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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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  • 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%…

  • Key Findings: Kaiser Health Tracking Poll — February 2009

    Poll Finding

    This document contains the key findings 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…

  • Today’s Topics In Health Disparities: Is the Health Care System Ready for Health Reform?

    Event Date:
    Event

    On Wednesday, November 4, at 1 p.m. ET, this Today's Topics In Health Disparities live webcast examined how ready the health care system is for the influx of newly covered individuals that health reform aims to deliver. In the health care proposals being considered by Congress, changes to Medicaid alone could mean as many as 15 million people would become newly eligible for the program and many live in medically underserved areas. The program will…

  • How States Are Responding to the Challenge of Financing Health Care for Retirees

    Report

    State governments are an important source of health insurance coverage for retired state employees. Confronted with rising health care costs, budget deficits, and an overall downturn in the economy, this report describes how states are responding to the challenge of financing health care for retirees who tend to be sicker and more costly to cover than active workers. This study, based on survey responses from 43 states and the District of Columbia, captures information on…

  • New Publications Examine SCHIP Experience; Trends in Access to Medicaid and SCHIP Coverage

    Fact Sheet

    Maintaining and expanding health coverage for children and parents will likely be in the forefront of health care policy debates in Washington and state capitols in 2007. With states generally in better financial shape since the fiscal crisis earlier in the decade, many have expressed interest in improving access to their Medicaid and State Children's Health Insurance Programs (SCHIP). A new 50-state survey shows that one-third of states (17) increased access to health coverage in…

  • Covering Uninsured Children: Reaching and Enrolling Citizen Children With Non-Citizen Parents

    Issue Brief

    This issue brief examines health insurance coverage for low-income citizen children whose parents are not citizens and some of the specific barriers to enrolling these children in Medicaid and the State Children's Health Insurance Program. It is based on findings from the Kaiser Survey of Children's Health Coverage, a telephone survey of parents conducted in 2007 to learn more about children’s access to coverage and care and the health care cost-related pressures facing their families.…

  • New Reports Profile the Growing Uninsured Population and Portray the Health Care Safety Net as Increasingly Strained

    Event Date:
    Event

    Five Kaiser Commission on Medicaid and the Uninsured reports released at a policy briefing profile the growing uninsured population and portray the health care safety net as increasingly strained to meet uninsured people’s needs. News Release Covering the Uninsured: Growing Need, Strained Resources Federal Spending on the Health Care Safety Net from 2001-2004: Has Spending Kept Pace with the Growth in the Uninsured? Health Affairs article, Changes in Economic Conditions and Health Insurance Coverage, 2000-2004…

  • Choices Under the New State Child Health Insurance Program: What Factors Shape Cost and Coverage? – Policy Brief

    Issue Brief

    Choices Under The New State Child Health Insurance Program: What Factors Shape Cost And Coverage? January 1998 The State Children's Health Insurance Program (CHIP), enacted as part of the Balanced Budget Act of 1997, provides over $20 billion in federal funds over five years to cover low-income uninsured children. This program gives states considerable flexibility in designing expanded health insurance coverage for children. The way states design their programs -- use of Medicaid or a…

  • Matching Health Benefit Packages to Health Needs: Key Issues To Consider In Health Reform

    Event Date:
    Event

    Three reports and a video collectively examine the range of health care needs and costs that people face today against the backdrop of the scope of health coverage that may be available to them under health reform. Children and Health Care Reform: Assuring Coverage That Meets Their Health Care Needs and Individuals With Special Needs and Health Reform: Adequacy of Health Insurance Coverage examine the needs of children and adults, respectively, focusing on those with…