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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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  • 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.

  • Health Care After the Supreme Court Decision: What’s Next?

    Event Date:
    Event

    The Alliance for Health Reform and the Kaiser Family Foundation discuss the recent Supreme Court ruling on the constitutionality of the health reform law. Panelists explore such questions as: What does the court's ruling mean for those without health insurance? Will states that choose to participate in the Medicaid expansion be ready to cover nearly all non-disabled adults under age 65 with household incomes at or below 133 percent of the federal poverty level as…

  • Program Integrity in Medicaid: A Primer

    Issue Brief

    Medicaid covers more than 60 million Americans and accounts for about one in six dollars spent on health care in the United States. Multiple agencies at the state and federal levels are involved in efforts to prevent waste, fraud and abuse in the program and ensure appropriate use of taxpayer dollars, and many program integrity initiatives are yielding positive results. The Affordable Care Act (ACA) builds on earlier efforts through the Deficit Reduction Act to…

  • A Guide to the Supreme Court’s Affordable Care Act Decision

    Issue Brief

    This policy brief describes the Supreme Court's decision on the Affordable Care Act and looks ahead to the implementation of health reform now that questions about the constitutionality of the law have been resolved. Brief (.pdf)

  • Oral Health and Medicare Beneficiaries: Coverage, Out-of-Pocket Spending, and Unmet Need

    Issue Brief

    This brief describes the oral health of Medicare beneficiaries, examines sources of dental coverage for the Medicare population, and examines the utilization of dental services, out-of-pocket spending on dental care, and access problems. This analysis uses data from the National Health and Nutrition Examination Survey (NHANES), the Medicare Current Beneficiary Survey Cost and Use file (MCBS), the National Health Interview Survey (NHIS) and the Kaiser Family Foundation Survey of Health Care Among Nonelderly People with…

  • Filling the Gaps: Dental Care, Coverage and Access

    Event Date:
    Event

    While the Affordable Care Act is expected to expand public and private coverage for children when it takes effect in 2014, significant gaps will remain, especially for low-income adults age 21 and older. This June 19, 2012, a public forum at the Foundation's Washington, D.C. offices examined the gaps and disparities in dental coverage and care in the United States today; the health, social, and other consequences of these systemic deficiencies; and promising strategies for…

  • Kaiser Health Security Watch

    Feature

    The Kaiser Health Security Watch uses Kaiser Health Tracking Poll data to measure the public's health care-related problems and worries, including problems paying medical bills, skipping or delaying health care due to cost, and worrying about their future ability to pay for care and keep insurance. The Health Security Watch describes the overall numbers, and examines which types of people are most likely to report these problems and worries. The May 2012 update to the Health…

  • CHIP Enrollment: June 2011 Data Snapshot

    Issue Brief

    This data snapshot provides the latest data on Children's Health Insurance Program (CHIP) enrollment and policy trends nationally and across the states through June 2011, based on survey responses and data provided by CHIP directors in all 50 states and the District of Columbia. The report finds that in June 2011, the number of children enrolled in CHIP reached 5.3 million. From June 2010 to June 2011, an additional 178,000 children enrolled in CHIP programs…

  • Oral Health in the U.S.: Key Facts

    Fact Sheet

    This fact sheet provides data on oral health care coverage and access for children, nonelderly adults and Medicaid beneficiaries, including state-by-state data on measures such as the share of adults who have had a dental visit within the past year. Fact Sheet (.pdf)