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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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  • Pulling it Together: The Sleeper in Health Reform

    Perspective

    The health reform legislation currently being crafted on Capitol Hill is undeniably complex.  To oversimplify slightly it can be boiled down into four parts: coverage (subsidies for private coverage and Medicaid expansions); delivery and payment reforms; insurance market reforms and regulations; and prevention, with each broad category containing a range of specific policy proposals and ideas. There’s been a lot of discussion so far about coverage expansions and how to pay for them, as well…

  • Pulling it Together: On Health Reform, Will All Roads Meet in the Middle?

    Perspective

    A few weeks ago a small group of upset single-payer advocates followed Senator Baucus into the parking garage of our D.C. building as he was arriving to do one of our health reform newsmaker breakfasts, cosponsored by Families USA and the National Federation of Independent Business. They were angry because they feel that single payer is not receiving enough attention in the current debate, and it is true that it is not getting a lot…

  • Chartpack: Kaiser Health Tracking Poll – June 2009

    Poll Finding

    This document contains the chartpack from the June Health Tracking Poll. The survey was designed and analyzed by public opinion researchers at the Kaiser Family Foundation and was conducted June 1 through June 8, 2009, among a nationally representative random sample of 1,205 adults ages 18 and older. Telephone interviews conducted by landline (804) and cell phone (401, including 157 who had no landline telephone) were carried out in English and Spanish. The margin of…

  • Key Findings: Kaiser Health Tracking Poll? – June 2009

    Poll Finding

    This document contains the key findings from the June Health Tracking Poll. The survey was designed and analyzed by public opinion researchers at the Kaiser Family Foundation and was conducted June 1 through June 8, 2009, among a nationally representative random sample of 1,205 adults ages 18 and older. Telephone interviews conducted by landline (804) and cell phone (401, including 157 who had no landline telephone) were carried out in English and Spanish. The margin…

  • Kaiser Health Tracking Poll – June 2009

    Poll Finding

    The June Kaiser Health Tracking Poll finds remarkable stability in public opinion on health reform as Congressional committees begin to hone in on the details of their health reform bills and debate intensifies. A solid majority of the American people continue to believe that health reform is more important than ever given the country’s economic problems. A solid majority of the American people continue to believe that health reform is more important than ever given…

  • Putting Women’s Health Care Disparities On The Map: Examining Racial and Ethnic Disparities at the State Level

    Report

    This Kaiser Family Foundation report documents the persistence of disparities between white women and women of color across the country. It provides a rare and comprehensive state-level look at disparities among women of different races and ethnicities on a broad range of indicators of health and well-being, including rates of diseases such as diabetes, heart disease, AIDS and cancer, and access to health insurance and health screenings.

  • CHIP TIPS: CHIP Financing Structure

    Issue Brief

    This brief, the fourth in a series, examines important changes to CHIP’s financing structure under the Children’s Health Insurance Program Reauthorization Act of 2009. The law includes a number of important programmatic and financing changes that affect both Medicaid and CHIP. Among the most important changes include significant new funding for the CHIP program, changes in the formula for distributing CHIP funds among states and a new option for states to decide whether to use…

  • Topline: Kaiser Health Tracking Poll – June 2009

    Poll Finding

    This document contains the toplines from the June Health Tracking Poll. The survey was designed and analyzed by public opinion researchers at the Kaiser Family Foundation and was conducted June 1 through June 8, 2009, among a nationally representative random sample of 1,205 adults ages 18 and older. Telephone interviews conducted by landline (804) and cell phone (401, including 157 who had no landline telephone) were carried out in English and Spanish. The margin of…

  • Women at Risk: A View from the Safety Net

    Video

    This video provides a snapshot of the Arlington (Va.) Free Clinic where, four times a month, medical personnel provide care and screenings exclusively to women. The video explores the hurdles that uninsured women face in accessing health care and the social issues, including work and family responsibilities, that create challenges for them. It is a companion to the report, “Putting Women’s Health Care Disparities On The Map: Examining Racial and Ethnic Disparities at the State…

  • Low-Income Adults Under Age 65 – Many are Poor, Sick, and Uninsured

    Issue Brief

    This policy brief from the Kaiser Commission on Medicaid and the Uninsured examines the characteristics and insurance coverage of low-income adults under age 65, a group numbering more than 50 million people. Members of this group are more likely to be in poor health than other Americans and are the least likely to have health insurance. Nearly a third are from families earning less than twice the poverty level. Fifteen percent live in poverty. Although…