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How Many Uninsured Are in the Coverage Gap?

This analysis estimates that 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 tax credits that would make coverage ACA's Marketplaces affordable to them.

Key Facts about the Uninsured Population

The number of people ages 0-64 who were uninsured held steady at 25.3 million in 2023, although the number of uninsured children rose from 3.8 million to 4.0 million. Most uninsured people are in low-income families and have at least one worker in the family.

How the Unwinding Affected Enrollees

Over half who were disenrolled say they put off needed medical care while trying to renew Medicaid. 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.

The uninsured: How costs affect care and health, 2023

Latest Polling
8%

Percent of adults who reported not having health insurance
55%

Percent of uninsured adults who reported delaying or forgoing some form of health care due to cost
19%

Percent of uninsured adults who report that they or a family member had difficulty paying medical bills
38%

Percent of uninsured adults who reported not having a usual source of care (vs. 8% of insured adults)
Peterson-KFF Health System Tracker

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  • Michigan’s Medicaid Section 1115 Waiver to Address Effects of Lead Exposure in Flint

    Fact Sheet

    On February 13, 2016, Governor Rick Snyder submitted a Medicaid Section 1115 Waiver proposal to the Centers for Medicare and Medicaid Services (CMS) to address issues related to lead exposure in Flint, Michigan. This fact sheet provides some insight into the situation in Flint, Michigan, the history of Medicaid disaster relief waivers and the details of the Medicaid waiver request.

  • Those Long Lines To Enroll In The ACA

    News Release

    In the latest post from the series Policy Insights, Kaiser Family Foundation President and CEO Drew Altman discusses the need for community based outreach to enroll the long term uninsured. All previous Policy Insights posts are archived online.

  • The Twin Goals of Health Insurance

    From Drew Altman

    Drew Altman, in The Wall Street Journal's Think Tank, examines a study finding Massachusetts' health reform saved lives in the context of health insurance's twin goal: better access to improve health and economic security.

  • Kaiser Health Tracking Poll: November 2014

    Feature

    Following the Nov. 4 midterm elections, nearly half of Americans expect increased debate between the two parties over the Affordable Care Act. In comparison, 42 percent say the amount of debate will not change, and very few (5%) say it will decrease. Conducted just prior to the start of the ACA's second open enrollment season, the poll also probes the views of people without health insurance, one of the key target groups for outreach and enrollment efforts. It finds the uninsured remain largely unaware of the renewed opportunity to purchase or enroll in health insurance through the marketplaces over the next few months.

  • Mapping Marketplace Enrollment

    Interactive

    This interactive zip code tool and map displays enrollment in the Health Insurance Marketplaces as a share of the potential market in small geographic areas across the country.

  • Kaiser Health Tracking Poll: January 2014

    Feature

    With enrollment in new coverage options underway, a majority of the public believes that only “some” of the ACA’s provisions have been put into place, while just about one in five think “most” or “all” of the law has been implemented. Awareness of the law’s individual mandate and health insurance exchanges has increased slightly since last year, but about four in ten of the public overall and half the uninsured remain unaware of other major provisions. For the third month in a row, overall views of the law remain at their post-rollout more negative levels (50 percent unfavorable, 34 percent favorable), though over half the public – including three in ten of those who view the law unfavorably – say opponents should work on improving the law rather than keeping up efforts to repeal it.

  • 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.