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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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  • Women, Work, and Family Health: A Balancing Act

    Issue Brief

    This issue brief examines women's roles in family health care decision-making and coordination, the effect of that involvement for women who work, and women's caregiving responsibilities. This analysis is based on data from the 2001 Kaiser Women's Health Survey, a nationally representative sample of nearly 4,000 women between the ages of 18 and 64. Issue brief (.pdf) News Release: Mothers Still Carry Primary Responsibility for Family Health -- Tradeoffs Between Caring for Children and Job Earnings…

  • New Reports Profile the Growing Uninsured Population and Portray the Health Care Safety Net as Increasingly Strained

    Event Date:
    Event

    Five Kaiser Commission on Medicaid and the Uninsured reports released at a policy briefing profile the growing uninsured population and portray the health care safety net as increasingly strained to meet uninsured people’s needs. News Release Covering the Uninsured: Growing Need, Strained Resources Federal Spending on the Health Care Safety Net from 2001-2004: Has Spending Kept Pace with the Growth in the Uninsured? Health Affairs article, Changes in Economic Conditions and Health Insurance Coverage, 2000-2004…

  • Summary of the Affordable Care Act

    Fact Sheet

    This document summarizes the comprehensive 2010 health reform law, often called the Affordable Care Act or ACA, including changes made to it by subsequent legislation, with a focus on provisions to expand coverage, control costs, and improve delivery systems.

  • California’s Uninsured on the Eve of ACA Open Enrollment

    Report

    This report presents the findings of a baseline survey of California’s uninsured adult population just before the start of the first open enrollment period under the Affordable Care Act (ACA). It will be followed by three other surveys over the course of the next two years that will capture the changing experiences and attitudes of this same group of 2,000 people over time, whether they obtain coverage or remain uninsured. The report analyzes the uninsured…

  • Advancing Opportunities, Assessing Challenges: Key Themes from a Roundtable Discussion of Health Care and Health Equity in the South

    Issue Brief

    This brief summarizes the primary themes expressed by participants of a roundtable discussion of current and future opportunities and challenges for advancing health care and health equity in the South organized by Kaiser Family Foundation’s Commission on Medicaid and the Uninsured and the Satcher Health Leadership Institute at Morehouse School of Medicine in Atlanta, Georgia.

  • Uninsured Rate Among the Nonelderly Population, 1972-2018

    Feature

    uninsured-rate-among-the-nonelderly-population-1972-2018Q1white Download Source CDC/NCHS, National Health Interview Survey, reported in http://www.cdc.gov/nchs/health_policy/trends_hc_1968_2011.htm#table01 and https://www.cdc.gov/nchs/data/nhis/earlyrelease/Insur201808.pdf.

  • What Options Exist If You’ve Lost Job-based Health Insurance? (Video)

    Video

    As unemployment skyrockets due to the COVID-19 pandemic, tens of millions of people are at risk of losing their job-based health insurance. However, the majority of people are eligible for other forms of health insurance coverage. Watch this two minute video to learn about the options: Medicaid, job-based coverage from a spouse or parent, ACA marketplace coverage, COBRA and short-term insurance plans.

  • A Look at the Private Option in Arkansas

    Issue Brief

    Based on stakeholder interviews and early data on coverage, reduced uncompensated care costs, and other topics, this issue brief provides an initial look at implementation of Arkansas' Section 1115 Medicaid expansion demonstration waiver to require most adults newly eligible for Medicaid through the Affordable Care Act's Medicaid expansion to enroll in Marketplace plans.

  • KFF Survey of Medicaid Unwinding

    Poll Finding

    KFF's survey examines adults who had Medicaid coverage in early 2023, just before states resumed eligibility checks and disenrollments after pandemic-era protections ended. Nearly a quarter (23%) of adults who say they were disenrolled from Medicaid since early 2023 report being uninsured now. Overall, 19% of adults who had Medicaid prior to the start of unwinding say they were disenrolled at some point in the past year.

  • Key Themes From Delivery System Reform Incentive Payment (DSRIP) Waivers in 4 States

    Issue Brief

    Building on an earlier brief that provided an overview of the components of DSRIP waivers, this analysis relied upon interviews with stakeholders to identify emerging trends and themes from DSRIP waivers in four states – California, Massachusetts, New York and Texas. It highlights that DSRIP waivers are spurring major change in relationships among providers; allowing providers to launch new initiatives aimed at improving care and reducing costs; and fostering a stronger focus on the social…