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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  • Immigration Reform and Access to Health Coverage: Key Issues to Consider

    Issue Brief

    The Obama administration and a bipartisan group of U.S. senators recently released blueprints for immigration reform proposals that include a roadmap to citizenship for the 11 million undocumented immigrants currently residing in the United States. Subject to meeting specified requirements, these individuals would be able to apply for a provisional lawful status. After completing an undefined number of years in this status, an individual would then be allowed to apply for lawful permanent residency and,…

  • Premiums and Cost-Sharing in Medicaid: A Review of Research Findings

    Issue Brief

    Medicaid covers nearly 60 million Americans. Because the population covered by the program is low-income, federal law limits the extent to which states can charge premiums and cost-sharing amounts, particularly for pregnant women, children and adults with incomes below poverty. Yet there is renewed interest in the use of premiums and cost-sharing in Medicaid given the continued focus on cost-containment due to ongoing state budget pressures as well as recently proposed changes to federal regulations…

  • 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…

  • Visualizing Health Policy: Medicaid Expansion Under the Affordable Care Act

    Other Post

    The March 2013 Visualizing Health Policy infographic looks at how expanding Medicaid under the Affordable Care Act will impact low-income and uninsured people, and how these groups will be affected in states that do not expand the program. See the full-size infographic at The Journal of the American Medical Association View the related Slideshow Visualizing Health Policy is a monthly infographic series produced in partnership with the Journal of the American Medical Association (JAMA). Each month’s infographic…

  • Visualizing Health Policy: Health Coverage Under the Affordable Care Act (ACA)

    Report

    Related Resources Study Highlights Role of Geography and Plan Shopping Under Medicare Premium Support System Medicare Part D: A First Look at Part D Plan Offerings in 2013 The Medicare Prescription Drug Benefit - An Updated Fact Sheet Online Consumer Guide to Medicare   The latest Visualizing Health Policy infographic is a flowchart illustrating the mechanisms by which people will get health coverage beginning in 2014. Medicare's Role and Future Challenges << Previous Visualizing Health…

  • Increasing Medicaid Payments for Certain Primary Care Physicians in 2013 and 2014: A Primer on the Health Reform Provision and Final Rule

    Issue Brief

    To help ensure that access in Medicaid expands to meet anticipated higher demand for care, the health reform law requires states to pay certain physicians Medicaid fees that are at least equal to Medicare’s for a list of 146 primary care services in 2013 and 2014. The idea is to attract new physicians to Medicaid and provide greater support for physicians who already participate. As a result, Medicaid fees paid to certain physicians for primary…

  • The Role of Medicaid for Adults With Chronic Illnesses

    Fact Sheet

    This report and related fact sheets provide data on spending, utilization, and access to care among low-income nonelderly adult Medicaid beneficiaries with chronic illnesses. Four fact sheets provide detail for beneficiaries with diabetes, respiratory disease, cardiovascular disease, and behavioral health conditions The reports show that, despite relatively high prevalence of chronic conditions and, correspondingly, relatively high spending and utilization rates, Medicaid beneficiaries with chronic illness report better access to care than their uninsured counterparts, many…

  • The Cost and Coverage Implications of the ACA Medicaid Expansion: National and State-by-State Analysis

    Report

    A central goal of the Patient Protection and Affordable Care Act (ACA) is to significantly reduce the number of uninsured by providing a continuum of affordable coverage options through Medicaid and new Health Insurance Exchanges. Following the June 2012 Supreme Court decision, states face a decision about whether to adopt the Medicaid expansion. These decisions will have enormous consequences for health coverage for the low-income population. This analysis uses the Urban Institute’s Health Insurance Policy…

  • Faces of the Medicaid Expansion: Experiences and Profiles of Uninsured Adults Who Could Gain Coverage

    Issue Brief

    These two papers provide insight into how state decisions to expand Medicaid under the Affordable Care Act are likely to impact people. Based on focus groups and interviews conducted in Cincinnati, Houston, Las Vegas and Tampa with uninsured adults who could be eligible for the Medicaid expansion in 2014, these papers highlight the experiences of uninsured adults and the significant health and financial consequences of being uninsured, which sometimes impact their ability to work and…