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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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  • Access to Care for Low-Income Women: The Impact of Medicaid

    Issue Brief

    Health coverage is of critical importance to low-income women. This study was undertaken to assess how low-income women with Medicaid, private insurance, or no insurance vary with regard to personal characteristics, health status, and health utilization. Data are from a telephone interview survey of a representative cross-sectional sample of 5,200 low-income women in Minnesota, Oregon, Tennessee, Florida, and Texas. On the whole, low-income women were found to experience considerable barriers to care; however, uninsured low-income…

  • Health Coverage by Race and Ethnicity: The Potential Impact of the Affordable Care Act

    Issue Brief

    Executive Summary One of the key goals of the Affordable Care Act (ACA) is to reduce the number of uninsured through a Medicaid expansion and the creation of health insurance exchange marketplaces with advance premium tax credits to help moderate-income individuals pay for this coverage. Given that people of color are at disproportionate risk of being uninsured and having low incomes, the ACA coverage expansions could particularly benefit communities of color and advance efforts to…

  • Analysis of the Number of Workers Covered by Self-Insured Health Plans Under the Employee Retirement Income Security Act of 1974 and 1995.

    Report

    This report presents findings based upon the KPMG health benefits survey of private and public employers and explores the extent of ERISA preemption on health plans covering U.S. workers. Included is estimated data on the total number of workers covered by fully and partly self-insured health plans in 1993 and 1995, a summary of the ERISA provisions and case law dealing with health plans and an analysis of potential changes to ERISA. Note: This publication…

  • Covering the Low-Income Uninsured: The Case For Expanding Public Programs

    Issue Brief

    An article in the January/February 2001 issue of Health Affairs by Judith Feder, Larry Levitt, Ellen O’Brien, and Diane Rowland assesses how best to expand health insurance coverage for the low-income uninsured. The article concludes that despite flaws in existing public programs, which can and should be remedied, strengthening programs like Medicaid and CHIP establishes a foundation for truly effective coverage for all low-income Americans. Available at www.healthaffairs.org.

  • Health Affairs Article: Health Care in New Orleans Before and After Hurricane Katrina

    Issue Brief

    On the first anniversary of Hurricane Katrina’s landfall, a paper authored by Foundation staff, released as a web exclusive by the journal Health Affairs, examines the impact of the storm on New Orleans, the current state of health care in the city, and lessons learned about the city’s health care delivery system. Health Affairs article: Full Article Abstract

  • The New Health Reform Law and Young Adults

    Event Date:
    Event

    Young adults have some of the highest uninsurance rates in America. In 2008, three in 10 uninsured Americans – almost 14 million people – were between 19 and 29 years of age. The new health reform law requires insurers to allow dependent children to remain on their parents’ plans until age 26. But many questions remain, such as who qualifies as a dependent? What does the Massachusetts reform experience teach us about insuring young adults?…

  • Snapshots from the Kitchen Table: Family Budgets and Health Care

    Video

    This Kaiser Family Foundation documentary, “Snapshots from the Kitchen Table: Family Budgets and Health Care,” profiles several American families who are struggling to make ends meet. It depicts the narrow financial ledge on which millions of low- and middle- income working households stand even in normal economic times, and illustrates the central role that health care costs and coverage play in a household’s economic stability. Some of the families profiled have health insurance, others do…

  • Few Uninsured Know Date of Pending Deadline for Obtaining Marketplace Coverage; Many Say They Will Get Coverage Soon, Though Cost is a Concern

    News Release

    Most Democrats Like Medicare-for-All, But Very Few Say the Issue Will Drive Their Votes in the 2016 Elections Similar to Last Month, More Hold Unfavorable Views of the ACA than Favorable Ones The Affordable Care Act's third open enrollment period will end on Jan. 31, but the latest Kaiser Health Tracking Poll finds that only a small share of people without health insurance realize it. Just 7 percent of the uninsured correctly identify January as…

  • Briefing: Medicaid and CHIP Eligibility and Enrollment in 2016, and a Look Ahead: Findings from a 50-State Survey

    Event Date:
    Event

    At 9:30 a.m. ET on Thursday, January 21, the Kaiser Family Foundation hosted a public briefing to present findings from our 14th annual 50-state survey of Medicaid and CHIP eligibility, enrollment, renewal, and cost-sharing policies. The survey, conducted by the Foundation’s Kaiser Commission on Medicaid and the Uninsured (KCMU) and Georgetown University’s Center for Children and Families, provides new data on states’ Medicaid eligibility and enrollment policies, which have undergone significant change in the two…

  • A Guide to Understanding Medicaid Expansion Waivers as States Debate What to Do Under the ACA

    News Release

    With the recent governors’ elections in Kentucky and Louisiana refocusing attention on state Medicaid expansion decisions, a newly updated issue brief from the Kaiser Family Foundation provides an overview of the waivers obtained by six states – Arkansas, Iowa, Michigan, Indiana, New Hampshire and Montana -- that are pursuing alternative Medicaid expansions under the Affordable Care Act.