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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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  • NPR/Kaiser/Harvard Survey: The Public on Requiring Individuals to Have Health Insurance – Toplines

    Poll Finding

    These toplines present detailed survey results from a February 2008 survey conducted jointly by NPR and public opinion researchers at the Kaiser Family Foundation and the Harvard School of Public Health that examines how the public views different approaches for expanding health coverage, including provisions that would require individuals to purchase insurance or parents to obtain coverage for their children. A nationally representative sample of 1,704 adults participated in telephone interviews from Feb. 14-24, 2008.…

  • What Shapes Lawmakers’ Views: A Survey of Members of Congress and Key Staff on Health Care Reform

    Report

    A report summarizing the findings of in-depths interviews conducted with Members of Congress and their staff who were actively involved in the health care reform debate about their opinions about what factors influenced the debate and shaped their views. The report finds that, among media sources, talk radio had the greatest influence in the debate and that public opinion trailed only Administration failures in terms of perceived influence on the debate's outcome. REPORT Download

  • Risk Selection Issues Under Medicare Reform Proposals

    Report

    This report compares the provisions designed to guard against risk selection among the Medicare population in both the Congressional Balanced Budget Act of 1995 and in the President's budget plan released in December 1995. The report also explores provisions in both that may exacerbate the potential for risk selection. Report:

  • The New Medicaid and CHIP Waiver Initiatives

    Report

    A new report describes past waiver activity, the principles of the new HIFA initiative, and related policy implications. Background Paper Appendix: Side-by-Side Comparison

  • Trends and Indicators in the Changing Health Care Marketplace: Chartbook

    Report

    This chartbook provides an overview of health care spending and trends in health plan enrollment. It highlights health insurance premiums and costs, health insurance benefits, the structure of the health care market. Data on the stock markets role within the health care industry and implications of health insurance trends for consumers and the safety net is also included. Chartbook

  • Public Subsidies and Private Markets: Coverage Expansions in the Current Insurance Environment

    Report

    Many proposals for incremental expansion of health insurance coverage would provide subsidies for the purchase of nongroup policies. This paper assesses how subsidy options might play out in regulated or unregulated markets and explores the possible trade-off between two distinct policy goals: maximizing the absolute number of families with insurance or maximizing access for the highest-risk families. This paper is part of the Kaiser Incremental Health Reform Project. Issue Paper

  • A Profile of the Low-Income Uninsured

    Issue Brief

    This policy brief provides an overview of the low-income, uninsured population. Based on an analysis of the March 1998 Current Population Survey, the report discusses the demographic characteristics of this vulnerable population. It also presents information detailing health insurance coverage for low-income children and adults, as well as trends in insurance coverage over the past decade. It concludes with a discussion of recent coverage expansions and policy changes that have affected low-income Americans. The policy…

  • Making Child Health Coverage a Reality: Lessons From Case Studies of Medicaid and CHIP Outreach and Enrollment Strategies

    Report

    Recent expansions in public health insurance for children and changes in welfare laws present states with the challenge of identifying and enrolling the large population of uninsured children in their Medicaid and Children's Health Insurance Programs (CHIP). This study describes and analyzes the outreach and enrollment strategies and systems in place in four states at the county level, highlighting issues and challenges states face during implementation. The study sites selected were Santa Clara County (San…

  • 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…

  • Racial and Ethnic Disparities in Access to Health Insurance and Health Care

    Fact Sheet

    Racial and ethnic groups in the United States continue to experience major differences in health status compared to the majority white population. Although many factors affect health status, the lack of health insurance and other barriers to obtaining health services markedly diminish minorities' use of both preventive services and medical treatments. This report, produced in collaboration with the UCLA Center for Health Policy Research, examines health insurance coverage and access to physician services among African…