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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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  • New KFF Focus Groups Reveal Medicaid Enrollee Experiences During Unwinding

    News Release

    Over six months after the expiration of pandemic-era enrollment protections, at least 27 million Medicaid enrollees—or roughly one-in-three enrollees across the country—have completed their state’s eligibility renewal process for the program. Over 18 million people have had their coverage renewed and over 10 million have been disenrolled, as of November 8, 2023. New KFF focus groups look beneath the numbers at the experiences of enrollees who have gone through the Medicaid renewal process. Drawing from…

  • Medical Care Research and Review

    Other Post

    Journal Supplement This special supplement of includes: original research tracking trends in disparities in health coverage and access to care over two decades; literature syntheses focused on medical treatment and the decision-making process; legal analysis of civil rights laws in the context of managed care; and findings from a national survey of public awareness of racial inequities in care. The supplement is comprised of work commissioned by the Foundation for its 1999 national policy roundtable,…

  • Targeting Medicare Drug Benefits: Costs and Issues

    Report

    This report, written by Marilyn Moon and Matthew Storeygard of the Urban Institute, estimates the potential cost of targeting drug benefits to low-income Medicare beneficiaries and those with catastrophic drug expenses and discusses some of the key programmatic issues that could arise under this approach. The authors predict that a targeted and comprehensive drug benefit would likely help more than half of the 11.3 million low-income beneficiaries who lack drug coverage through Medicaid or an…

  • Warning: Inadequate Low-Income Subsidy Design Can Cause Problems for Health Care Reform

    Other Post

    Warning: Inadequate Low-Income Subsidy Design Can Cause Problems for Health Care Reform This report examines potential adverse consequences of low-income subsidy systems contained in the leading health care reform approaches including: work disincentives as a result of high marginal taxrates; employer incentives to drop coverage; and loss of coverage due to budgetary control mechanisms. Note: This publication is no longer in circulation. However, a copy may still exist in the Foundation's internal library that could…

  • Medicaid Managed Care for Persons With Disabilities: State Profiles-2114

    Report

    Medicaid Managed Care for Persons With Disabilities: State Profiles This report provides state estimates of the number of Medicaid disabled enrolled in managed care and profiles these programs. It provides detailed comparative state information on enrollment, program features, rate setting, quality issues, and special enrollment features for the disabled in Medicaid managed care. It also highlights individual state profiles on the Medicaid managed care programs that include persons with disabilities. Report

  • Coverage and Cost Impacts of the President’s Health Insurance Tax Credit and Tax Deduction Proposals

    Issue Brief

    This issue brief looks at the coverage impacts and costs of two components of the administration’s FY 2005 budget proposals to increase the affordability of health insurance: a new tax credit for people purchasing non-group health insurance and a new tax deduction for premiums for high-deductible, non-group health insurance policies. The estimates were prepared by Jonathan Gruber, Ph.D., Professor of Economics at the Massachusetts Institute of Technology, using a micro-simulation model developed in conjunction with…

  • Hearing Their Voices: Lessons from the Breast and Cervical Cancer Prevention and Treatment Act (BCCPTA)

    Report

        In 2000, Congress passed a landmark law that gave states the option of extending Medicaid coverage to certain low-income women with breast or cervical cancer. In California, approximately 10,000 women have been assisted by this program. This policy brief, "Hearing Their Voices: Lessons from the Breast and Cervical Caner Prevention and Treatment Act (BCCPTA)," reports on the impact of this program on low-income women in California, using focus group analysis. The report was…

  • Navigating Medicare and Medicaid, 2005: A Resource Guide for People with Disabilities, Their Families, and Their Advocates

    Report

    This guide explains the critical role Medicare and Medicaid have come to play in the lives and the futures of roughly 20 million children, adults, and seniors with disabilities - and gives people with disabilities new information to help them get the most from these programs. Full PDF Report (.pdf) Section 1: Introduction HTML PDF Section 2: Medicare HTML PDF Section 3: Medicaid HTML PDF Section 4: Interaction Between Medicare and Medicaid HTML PDF

  • March 30, 2006 Policy Forum to Release the National ADAP Monitoring Report

    Event Date:
    Event

    The National ADAP Monitoring Report provides the latest data on state AIDS Drug Assistance Programs (ADAPs). ADAPs, authorized under Title II of the Ryan White Comprehensive AIDS Resources Emergency (CARE) Act, provide HIV/AIDS-related prescription drugs to uninsured and underinsured individuals living with HIV/AIDS. ADAPs operate in 57 U.S. states, territories, and associated jurisdictions. The report, the tenth in an annual series, was prepared by the Kaiser Family Foundation and the National Alliance of State and…

  • Health Challenges for the People of New Orleans

    Poll Finding

    Health Challenges for the People of New Orleans This analysis of a household survey of Greater New Orleans area residents conducted in Fall 2006 examines the health care status of the adult population and details their health coverage and access to health care services after the disaster. News Release Full Report (.pdf) Executive Summary (.pdf) Health Status (.pdf) Health Coverage and Access (.pdf) Households with Children (.pdf) Appendices (.pdf)