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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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  • Analysis Examines How Gaining Health Coverage Affected Consumers’ Lives in 2014

    News Release

    An analysis of a 2014 survey by the Kaiser Family Foundation finds that previously uninsured Americans who obtained health coverage that year experienced improved access to care and a decrease in financial insecurity, though they remained concerned about cost.  The analysis of the 2014 Kaiser Survey of Low-Income Americans and the ACA finds that about 11 million previously uninsured nonelderly adults obtained health coverage during 2014, the year the ACA’s new coverage options were fully…

  • How Have State Medicaid Expansion Decisions Affected the Experiences of Low-Income Adults? Perspectives from Ohio, Arkansas, and Missouri

    Issue Brief

    This brief examines the experiences of low-income adults in three states that have made varied Medicaid expansion decisions: Ohio, which adopted the ACA Medicaid expansion, Arkansas which implemented the Medicaid expansion through a “Private Option” waiver, and Missouri, which has not adopted the expansion. While Arkansas and Ohio implemented the expansion in different ways, participants in both states described how obtaining coverage improved their ability to access care, contributing to improvements in their ability to…

  • Newly Insured Californians Report Easier Access to Care Than the Uninsured

    News Release

    Low-income California adults who gained insurance coverage in 2014 had an easier time accessing health care than those who were uninsured and increased financial protection from medical bills, according to a new Kaiser Family Foundation (KFF) report. The report, funded by the Blue Shield of California Foundation and based on findings from the California sample of the 2014 Kaiser Survey of Low-Income Americans and the ACA, finds that newly-insured Californians were more likely to have…

  • Access to Care for the Insured and Remaining Uninsured: A Look at California During Year One of ACA Implementation

    Issue Brief

    California is a bellwether state for understanding the impact of the Affordable Care Act (ACA). Much attention has been paid to enrollment in California's new coverage options, such as the Medicaid expansion (Medi-Cal) and plans sold through ACA marketplaces (Covered California), and to changes in the uninsured from 2013 to 2014. However, less is known about how this coverage has affected people’s access to care and financial security, and why others remain uninsured. This report,…

  • Coverage Expansions and the Remaining Uninsured: A Look at California During Year One of ACA Implementation

    Report

    California is a bellwether state for understanding the impact of the Affordable Care Act (ACA). Much attention has been paid to enrollment in California's new coverage options, such as the Medicaid expansion (Medi-Cal) and plans sold through ACA marketplaces (Covered California), and to changes in the uninsured from 2013 to 2014. However, less is known about how this coverage has affected people’s access to care and financial security, and why others remain uninsured. This report,…

  • Briefing on the ACA in CA: Year One & Beyond

    Event Date:
    Event

    Continuing an effort to explore Affordable Care Act (ACA) implementation in the states, the Kaiser Family Foundation and the Blue Shield of California Foundation examined ACA implementation in California (CA) at a Sacramento, Calif. briefing and panel discussion on May 28. A state official, experts and advocates discussed issues and challenges related to implementation of the law, and the practical impact of providing coverage to roughly 4.5 million Californians who have coverage via the state…

  • Health Insurance Coverage in 2013: Gains in Public Coverage Continue to Offset Loss of Private Insurance

    Issue Brief

    The recession accelerated the long-standing decline in employer-sponsored health insurance and through 2013 most of the recovery in the uninsured rate was due to increased enrollment in public insurance, primarily Medicaid and the Children’s Health Insurance Program (CHIP). With the exception of young adults ages 19 to 25, who are able to remain on their parents’ health plan until age 26 under the ACA, ESI coverage rates for adults and children continued to decrease between…

  • At Tax Time, No Public Backlash Over Obamacare’s Individual Mandate

    News Release

    As tax season closes, Drew Altman looks at why the ACA’s individual mandate and tax credit reconciliation process “passed their first major hurdles this tax season with no significant public backlash,” in his latest column for The Wall Street Journal's Think Tank.