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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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  • Rewarding Healthy Behaviors: Variation in Health Risk Across Industries Among American Workers

    Issue Brief

    Faced with an unsustainable growth in health care costs, both employers and policymakers have begun to consider the potential savings that might be achieved by investments in health promotion and better access to preventive care. There has also been public discussion about the potential of building financial incentives for healthy behaviors and the use of prevention services into health plans. Creating the right incentives is a challenge however, because experience is so limited and healthy…

  • Rising Health Pressures in an Economic Recession: A 360-Degree Look at Four Communities

    Report

    This report draws on interviews and focus groups in four communities to examine at the grassroots levels the experiences of families, employers, safety-net providers and community organizations in four U.S. communities hard hit by the recession. The communities are Beloit, Wisc.; Tampa-St. Petersburg, Fla.; Long Island, N.Y.; and Sonoma, Calif. The report explores the financial and personal struggles of families who have suffered economic reversals and lost health coverage, forcing many to juggle bills and…

  • New Option for States to Provide Federally Funded Medicaid and CHIP Coverage to Additional Immigrant Children and Pregnant Women

    Fact Sheet

    This fact sheet provides state-level data from a Kaiser survey that found that a large number of states are using state funds to provide health coverage to legal immigrant children and pregnant women through Medicaid, CHIP or another state program. Under the Children's Health Insurance Program Reauthorization Act of 2009, states now have the option to provide federally matched Medicaid or CHIP to some or all of the legal immigrants they have been covering solely…

  • Patients Under Pressure: Profiles of How Families Affected by Cancer Are Faring in the Recession

    Report

    This report by the Kaiser Family Foundation and the American Cancer Society profiles six cancer patients and survivors and the challenges they face to help gauge how the recession and rising unemployment is affecting workers who are most in need of ongoing medical care. The report, "Patients Under Pressure: Profiles of How Families Affected by Cancer are Faring in the Recession," illustrates the kinds of problems such patients face in a recession, including obstacles to…

  • Key Findings: Kaiser Health Tracking Poll — July 2009

    Poll Finding

    This document contains the key findings from the July Health Tracking Poll. The survey was designed and analyzed by public opinion researchers at the Kaiser Family Foundation and was conducted July 7 through July 14, 2009, among a nationally representative random sample of 1,205 adults ages 18 and older. Telephone interviews conducted by landline (800) and cell phone (405, including 126 who had no landline telephone) were carried out in English and Spanish. The margin…

  • Kaiser Health Tracking Poll – July 2009

    Poll Finding

    The July Kaiser Health Tracking Poll finds a majority of the public remains supportive of taking action on health reform now, though there is some softening of support as criticisms and doubts seem to be registering. As has been the case over the past ten months, a majority of the American people continue to believe that health reform is more important than ever despite the country's economic problems, and the public believes by a two…

  • Explaining Health Care Reform: How Might a Reform Plan Be Financed?

    Issue Brief

    One of the key challenges in enacting a health care reform plan is how to finance it among government, employers, and individuals. Of particular concern to policymakers is what effect a health reform plan would have on government spending and the federal budget. President Obama and Congressional leaders have said that any health reform plan should not add to the budget deficit over a 10 year period. This brief explains the likely sources of added…

  • Chartpack: Kaiser Health Tracking Poll — July 2009

    Poll Finding

    This document contains the chartpack from the July Health Tracking Poll. The survey was designed and analyzed by public opinion researchers at the Kaiser Family Foundation and was conducted July 7 through July 14, 2009, among a nationally representative random sample of 1,205 adults ages 18 and older. Telephone interviews conducted by landline (800) and cell phone (405, including 126 who had no landline telephone) were carried out in English and Spanish. The margin of…

  • Toplines: Kaiser Health Tracking Poll — July 2009

    Poll Finding

    This document contains the toplines from the July Health Tracking Poll. The survey was designed and analyzed by public opinion researchers at the Kaiser Family Foundation and was conducted July 7 through July 14, 2009, among a nationally representative random sample of 1,205 adults ages 18 and older. Telephone interviews conducted by landline (800) and cell phone (405, including 126 who had no landline telephone) were carried out in English and Spanish. The margin of…

  • Health Care and the Middle Class: More Costs and Less Coverage

    Report

    This analysis paper examines the availability, affordability and stability of the health insurance coverage of the American middle class, defined as those with incomes of $44,000 to $88,000 for a family of four. It also addresses the growing burden of health care costs for the middle class, the adequacy of today's health insurance plans to protect them from large medical bills, and the difference both make as individuals and families make health care decisions for…