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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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  • 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…

  • Falling Through the Cracks: Health Insurance Coverage of Low-Income Women

    Report

    Access to health coverage is a challenge for millions of low-income women. Because they are more likely to be low-wage workers and work in industries that don't offer benefits, access to job-based coverage is often problematic. Avenues for assistance are available to some through Medicaid. However, despite the program s broadened focus on children and pregnant women, restrictive income and categorical requirements still leave millions of women ineligible and often uninsured. Recent changes in public…

  • The Characteristics and Roles of Medicaid-Dominated Managed Care Plans

    Report

    This policy brief (Publication #2180) provides a national profile of Medicaid-dominated managed care plans - those in which Medicaid enrollees make up at least 75 percent of total enrollment. While recent policy and market forces have encouraged the growth of these plans, basic information about them has been lacking, partly because many are not licensed as HMOs by states. As of June 1997, 118 of these Medicaid-dominated plans served 3.4 million Medicaid enrollees across the…

  • A Study of Media Coverage of Health Policy 1997-2000

    Poll Finding

    The debate over President Clinton's national health care reform plan put health care policy at the forefront of the national agenda in 1993 and 1994. After the end of that debate, it remained to be seen whether or not health policy would hold the media's and the public s interest to the same degree. To help answer that and other questions, a comprehensive study of health policy media coverage from 1997 through 2000 - focusing…

  • An Analysis of Reforming Medicare Through a ‘Premium Support’ Program

    Report

    An Analysis of Reforming Medicare Through a 'Premium Support' Program This report examines one of the leading approaches to reforming the Medicare program, known as premium support. Under this model, the current Medicare program would be replaced by a system of competing public and private health plans, and the federal government would pay a set amount per beneficiary. The authors conclude that, while premium support could potentially improve Medicare's efficiency and improve quality, traditional Medicare…

  • Seniors and Prescription Drugs: An 8-State Survey

    Report

    A new study conducted by researchers at Tufts-New England Medical Center, the Henry J. Kaiser Family Foundation, and the Commonwealth Fund, reports results from a 2001 survey of 10,927 noninstitutionalized seniors in eight geographically diverse states: California, Colorado, Illinois, Michigan, New York, Ohio, Pennsylvania, and Texas. State-level data on drug coverage, medication use, out-of-pocket costs, and cost-related medication skipping among community-dwelling seniors are highlighted to examine how coverage and experiences differ by state and how…

  • How Well Does the Employment-Based Health Insurance System Work for Low-Income Families?

    Other Post

    Part 2 Even when insurance is offered to low-wage workers, its costs to these workers may be substantial, and, for some, a barrier to coverage. In 1996, workers had to contribute an average of $1,615 per year for family coverage, or about 30% of the total premium.5 Thus, a worker who earned $10 an hour in 1996, with annual wages of about $20,000, would have had to spend 8% of earnings to buy family coverage.*…

  • Is Lack of Coverage a Short- or Long-Term Condition?

    Issue Brief

    This paper produces alternative estimates of the numbers of uninsured and explores the distribution of the duration of uninsured spells for people who lacked coverage at some time during a 12-month period. Policy Brief Link to fact sheet, Lack of Coverage: A Long-Term Problem for Most Uninsured

  • Maintaining Health Coverage and Securing the Medicaid Safety Net in a Sluggish Economy

    Fact Sheet

    The current economy is a key concern as federal and state leaders worry about the expected rise in unemployment and the related loss of employer health coverage. Policymakers are considering several options to ensure that we do not experience a health coverage crisis as we deal with the impact of the September 11th tragedy and ongoing concerns. In addition, states that were already preparing for budget problems are reporting even worse scenarios for their fiscal…