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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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  • Toplines: Kaiser Health Tracking Poll — November 2009

    Poll Finding

    This document contains the toplines from the November Health Tracking Poll. The survey was designed and analyzed by public opinion researchers at the Kaiser Family Foundation and was conducted November 5 through November 12, 2009, among a nationally representative random sample of 1,203 adults ages 18 and older. Telephone interviews conducted by landline (802) and cell phone (401, including 112 who had no landline telephone) were carried out in English and Spanish. The margin of…

  • Key Findings: Kaiser Health Tracking Poll — November 2009

    Poll Finding

    This document contains the key findings from the November Health Tracking Poll. The survey was designed and analyzed by public opinion researchers at the Kaiser Family Foundation and was conducted November 5 through November 12, 2009, among a nationally representative random sample of 1,203 adults ages 18 and older. Telephone interviews conducted by landline (802) and cell phone (401, including 112 who had no landline telephone) were carried out in English and Spanish. The margin…

  • State Variation and Health Reform: A Chartbook

    Report

    This chartbook pulls together data related to state variation in key areas such as major industry types, poverty and unemployment rates and fiscal conditions; health coverage and the uninsured; Medicaid and CHIP eligibility and enrollment; Medicaid spending and financing; access to Health Care; health care costs; and insurance markets.

  • The Role of Health Coverage for Communities of Color

    Issue Brief

    The current health reform debate in this country focuses heavily on providing access to affordable health coverage for the millions of people who are uninsured. Any effort to expand coverage, alter current public programs, and/or create new public programs will have important consequences for the health of communities of color, who are more likely than Whites to be enrolled in public programs or be uninsured. This issue brief highlights variations in coverage by race and…

  • Children’s Health Coverage: Medicaid, CHIP, and Next Steps

    Event Date:
    Event

    The Alliance for Health Reform and the Robert Wood Johnson Foundation co-sponsored this briefing to examine the factors which influence children's coverage. Questions addressed include:What are the trends in private sector coverage? How well are the enrollment simplification and outreach tools that are included in this year’s CHIP reauthorization helping to reach those children who are eligible but unenrolled? How much does a child’s coverage depend on where he or she lives? For more information,…

  • Putting Children on the Express Lane to Health Insurance: Streamlining Enrollment and Renewal of Children in Medicaid and CHIP Through Express Lane Eligibility

    Issue Brief

    Express Lane Eligibility (ELE) is a new tool available to states to streamline enrollment and renewal of children in Medicaid and CHIP. It allows state Medicaid and CHIP agencies to utilize data and eligibility findings from other public need-based programs, such as Head Start or Food Stamps, and/or tax return data to identify, enroll and recertify children rather than requiring them to re-analyze and determine eligibility under their own rules. A primary goal of this…

  • Why Express Lane Eligibility Makes Sense for States and Low-Income Families

    Issue Brief

    Express Lane Eligibility (ELE) is a new tool available to states to streamline enrollment and renewal of children in Medicaid and CHIP. It allows state Medicaid and CHIP agencies to utilize data and eligibility findings from other public need-based programs, such as Head Start or Food Stamps, and/or tax return data to identify, enroll and recertify children rather than requiring them to re-analyze and determine eligibility under their own rules. This issue brief, one in…

  • Kaiser Health Tracking Poll — October 2009

    Feature

    The October Kaiser Health Tracking Poll finds public support for health reform unchanged since last month, with more in favor than opposed. Fifty-five percent of Americans believe that it is more important than ever to take on health care reform now, while 41 percent say the country cannot afford it right now. The survey also shows about half of the public believes that if reform passes, help for the uninsured and changes in insurance market…

  • Changes in Health Insurance Coverage, 2007-2008: Early Impact of the Recession

    Issue Brief

    This issue brief examines trends in health insurance coverage from 2007 to 2008, a period marked by the start of a deep recession. It finds that the share of the nonelderly population covered by employer-provided insurance declined, the share covered by public programs increased and the number of uninsured people continued to rise. Notably, the economic downturn affected health insurance coverage differently for adults compared to children. The increase of 1.5 million in the number…

  • Today’s Topics In Health Disparities: Is the Health Care System Ready for Health Reform?

    Event Date:
    Event

    On Wednesday, November 4, at 1 p.m. ET, this Today's Topics In Health Disparities live webcast examined how ready the health care system is for the influx of newly covered individuals that health reform aims to deliver. In the health care proposals being considered by Congress, changes to Medicaid alone could mean as many as 15 million people would become newly eligible for the program and many live in medically underserved areas. The program will…