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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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361-370 of 1,314 results

  • How Accessible is Individual Health Insurance for Consumers in Less-Than Perfect Health?

    Report

    This report documents the findings of a study examining access to health insurance coverage in the individual market for people with health problems. Seven hypothetical consumers with varying health conditions were defined and insurers and HMOs in eight different markets around the country were asked to consider them as though they were real consumers applying for coverage. Renewed debate over proposals to expand coverage for the uninsured using tax credits for the purchase of individual…

  • Maintaining Health Coverage and Securing the Medicaid Safety Net in a Sluggish Economy

    Fact Sheet

    The current economy is a key concern as federal and state leaders worry about the expected rise in unemployment and the related loss of employer health coverage. Policymakers are considering several options to ensure that we do not experience a health coverage crisis as we deal with the impact of the September 11th tragedy and ongoing concerns. In addition, states that were already preparing for budget problems are reporting even worse scenarios for their fiscal…

  • Uninsured Children in the South

    Fact Sheet

      Over 4 million children living in the South have no health insurance coverage. While the South experienced a decrease (3 percent) in the number of uninsured children from 1989 to 1993 -- the number of uninsured children nationally increased by 9 percent (Figure 1) -- the region accounts for a dispro-portionately high share of uninsured children in America. Over a third (36 percent) of American children live in the South, but the region accounted…

  • How Well Does the Employment-Based Health Insurance System Work for Low-Income Families?

    Other Post

    Part 3 What Explains the Coverage Decline? Rapidly rising health care costs-or, more precisely, employers' responses to costs-have contributed to the widespread erosion of employer coverage. As employers have shifted costs to workers, participation has dropped. Low-wage workers have been disproportionately affected by rising costs, losing access to coverage as well as finding participation more difficult. Their problems have been exacerbated by structural changes in labor markets, which have weakened the tie between jobs and…

  • The Number of Uninsured People Rose in 2017, Reversing Some of the Coverage Gains Under the Affordable Care Act

    News Release

    The number of uninsured people rose by nearly 700,000, to 27.4 million people, in 2017, reversing some of the coverage gains achieved under the Affordable Care Act, according to latest analysis of uninsured data by KFF (the Kaiser Family Foundation). It was the first uptick in the uninsured since implementation of the ACA in 2014, which helped drive down the number of uninsured people in the U.S. from 44 million in 2013 to under 27 million…

  • Enrollment Increases in State CHIP Programs: December 1998 to June 1999

    Report

    A new survey of state officials, conducted by Vernon Smith of Health Management Associates for the Kaiser Commission on Medicaid and the Uninsured, found that the number of children enrolled in stateCHIP programs has grown to more than 1.3 million in June 1999 from about 835,000 in December 1998. The survey was released at the July 30th Alliance for Health Reform Briefing on state efforts to enroll more kids in the Children's Health Insurance Program.…

  • Expanding Medicaid to Low-Income Childless Adults Under Health Reform: Key Lessons From State Experiences

    Issue Brief

    The health reform law will expand Medicaid to millions of low-income adults, including many childless adults who have historically been ineligible for the program, necessitating one of the largest enrollment efforts in the program's history. This report, based on interviews with officials in seven states and the District of Columbia and national experts, examines lessons learned from past state experience covering childless adults through waiver and state-funded programs and profiles the programs included in the…

  • The Arizona KidsCare CHIP Enrollment Freeze: How Has It Impacted Enrollment and Families?

    Issue Brief

    This paper examines the impact on enrollment and families of Arizona's Dec. 21, 2009, decision to freeze enrollment in KidsCare, the state's Children's Health Insurance Program (CHIP). The CHIP enrollment freeze, enacted in response to recession-driven state budget pressures, saved the state $12.9 million in FY 2011, but has also resulted in more than 100,000 children being placed on a waiting list for coverage and the loss of $41 million in federal matching funds. Issue…

  • Express Lane Eligibility: How to Enroll Large Groups of Eligible Children in Medicaid and CHIP

    Report

    This issue paper explores the potential for increasing enrollment in children's health insurance programs through "Express Lane Eligibility." Express Lane Eligibility is the accelerated enrollment of low-income uninsured children already participating in other income-comparable publicly funded programs, such as WIC or school lunch, into Medicaid or CHIP. The paper reviews Express Lane Eligibility's potential impact on Medicaid and CHIP enrollment, analyzes different models, discusses key challenges with implementation, and suggests steps states and localities can…

  • Health Insurance Coverage Of Low-Income Women

    Fact Sheet

    Low-income women's high rate of health problems and limited economic resources make access to health care and adequate health insurance coverage particularly important. Health coverage, whether through the private sector or publicly through Medicaid, has been demonstrated to improve access to care for low-income women. However, obtaining coverage is not easy or even possible for many women. Job-based insurance is not always an option for low-income women, despite their high workforce participation. Assistance is available…