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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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  • 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…

  • The Role of Medicaid in State Budgets

    Issue Brief

    A new policy brief examines the role of Medicaid in state budgets, the reasons behind rising growth in the program, and explores strategies for states to cope with higher spending in tough economic times. Policy Brief Also see recent publications on maintaining health coverage and securing Medicaid in today's economy

  • Women, Work, and Family Health: A Balancing Act

    Issue Brief

    This issue brief examines women's roles in family health care decision-making and coordination, the effect of that involvement for women who work, and women's caregiving responsibilities. This analysis is based on data from the 2001 Kaiser Women's Health Survey, a nationally representative sample of nearly 4,000 women between the ages of 18 and 64. Issue brief (.pdf) News Release: Mothers Still Carry Primary Responsibility for Family Health -- Tradeoffs Between Caring for Children and Job Earnings…

  • Compendium of Cultural Competence Initiatives in Health Care

    Report

    Public and private sector organizations are involved in a number of activities that seek to reduce cultural and communication barriers to health care. These activities are often described as cultural competency and/or cross-cultural education. A recent Institute of Medicine report recommended that the health care system pursue several of these techniques as part of a multi-level strategy to reduce racial and ethnic disparities in medical care. To address this need, the Henry J. Kaiser Family…

  • Coverage and Access of Adults 18-64 in the District of Columbia: Key Facts

    Fact Sheet

    This fact sheet summarizes the findings of the DC Health Access Survey, released in the Fall of 2003. It includes information on topics including: the demographics of the uninsured adults in the District of Columbia, findings about where and to what extent uninsured adults in the District of Columbia get medical care, and financial barriers to care. Fact Sheet (.pdf) Survey Highlights, Chartpack, and Toplines

  • Toplines: Kaiser Health Tracking Poll — February 2009

    Poll Finding

    This document contains the full toplines from the February 2009 Kaiser Health Tracking Poll. The survey was conducted February 3 through February 12, 2009, among a nationally representative random sample of 1,204 adults ages 18 and older. Telephone interviews conducted by landline (903) and cell phone (301, including 123 who had no landline telephone) were carried out in English and Spanish. The margin of sampling error for the total sample is plus or minus 3…

  • A Forum on the Implications of Changes in the Health Care Environment for Native American Health Care

    Report

    With the assistance of the First Nations Development Institute, the Henry J. Kaiser Family Foundation commissioned several studies of critical issues in Native-American health care. These studies examined the trends shaping the future of Native-American health care; the existing health systems and planning capacity in the Native-American health care system; the changes occurring in the IHS; the role of Medicaid in Native-American health care; the attitudes and preferences of Native American health care consumers; and…

  • Child Health Facts:  National and State Profiles of Coverage

    Other Post

    Child Health Facts: National and State Profiles of Coverage Appendix 2 Medicaid Enhanced Matching Rate Matching Rate Alabama 69.3% 78.5% Alaska 59.8% 71.9% Arizona 65.3% 75.7% Arkansas 72.8% 81.0% California 51.2% 65.9% Colorado 52.0% 66.4% Connecticut 50.0% 65.0% Delaware 50.0% 65.0% District of Columbia 70.0% 79.0% Florida 55.7% 69.0% Georgia 60.8% 72.6% Hawaii 50.0% 65.0% Idaho 69.6% 78.7% Illinois 50.0% 65.0% Indiana 61.4% 73.0% Iowa 63.8% 74.6% Kansas 59.7% 71.8% Kentucky 70.4% 79.3% Louisiana 70.0%…