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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
Other key facts about the uninsured >>

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  • Changes in Health Insurance Status over a Two-Year Period

    Issue Brief

    The ability to maintain health insurance in the face of rising costs and an uncertain economy is a key concern for families and featured prominently in the health reform debate. While the percentage of the population without coverage at any one time changes by only a relatively small amount over a one- or two-year period, the percentage of people who start out with coverage and lose it for a meaningful amount of time during the…

  • Money Follows the Person Transitions Individuals from Nursing Homes to the Community

    Issue Brief

    This brief presents short profiles of four Ohio residents who have benefited from the state's Money Follows the Person demonstration program, known as HOME Choice. It was released along with several other resources on Medicaid long-term services and supports at a Feb. 7, 2011 briefing at the Foundation's Washington, D.C., offices. Profiles (.pdf)

  • The Inequity Of The Medicaid Coverage Gap and Why It Is Hard To Fix It

    Perspective

    In this column for the JAMA Health Forum, Larry Levitt explores why the Medicaid "coverage gap" still exists in 12 states that have not expanded their Medicaid programs under the Affordable Care Act, why it matters, and why eliminating it could prove challenging.

  • Health Coverage in a Period of Rising Unemployment

    Issue Brief

    This policy brief reviews the public and private options available to help people maintain coverage if they become unemployed during a downturn and cannot get employer-sponsored coverage through a spouse. Specifically, it examines COBRA, non-group insurance and Medicaid. And it explains why, despite such options, more people will become uninsured as unemployment rises. Recent analysis predicts that each 1 percentage point increase in unemployment will lead to 1.1 million more uninsured adults. Issue Brief (.pdf)

  • Pulling It Together: A Public Opinion Surprise

    Perspective

    Medicaid is the nation’s primary health insurance program for low-income people and people with disabilities, covering more than 60 million people this year.  And it's about to get a lot of attention: it's likely to be a prime target for spending reductions by "deficit hawks" in debate over the budget; governors are arguing that federal rules requiring them to maintain coverage under Medicaid tie their hands at a time when they are trying to crawl…

  • Pulling it Together: 2012: The ACA, and More

    From Drew Altman

    What is remarkable about 2012 (and the current era in health policy) is how many big health policy issues and marketplace changes will be in play at the same time: HEALTH REFORM: There is the implementation of a historic but fragile health reform law, with a Supreme Court decision pending and so much hanging in the balance. MEDICARE AND MEDICAID: There are continuing debates about potentially big changes in Medicare and Medicaid, driven by the…

  • New Publications Examine SCHIP Experience; Trends in Access to Medicaid and SCHIP Coverage

    Fact Sheet

    Maintaining and expanding health coverage for children and parents will likely be in the forefront of health care policy debates in Washington and state capitols in 2007. With states generally in better financial shape since the fiscal crisis earlier in the decade, many have expressed interest in improving access to their Medicaid and State Children's Health Insurance Programs (SCHIP). A new 50-state survey shows that one-third of states (17) increased access to health coverage in…

  • Healthy San Francisco

    Fact Sheet

    In 2007, San Francisco became the first city in the nation to begin implementation of a plan to provide health care services to all uninsured residents. Healthy San Francisco is not health insurance, but rather it provides access to affordable basic and ongoing health care services for uninsured residents. The program provides medical homes to uninsured adults and focuses on prevention and the management of chronic conditions. Fact Sheet (.pdf)

  • Chartpack: Kaiser Health Tracking Poll — August 2009

    Poll Finding

    This document contains the chartpack from the August Health Tracking Poll. The survey was designed and analyzed by public opinion researchers at the Kaiser Family Foundation and was conducted August 4 through August 11, 2009, among a nationally representative random sample of 1,203 adults ages 18 and older. Telephone interviews conducted by landline (801) and cell phone (402, including 123 who had no landline telephone) were carried out in English and Spanish. The margin of…

  • Pulling it Together: When Premiums Go Up 39%

    Perspective

    Our group that works on health care cost issues just updated an analysis that sheds light on what’s really happening to people in the individual health insurance market, the issue Secretary Sebelius, a former Kansas insurance commissioner, and others have put in the spotlight by calling on Anthem and other insurance companies to account for their proposed high premium increases. The analysis shows that people buying health insurance on their own in the individual market…