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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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  • 2003 Health Insurance Survey – Summary and Chartpack

    Report

    The 2003 Kaiser Family Foundation Health Insurance Survey examines the public's level of satisfaction with their insurance coverage, their expectations of health insurance, the role of costs and other factors in health insurance decision-making, and attitudes toward employer-sponsored coverage. It also explores people's opinions about several alternative health insurance plans that are currently under consideration and explores how they might respond to these new options. Summary and Chartpack (.pdf)

  • Trends in Health Plans Serving Medicaid — 2000 Data Update

    Report

    An updated study follows trends in commercial health plan participation in Medicaid managed care and includes new analyses on the performance of Medicaid-dominated and commercial plans on measures of effective care and access to care, and on the extent to which plans restrict their Medicaid service areas.

  • How Trends in the Health Care System Affect Low-Income Adults: Identifying Access Problems and Financial Burdens

    Issue Brief

    As policymakers focus on strategies to improve health insurance coverage, this brief highlights findings from the Kaiser Low-Income Coverage and Access Survey on the current role that insurance plays in facilitating access to care for low-income adults and in protecting against financial burdens. Findings demonstrate that health insurance is a critical lever to open the door to health care services for low-income adults. Uninsured low-income adults often experience health problems, but are more likely than…

  • Explaining Health Care Reform: What Is An Employer “Pay-or-Play” Requirement?

    Issue Brief

    To broaden coverage, some health reform proposals would require employers to offer coverage or pay to help finance subsidies for those without access to affordable coverage. These types of reforms are often referred to as “pay-or-play” policies. The brief explains the concept and policy implications of employer pay-or-play proposals, which can vary in terms of the level of coverage required for compliance, the cost of the penalty to employers who do not offer, and whether…

  • Key Findings: Kaiser Health Tracking Poll — November 2009

    Poll Finding

    This document contains the key findings from the November Health Tracking Poll. The survey was designed and analyzed by public opinion researchers at the Kaiser Family Foundation and was conducted November 5 through November 12, 2009, among a nationally representative random sample of 1,203 adults ages 18 and older. Telephone interviews conducted by landline (802) and cell phone (401, including 112 who had no landline telephone) were carried out in English and Spanish. The margin…

  • Parents’ Views of Children’s Health Insurance Programs: A Survey of Denied Applicants for Kaiser Permanente’s Child Health Plan

    Poll Finding

    In 1997, Kaiser Permanente launched the Child Health Plan to provide subsidized health insurance for low income California children not eligible for Medi-Cal (California's Medicaid program) or Healthy Families (California's State Children's Health Insurance Program). As part of a broader evaluation of the Child Health Plan funded jointly by the Kaiser Family Foundation and the California HealthCare Foundation, these reports provide findings from a survey of low income parents who were eligible for Medi-Cal or…

  • Retiree Health Trends and Implications of Possible Medicare Reforms – Report

    Report

    Retiree Health Trends and Implications of Possible Medicare Reforms Prepared by: Hewitt Associates LLC Prepared for: Kaiser Medicare Policy Project September 1997 Preparation of this report was supported by The Henry J. Kaiser Family Foundation Grant Number 96-1710B. The study consists of a review and analysis of recent trends in the provision of employer-sponsored health benefits to retirees, as well as an assessment of potential changes to employer-sponsored retiree health plans in the future, including…

  • Primers on Key Health Care Topics and Programs

    Issue Brief

    The Kaiser Family Foundation maintains a number of primers providing overviews of key health care programs and issues. Written by Foundation staff, each primer provides key data and information that helps illustrate the topic and its relevance for the nation's health care system. Medicaid: A Primer Medicare: A Primer The Uninsured: A Primer Health Care Costs: A Primer How Private Health Coverage Works: A Primer Mental Health Financing in the United States: A Primer The…

  • Premiums and Cost-Sharing in Medicaid: A Review of Research Findings

    Issue Brief

    Medicaid covers nearly 60 million Americans. Because the population covered by the program is low-income, federal law limits the extent to which states can charge premiums and cost-sharing amounts, particularly for pregnant women, children and adults with incomes below poverty. Yet there is renewed interest in the use of premiums and cost-sharing in Medicaid given the continued focus on cost-containment due to ongoing state budget pressures as well as recently proposed changes to federal regulations…