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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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  • CHIP TIPS: Children’s Oral Health Benefits

    Issue Brief

    This brief examines a new requirement under the Children's Health Insurance Program Reauthorization Act of 2009 that state CHIP programs cover comprehensive dental benefits. The reauthorization law also allows states with separate CHIP programs to offer a dental-only plan for children who have other health insurance but lack adequate dental benefits. Other oral health improvements in the law include education for new parents, better access to benefit and provider information and enhanced reporting on the…

  • Covering the Uninsured:  Growing Need, Strained Resources

    Fact Sheet

    Covering the Uninsured: Growing Need, Strained Resources This summary of key findings provides an overview of studies examining trends in health coverage and federal spending on the health care safety net. Fact Sheet (.pdf)

  • SCHIP Enrollment in 50 States: June 2005 Data Update

    Report

    This report finds that monthly SCHIP enrollment reached a record high of more than 4 million in June 2005, reversing the decline seen in the previous 12 month period. SCHIP enrollment rose in all but nine states, including large increase in California, Georgia, and Illinois. Report (.pdf)

  • Health Affairs Article: From ‘Soak The Rich’ To ‘Soak The Poor: Recent Trends In Hospital Pricing

    Report

    Health Affairs Article: From 'Soak The Rich' To 'Soak The Poor': Recent Trends In Hospital Pricing The May-June 2007 issue of Health Affairs features a Foundation-supported study on recent trends in hospital pricing, including comparisons of rates charged to self-pay patients versus those with insurance coverage. The article also examies three specific policy options that could lower the markups for self-pay patients: a voluntary effort by hospitals, litigation, and legislation Health Affairs article "From 'Soak…

  • The Effects of the Economic Recession on Communities of Color

    Issue Brief

    This issue brief examines some of the challenges associated with employment, daily life and access to health care among racial minorities, who tend to be disproportionately affected by many of the consequences of economic hard times. High unemployment rates, coupled with vast differences in savings and wealth, have left many individuals struggling to afford such basic necessities as housing and food, and have resulted in lapses in health coverage and difficulties paying for needed medical…

  • Putting Men’s Health Care Disparities on the Map: Examining Racial and Ethnic Disparities at the State Level

    Report

    This Kaiser Family Foundation report finds that men of color in almost every state continue to fare worse than white men on a variety of measures of health, health care access and other social determinants of health. It documents the persistence of such disparities between white men and men of color -- and among different groups within men of color -- on 22 indicators of health and well-being, including rates of diseases such as AIDS,…

  • The President’s FY 2007 Budget Proposal: Overview and Briefing Charts

    Report

    This chartpack reviews the President’s FY 2007 budget request to Congress and highlights overall budget assumptions and funding for major health programs. It begins with a description of the federal budget process, followed by summary information on the overall composition of the Administration’s budget. Overall, the budget includes net reductions for Medicare, Medicaid, and other health programs administered by the Department of Health and Human Services. The budget also includes additional expenditures for proposals to…

  • Summary and Chartpack: National Survey of Households Affected by Cancer

    Poll Finding

        These charts highlight data from the National Survey of Households Affected by Cancer conducted jointly by USA Today, the Kaiser Family Foundation and the Harvard School of Public Health by telephone between Aug. 1 and Sept. 14, 2006. The survey provides an in-depth look at how families cope with cancer, and in particular, examines problems of health insurance and health care costs through the lens of those who have experienced this major illness.…

  • Covering New Americans:  A Review of Federal and State Policies Related to Immigrants’ Eligibility and Access to Publicly Funded Health Insurance

    Report

    Covering New Americans: A Review of Federal and State Policies Related to Immigrants' Eligibility and Access to Publicly Funded Health Insurance This brief provides an overview of health coverage challenges facing immigrants, the federal rules regarding immigrants’ eligibility for Medicaid and SCHIP, and state efforts to provide replacement coverage for immigrants who are ineligible for Medicaid and SCHIP. Report (.pdf)

  • Spotlight on Uninsured Parents: How a Lack of Coverage Affects Parents and Their Families

    Issue Brief

    Providing health coverage for the entire family can both help to increase coverage of children and assist low-income families in obtaining more affordable health care services. This brief uses data from the 2005 Kaiser Low-Income Coverage and Access Survey to examine health coverage, access and the financial impacts of health care for low-income parents and their families. Issue Brief (.pdf)