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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  • Putting Men’s Health Care Disparities On The Map: Access and Utilization Highlights

    Fact Sheet

    This fact sheet provides a brief overview of racial disparities in health access and utilization among men of different races in the United States. It draws findings from the report, Putting Men’s Health Care Disparities On the Map, which uses national data sources from multiple years to generate state-level estimates on a range of indicators of health status, access, and well-being for men of different racial and ethnic backgrounds. Men and women use health care…

  • Resources Examine Racial and Ethnic Disparities Among Men at the State Level

    Other Post

    The Foundation has created a package of resources, including a comprehensive report, fact sheets and other materials, that document the persistence of disparities on 22 indicators between white men and men of color, including rates of diseases such as diabetes, heart disease, AIDS and cancer, and access to health insurance and health screenings. The resources provide a rare look at state-level variations, quantifying where disparities are greatest. Also available are state-level data for men of…

  • Medicaid Coverage and Care for the Homeless Population: Key Lessons to Consider for the 2014 Medicaid Expansion

    Report

    Beginning in 2014, the Affordable Care Act ACA provides for a significant Medicaid expansion uninsured, low-income adults. Given their low incomes and high uninsured rate, individuals experiencing homelessness could significantly benefit from this expansion. However, it will be important to address the barriers they face to enrolling in coverage and accessing needed care. This report, based on eight focus group discussions with administrators and frontline workers serving the homeless population in four cities, identifies enrollment…

  • Visualizing Health Policy: Medicaid—Its Role Today and Under the Affordable Care Act

    Other Post

    The August 2012 Visualizing Health Policy infographic examines the role Medicaid plays in the lives of many Americans today, and how that role will change under the Affordable Care Act. 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). The infographics will be freely available on JAMA’s website and will be…

  • Health Homes for Medicaid Beneficiaries with Chronic Conditions

    Issue Brief

    This brief profiles four states that were the first to receive federal approval to take up a state option under the Affordable Care Act to implement health homes for Medicaid beneficiaries with chronic conditions. Almost half of the 9 million people who qualify for Medicaid on the basis of disability suffer from mental illness and 45 percent have three or more diagnosed chronic conditions. Health homes provide an important tool for states trying to manage…

  • A Historical Review of How States Have Responded to the Availability of Federal Funds for Health Coverage

    Issue Brief

    This historical review finds that the availability of federal funds has served as an effective incentive for states to provide health coverage to meet the health and long-term care needs of their low-income residents despite state budget pressures. The brief examines the history of earlier experiences and provides important context for how states may respond as they weigh the costs and benefits of expanding their Medicaid programs in 2014 as called for under the Affordable…

  • Implementing the ACA’s Medicaid-Related Health Reform Provisions After the Supreme Court’s Decision

    Issue Brief

    On June 28, 2012, the U.S. Supreme Court upheld the constitutionality of the Affordable Care Act (ACA). A majority of the Court also found the ACA’s Medicaid expansion unconstitutionally coercive of states, while a different majority of the Court held that this issue was fully remedied by limiting the Health and Human Services (HHS) Secretary’s enforcement authority. The practical effect of the Court's decision makes the Medicaid expansion optional for states. This brief addresses questions…

  • How Five Leading Safety-Net Hospitals Are Preparing For The Challenges and Opportunities of Health Care Reform

    Report

    This study, published in the journal Health Affairs, examines how five leading safety-net hospitals are preparing for major changes expected to result from the Affordable Care Act (ACA), including less government support for uncompensated care and the need to compete for newly insured people. The hospitals studied are Bellevue Hospital Center in New York City; Denver Health Medical Center in Colorado; Parkland Health and Hospital System in Dallas; San Francisco General Hospital in California; and…

  • A Guide to the Supreme Court’s Decision on the ACA’s Medicaid Expansion

    Issue Brief

    On June 28, 2012, the U.S. Supreme Court issued its decision in the case challenging the Affordable Care Act (ACA). The Court upheld the constitutionality of the ACA's individual mandate, which requires most people to maintain a minimum level of health insurance coverage beginning in 2014. A majority of the Court also found the ACA's Medicaid expansion unconstitutionally coercive of states, while a different majority of the Court held that this issue was fully remedied…

  • Summary of Coverage Provisions in the Patient Protection and Affordable Care Act

    Issue Brief

    This short summary describes the health coverage provisions contained in the final version of the Affordable Care Act signed into law in March 2010, including the individual mandate requirements, expansion of public programs, health insurance exchanges, changes to private insurance and employer requirements.