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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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  • Medicaid Support for Family Planning in the Managed Care Era

    Report

    As the largest source of public funding for contraceptive care in the United States, Medicaid plays a crucial role in financing family planning services and supplies for millions of low-income women across the nation. In the past 15 years, managed care has become the primary way of delivering care to children and adults on Medicaid, a development which has had significant implications for how family planning services are financed, organized and delivered under Medicaid. This…

  • New Incentive for States to Adopt the ACA Medicaid Expansion: Implications for State Spending

    Issue Brief

    The American Rescue Plan Act of 2021 encourages non-expansion states to take up the expansion by providing an additional temporary fiscal incentive for states to newly implement the ACA Medicaid expansion. This brief provides illustrative estimates of the net fiscal benefit to states from these incentives relative to state costs under the expansion.

  • Women’s Health Data Book: A Profile of Women’s Health in the United States

    Fact Sheet

    The Women's Health Data Book: A Profile of Women's Health in the United States, offers the latest data and trends on the wide range of health issues that affect women across their life spans. Published by the Kaiser Family Foundation and the Jacobs Institute of Women's Health, the Data Book is edited by Dawn Misra, Ph.D. This book addresses social and economic factors and provides up-to-date information on chronic conditions, reproductive health, mental health, violence,…

  • Managed Care And Low-Income Populations: A Case Study of Texas

    Report

    This study is part of a larger initiative, funded by both the Henry J. Kaiser Family Foundation and The Commonwealth Fund. Case studies of seven states that are restructuring their health care systems for the Medicaid and uninsured populations: California, Florida, Minnesota, New York, Oregon, Tennessee, and Texas, are designed to provide early insights and timely analyses that will help states and other efforts shape rapidly evolving managed care systems and health reform programs for…

  • Oral Health in the U.S.: Key Facts

    Fact Sheet

    This fact sheet provides data on oral health care coverage and access for children, nonelderly adults and Medicaid beneficiaries, including state-by-state data on measures such as the share of adults who have had a dental visit within the past year. Fact Sheet (.pdf)

  • Health Care and the Middle Class: More Costs and Less Coverage

    Report

    This analysis paper examines the availability, affordability and stability of the health insurance coverage of the American middle class, defined as those with incomes of $44,000 to $88,000 for a family of four. It also addresses the growing burden of health care costs for the middle class, the adequacy of today's health insurance plans to protect them from large medical bills, and the difference both make as individuals and families make health care decisions for…

  • Research Brief: Insurance Coverage and Access to Care in Primary Care Shortage Areas

    Issue Brief

    As both federal and state governments gear up to implement the Patient Protection and Affordable Care Act (ACA), concerns about the supply and distribution of physicians, particularly primary care physicians, are being raised. In many areas of the country, there is a shortage of primary care physicians, and some worry about whether the current workforce can meet the growing demand for services that will likely accompany coverage expansions. To inform provider workforce issues related to…

  • Understanding the Health-Care Needs and Experiences of People with Disabilities:  Findings from a 2003 Survey

    Report

    Understanding the Health-Care Needs and Experiences of People with Disabilities: Findings from a 2003 Survey People with disabilities are at risk in the health-care system because of their wide-ranging health-care needs, their relatively heavy use of prescription drugs, health-care and support services, and typically low incomes. A new survey of people with permanent mental and/or physical disabilities explores their health-care experiences and challenges in accessing and paying for care. Report (.pdf) Chartpack, video, press release,…

  • The U.S. Economy and Changes in Health Insurance Coverage, 2000-2006

    Other Post

    Health Affairs Article: The U.S. Economy and Changes in Health Insurance Coverage, 2000-2006 A Foundation study featured as a web-exclusive Health Affairs article examines health coverage trends from 2000-2006 showing that over this period the dominant factor contributing to a rise in the uninsured population has been the decline in employer-sponsored insurance, even as the economy rebounded from the last recession. Access web-exclusive Health Affairs article

  • Health Reform and Communities of Color: Implications for Racial and Ethnic Health Disparities

    Issue Brief

    This issue brief examines the key provisions of the 2010 health reform law that will expand health coverage and are likely to improve access to care for people of color, as well as some of the other provisions that will likely have either a direct or indirect impact on health disparities. Issue Brief (.pdf)) Previous Version: November 2009 (.pdf)