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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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  • Kaiser Health Tracking Poll — December 2010

    Feature

    As 2010 draws to a close, the latest tracking poll shows the public still divided in their views of the health reform law, a sentiment largely unchanged since the law’s enactment in March. Forty-two percent of Americans say they have a generally favorable view of the law, while 41 percent have a generally unfavorable view of it. Seniors, generally more critical of the law than younger people, seem to be softening in their opposition as…

  • Trends in Health Insurance Coverage in the U.S.: The Impact of the Economy

    Event Date:
    Event

    The rising number of uninsured, who they are and how they might obtain health insurance coverage were much debated during the consideration and passage of health reform in the last year. Panelists at this briefing examined the recent health insurance coverage numbers and trends, what they mean, who the newly uninsured are and the impact of being uninsured. They also reviewed what states are doing during the current economic climate and how they are preparing…

  • Optimizing Medicaid Enrollment: Spotlight on Technology – Using Schools and Data Matching to Enroll Kids in Medicaid and CHIP

    Issue Brief

    This brief examines efforts by the Chicago Public School system to use multiple strategies including data matching with the school lunch program, marketing and local organizing to target children for outreach and enrollment in public health insurance and other benefits. It is the third brief in a Spotlight on Technology series profiling several states' innovative applications of technology to Medicaid enrollment efforts. The series illustrates a range of approaches that states can adopt to improve…

  • Pulling it Together: The People Behind The Entitlement Debate

    Perspective

    Well before we have any clarity on the impact of the election on health reform, the pundits are handicapping the prospects of efforts to make a serious dent in the national debt and deficit.  Three national commissions are hammering out recommendations for reducing the debt and reining in entitlement spending, putting two giant health programs that serve the elderly, disabled and low-income Americans, Medicaid and Medicare, as well as Social Security, in the crosshairs of…

  • West vs. South: Regional Differences in Views of the Health Reform Law

    Poll Finding

    This Data Note examines regional variations in public opinion of the health reform law based on the November 2010 Kaiser Health Tracking Poll. The analysis takes a special look at the Western and Southern regions of the country, where many states are likely to see the biggest increases in coverage under the law, and which stand to be disproportionately eligible for federal Medicaid funds. Despite these similarities in how the two regions might be affected,…

  • Explaining Health Reform: Building Enrollment Systems That Meet The Expectations of the Affordable Care Act

    Issue Brief

    The new health reform law will require most U.S. citizens and legal residents to have health coverage by 2014. It provides new options for coverage by expanding Medicaid eligibility to more low-income people and creating a state-based system of health insurance Exchanges through which individuals can purchase coverage, with federal subsidies for many. The success of the law in achieving near-universal health coverage will depend on the effectiveness of the enrollment and renewal processes that…

  • Optimizing Medicaid Enrollment: Spotlight on Technology – Wisconsin’s ACCESS Internet Portal

    Issue Brief

    This brief examines how ACCESS, a web-based, self-service tool developed by the state of Wisconsin, helps Wisconsin residents find out whether they may be eligible for BadgerCare Plus and other public programs, as well as apply for benefits, check and renew benefits, and report changes to keep their eligibility current -- all online. It is the second brief in a Spotlight on Technology series profiling several states' innovative applications of technology to Medicaid enrollment efforts.…

  • Coordinating Coverage and Care in Medicaid and Health Insurance Exchanges

    Issue Brief

    The Kaiser Commission on Medicaid and the Uninsured convened a roundtable discussion on August 31, 2010 with a group of national and state experts to discuss key issues related to coordinating coverage and care in Medicaid and the new Health Insurance Exchanges under health reform. The Patient Protection and Affordable Care Act requires states to create a coordinated, simple and technologically-supported process through which individuals may obtain Medicaid, Children’s Health Insurance Program and subsidized Exchange…

  • Pulling it Together: A Primer on Health in the Election

    Perspective

    There is a lot of talk in polling and political circles and some speculation in the media about the role of health reform in the midterm elections. We regularly measure what the public thinks about health reform and you see reports from our monthly tracking polls about that. But whether those opinions will translate into an impact on people’s votes in the upcoming election is an entirely different question. First, to understand what might happen in…

  • Pulling it Together: Health Reform’s Six-Month Checkup

    Perspective

    Six months after its enactment, there are two totally different stories to tell about the health-reform law. The public remains split on the law largely along traditional partisan lines. Confusion and misperception are rampant, with more than a third of seniors still thinking the law contains "death panels" (it does not). Yet beneath the political battle lies a success story of early implementation: The federal government that many regard as sluggish and ineffective has turned…