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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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  • In Their Own Words: Family Profiles

    Other Post

    In Their Own Words: Family Profiles As the U.S. Congress and state legislatures explore policies to cover the uninsured, the Commission has profiled four families with uninsured members, including their family budgets, to better understand how specific policy ideas will practically affect typical uninsured Americans. Family Profiles Read the full report, "In Their Own Words: The Uninsured Talk About Living Without Health Insurance"

  • First Glance at the Children’s Health Initiative in Santa Clara County, California

    Report

    A new background report examines Santa Clara County in California in its effort to provide health insurance coverage (Children's Health Initiative or CHI) to all children living in the county. As one of the first localities to attempt such an initiative, its experiences can highlight important lessons and potential best practices for policymakers at the county, state, and national level considering coverage expansions for children. Also see Lessons from the Field: Increasing Enrollment in Children's…

  • Low-Income and Uninsured: The Challenge for Extending Coverage

    Event Date:
    Event

    Diane Rowland, executive director of the Commission, testified to the Senate Committee on Finance about the low-income uninsured. The testimony provides a comprehensive description and analysis of the population and discusses the challenges of providing them health coverage. Please note: the video is no longer available.  If you have an urgent need for the video, you may contact us (choose “problem with video” on the form) and we will try to locate the video. Include the…

  • Medicaid Overview: Briefing Charts

    Report

    Complements the Medicaid primer by providing basic information and statistics about the program through a series of charts. Chart Pack

  • Changes in Employer-Sponsored Health Insurance Sponsorship, Eligibility, and Participation: 2001 to 2005, Full Report

    Report

    This report provides a detailed account of how employer-sponsored insurance (ESI) coverage changed between 2001 and 2005, particularly among employees (i.e., workers who are not self-employed). The report begins with a short description of the major forces driving employer-sponsored insurance: changes in the workforce and the rising costs of health insurance over the four year period. Next, the report examines the decline in ESI among employees and the reasons determining whether or not an employee…

  • NPR/Kaiser/Harvard Survey: Public Views on SCHIP Reauthorization: Chartpack

    Poll Finding

    This chartpack presents key findings from an October 2007 survey conducted jointly by NPR, the Kaiser Family Foundation, and the Harvard School of Public Health on the public’s views and opinions of the State Children’s Health Insurance Program and the pending legislation surrounding its reauthorization. Chartpack (.pdf)

  • Reports and Other Resources on Trends in Children’s Health Coverage

    Event Date:
    Event

    With Congress poised to reauthorize the State Children's Health Insurance Program (SCHIP) with a substantial increase in its federal funding, there are potentially new opportunities for reducing the estimated 9 million uninsured children nationwide. At the same time, the nation’s weak economy and growing unemployment is resulting in fewer families and children covered by employer-sponsored coverage. Against that backdrop, the Kaiser Family Foundation's Commission on Medicaid and the Uninsured (KCMU) released a package of new…

  • Resources on Community Health Centers

    Fact Sheet

    The Kaiser Family Foundation has issued three new resources that examine the role of community health centers as key components of the U.S. health care system, providing primary care to more than 16 million patients nationwide in 2007. The documents, produced for the Kaiser Commission on Medicaid and the Uninsured, include a fact sheet on community health centers, an updated issue brief on their role in the health system and a report on how such…

  • Optimizing Medicaid Enrollment: Spotlight on Technology

    Report

    The health reform law provides for a national expansion of Medicaid in 2014 that will extend eligibility to millions more low-income people, primarily uninsured adults. It also requires implementation of a coordinated system for determining eligibility for Medicaid and subsidized coverage in the new health insurance exchanges. Given the expected new demands on Medicaid eligibility and enrollment systems, and continuing fiscal strains on states, the impetus to streamline and automate Medicaid systems has never been…

  • Health Challenges Facing the Nation

    Event

    Diane Rowland, executive vice president of the Kaiser Family Foundation and executive director of the Kaiser Commission on Medicaid and the Uninsured, testified to the Joint Economic Committee of the U.S. Congress on health insurance coverage and how the uninsured population remains one of the nation's most pressing health care challenges. Testimony (.pdf)