Uninsured

New and noteworthy

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

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  • Ensuring Access to Care in Medicaid Under Health Reform

    Issue Brief

    This paper examines the key issues raised in a December 2010 roundtable discussion of federal and state officials and experts convened by the Kaiser Commission on Medicaid and the Uninsured to examine important issues related to ensuring access to care in Medicaid under the Patient Protection and Affordable Care Act (ACA). The ACA expands Medicaid to reach millions of low-income uninsured Americans and, recognizing current serious access problems system-wide, takes significant steps to build capacity…

  • A Pre-Katrina Look At the Health Care Delivery System For Low-Income People In New Orleans

    Issue Brief

    A Pre-Katrina Look At the Health Care Delivery System For Low-Income People InNew Orleans This issue brief offers a retrospective look at how care was provided to poor residents in New Orleans before Hurricane Katrina hit. It describes the structure of the public safety net and briefly discusses the challenges facing the system as it tries to rebuild. Issue Brief (.pdf)

  • Pulling it Together: A Holiday Reminder on the Economy and Health Care

    Perspective

    With so much of the focus on the political dynamics of the health reform debate and a few hot button issues, I wonder if we have lost track of what propelled health care to the top domestic issue in the first place—people’s concerns about paying for health care in the middle of a deep recession. This gave health greater traction as a national issue and brought us our best chance at national health reform legislation…

  • Coping with Fragmented Payment in the Real World

    Event Date:
    Event

    The Alliance for Health Reform and The Commonwealth Fund sponsored this briefing which focused on three communities that have reformed and harmonized health care payments across payers to improve care: a New York health center that serves a low income population; a Colorado community that pools money from public and private sources to provide care for all patients; and the State of Maryland, which has been using an all payer hospital rate setting system for…

  • The Uninsured in Rural America (Update)

    Fact Sheet

    The Uninsured in Rural America Summarizes the number of uninsured individuals in rural America, who they are, and the barriers to coverage they experience. Fact Sheet (.pdf)

  • Enrolling Uninsured Low-Income Children in Medicaid & SCHIP

    Fact Sheet

    This fact sheet outlines issues in outreach and enrollment for Medicaid and SCHIP. It provides a profile of eligible but uninsured children, discusses the greatest barriers to enrollment, and offers strategies to improve enrollment. Fact Sheet (.pdf)

  • Health Insurance Coverage in Rural America

    Report

    This chartbook presents analysis of national data on health insurance coverage based on a county's proximity to a large urban area. It answers questions of how much health insurance coverage differs among people living in rural vs. urban communities, as well as, the differences in socio-economic and employment characteristics of those living in rural vs. urban counties. Chartbook (.pdf)

  • Health Care in New Orleans from the People’s Perspective

    Event

    Diane Rowland, executive vice president of Kaiser, testified to the House Energy and Commerce Subcommittee on Oversight and Investigation about the health care needs of New Orleans' residents and their access to health services in the area. Her testimony was a part of the hearing, "Post-Katrina Health Care in the New Orleans Region: Progress and Continuing Concerns, Part II." Testimony (.pdf)

  • Who Pays and How Much? The Cost of Caring for the Uninsured

    Report

    This report answers how much the country spends on care for the uninsured and how much care the uninsured receive compared to insured Americans. It is part of our Cost of Not Covering the Uninsured project. Report

  • The New Middle-Class of Uninsured Americans — Is it Real?

    Report

    This issue paper discusses and answers the question are the newly uninsured in 2001 predominantly from the middle-class. The paper examines U.S. Census Bureau s data and concludes that most of the increase in the uninsured (1.3 million people) was among low-income people with incomes less than 200% of the poverty level. Issue Paper