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Uninsured

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.

New and noteworthy

Affordability Is the Issue Now, But Look for the Uninsured to Make a Comeback

A new column on the uninsured from President and CEO Dr. Drew Altman explains: “The uninsured is not the most politically salient problem in health care now, that’s affordability, nor is it the non-problem some say it is. But it’s coming back. And the problem of the chronically ill uninsured is glaring.” Read more.

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.

More on the uninsured population >>

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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  • Quick Take: Timing Matters: States Waiting for a Supreme Court Decision to Plan an Exchange

    Fact Sheet

    State-based health insurance exchanges are an important component of the Patient Protection and Affordable Care Act (ACA) designed to extend subsidized private health insurance coverage to millions of Americans by 2014. Though projections show exchange enrollment could grow to 20 million individuals nationally, aggressive planning on the part of states will be necessary to meet implementation timelines—exchanges must be fully operational by January 1, 2014 and the Department of Health and Human Services will begin…

  • Faces of the Medicaid Expansion: How Obtaining Medicaid Coverage Impacts Low-Income Adults

    Report

    The Affordable Care Act (ACA) seeks to fill the longstanding gap in Medicaid coverage for low-income adults by expanding eligibility to a minimum floor of 138% of the federal poverty level (FPL), or $24,344 for a family of 3 in 2012. However, the Supreme Court ruling on the ACA effectively made implementation of the Medicaid expansion a state choice. If a state does not expand Medicaid, poor uninsured adults in that state will not gain…

  • Millions of Uninsured People Can Get Free ACA Plans

    Policy Watch

    This post estimates that about 5 million uninsured people across the country could get coverage through an Affordable Care Act (ACA) Marketplace health plan with virtually no monthly premium if they enroll during the 2023 open enrollment period, which runs through Jan. 15 in most states.

  • Health Care One Year After Hurricane Katrina

    Event Date:
    Event

    Health Care One Year After Hurricane Katrina Extended interviews with survivors and a related film, "Voices of the Storm: Health Care After Katrina," are available below. August 29, 2006, marks the first anniversary of Hurricane Katrina's catastrophic landfall. The Kaiser Family Foundation continues its commitment to help respond to the devastation from Hurricane Katrina with new resources about the health care impact of Katrina's aftermath. At a forum held on August 8, the Foundation released…

  • National Survey of Public Knowledge of the Medicare Program and Public Support for Medicare Policy Proposals

    Other Post

    New Survey finds most Americans oppose slowing the growth of Medicare to balance the budget or cut taxes, but would support changes to avoid bankruptcy Embargoed for release until: 9:30 AM EST Thursday, June 29, 1995 Contacts: Matt James Tina Hoff (415) 854-9400 --Public Favors Incremental Rather than Sweeping Reforms-- --Significant Generational Differences on Medicare Reform-- Washington, D.C. -- A new survey has found that close to three out of four Americans (73%) support reducing…

  • Benefits and Costs of Consumer Protection Proposals in California: An Analysis of Selected Recommendations of the California Managed Care Task Force

    Report

    This report assesses the potential impact of selected recommendations of the Managed Health Care Improvement Task Force in the areas of access to care and specialists, information disclosure, and dispute resolution. The Managed Health Care Improvement Task Force was established in 1998 to inform state leaders about the health industry in California; the impact of managed care on quality, access, and cost of care; issues of special concern to consumers; and the appropriate role of…

  • Protection For Consumers In Managed Care Plans: A Comparison Of Medicare, Medicaid and the Private Insurance Market

    Report

    This policy paper describes key requirements of consumer protection regulation under Medicare, Medicaid and federal and state laws as they apply to private health insurance. These include choice and availability of plans, disclosure of information, marketing, access, quality, and the grievance and appeals process. The discussion highlights differences and similarities across public programs and private insurance and compares public and private insurance protection with provisions of the Consumer Bill of Rights (CBRR) developed by the…

  • The Role of PBMs in Managing Drug Costs: Implications for a Medicare Drug Benefit

    Other Post

    Extending a drug benefit to Medicare beneficiaries has been a highly publicized issue in recent months. To address the question of how to finance and administer such a benefit while controlling its cost, some have proposed using pharmacy benefit managers (PBMs)--companies that administer pharmaceutical benefits for health plans, HMOs, and employers while managing drug utilization and obtaining discounts from both retail pharmacies and manufacturers. Most recently, the Clinton Administration introduced a proposal for a Medicare…

  • Incrementalism: Ethical Implications of Policy Choices

    Report

    This paper discusses ethical issues in incremental approaches to expanding health insurance coverage. Although any reduction in the number of uninsured is morally desirable, there are real moral differences between different policy options. This paper, which is part of the Kaiser Incremental Health Reform Project, examines these moral differences by identifying the values and commitments that ground the different policy options. Issue Paper

  • Retiree Health Coverage: Recent Trends and Employer Perspectives on Future Benefits

    Report

    The report, based on an analysis of Hewitt Associates' client database, presents new trend data on the prevalence of retiree health coverage sponsored by large employers and finds a continued erosion of retiree health benefits. The report also includes findings from a new survey assessing how large employers might change their retiree health programs in the future, and on their reaction to the Administration's proposal to add a prescription drug benefit to Medicare. The Hewitt…