance the budget or cut taxes, but would support changes to avoid bankruptcy Embargoed for release until: 9:30 AM EST Thursday, June 29, 1995 Contacts: Matt James Tina Hoff (415) 854-9400 --Public Favors Incremental Rather than Sweeping Reforms-- --Significant Generational Differences on Medicare Reform-- Washington, D.C. -- A new survey has found that close to three out of four Americans (73%) support reducing…

  • What Shapes Lawmakers’ Views: A Survey of Members of Congress and Key Staff on Health Care Reform

    Report

    A report summarizing the findings of in-depths interviews conducted with Members of Congress and their staff who were actively involved in the health care reform debate about their opinions about what factors influenced the debate and shaped their views. The report finds that, among media sources, talk radio had the greatest influence in the debate and that public opinion trailed only Administration failures in terms of perceived influence on the debate's outcome. REPORT Download

  • Directions for Health Reform: Testimony before the Committee on Labor and Human Resources, United States Senate

    Event Date:
    Event

    This testimony presents a brief overview of the uninsured and health insurance coverage in the United States. The testimony describes the important role that the Medicaid program has come to play in providing health insurance coverage for 32 million low-income Americans, and it provides some perspective on policy options for consideration in the debate on the future direction of health reform.