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

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  • Health Policy 101 Introduction

    Feature

    Health Policy 101 is a comprehensive guide covering fundamental aspects of U.S. health policy and programs, including Medicare, Medicaid, the Affordable Care Act, employer-sponsored insurance, the uninsured population, health care costs and affordability, women's health issues, and health care politics. It includes overviews of private health insurance regulation, racial and ethnic disparities, public health, international comparison of health systems, U.S. global health policy, and the federal role in health policy. The chapters can be downloaded…

  • The politics of health care are as broken as the system (and are a reason it is broken). For decades, Democrats and Republicans have not been able to agree on any major solutions to our health care problems and disagree sharply on the role of the federal government in health, forcing us to gravitate to smaller incremental changes where there might be some agreement.

    A One-Pager on What’s Wrong with U.S. Health Care

    From Drew Altman

    Asked for a one-pager on what's wrong with the U.S. health system, Dr. Drew Altman, Founding President and CEO, explains the top issues in this piece, published today as his latest column. Altman explains, "We have neither a competitive health care system nor a regulated one—we have a fragmented, micromanaged health system that fails to control costs and makes both patients and health professionals more miserable than they should be..."

  • Map shows the percentage point increase in the uninsured population due to the budget reconciliation package based on CBO estimates, by state. An Additional 10M People Nationwide Could be Uninsured in 2034 Due to the Budget Reconciliation Law

    How Will the 2025 Reconciliation Law Affect the Uninsured Rate in Each State?

    Issue Brief

    This analysis apportions the increase in the number of uninsured across the 50 states and DC. CBO estimates that the reconciliation law will increase the number of uninsured by 10M in 2034 and rise to over 14M if enhanced premium tax credits for ACA Marketplace enrollees expire later this year.

  • 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,…

  • How Will the Uninsured in Hawaii Fare Under the Affordable Care Act?

    Fact Sheet

    This state report explains how the ACA expands coverage in Hawaii, including a breakdown of how many uninsured people are eligible for Medicaid, how many are eligible for financial assistance to help them buy private insurance in the new Marketplace and how many will not receive any financial assistance at all. The report also details, in specific dollar figures, the income levels at which people in Hawaii are eligible for Medicaid or financial assistance in…

  • How Will the Uninsured in Indiana Fare Under the Affordable Care Act?

    Fact Sheet

    This state report explains how the ACA expands coverage in Indiana, including a breakdown of how many uninsured people are eligible for Medicaid, how many are eligible for financial assistance to help them buy private insurance in the new Marketplace and how many will not receive any financial assistance at all. The report also details, in specific dollar figures, the income levels at which people in Indiana are eligible for Medicaid or financial assistance in…

  • Which Path for Health-Care Politics in 2015?

    News Release

    In his first 2015 column for The Wall Street Journal's Think Tank, Drew Altman explains why this year, status quo for the Affordable Care Act is not an option and how the Supreme Court rules in King v. Burwell will determine its path. All previous columns by Drew Altman are available online.

  • August Kaiser Health Tracking Poll: The Uninsured and the Health Reform Law

    Perspective

    The August Kaiser Health Tracking Poll finds that even though 32 million uninsured Americans will gain health insurance under the ACA, only about half of non-elderly Americans currently without coverage say they are familiar with the chief components in the law designed to achieve this goal. Fifty-two percent of the uninsured say they are aware the law will provide subsidies to help low- and moderate-income people without insurance purchase it. And 47 percent are aware that…