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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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  • A Profile of the Low-Income Uninsured

    Issue Brief

    This policy brief provides an overview of the low-income, uninsured population. Based on an analysis of the March 1998 Current Population Survey, the report discusses the demographic characteristics of this vulnerable population. It also presents information detailing health insurance coverage for low-income children and adults, as well as trends in insurance coverage over the past decade. It concludes with a discussion of recent coverage expansions and policy changes that have affected low-income Americans. The policy…

  • Making Child Health Coverage a Reality: Lessons From Case Studies of Medicaid and CHIP Outreach and Enrollment Strategies

    Report

    Recent expansions in public health insurance for children and changes in welfare laws present states with the challenge of identifying and enrolling the large population of uninsured children in their Medicaid and Children's Health Insurance Programs (CHIP). This study describes and analyzes the outreach and enrollment strategies and systems in place in four states at the county level, highlighting issues and challenges states face during implementation. The study sites selected were Santa Clara County (San…

  • Public Health in a Changing Health Care System: Linkages Between Public Health and MCOs In the Treatment and Prevention of STDs

    Report

    Public health agencies and managed care organizations share responsibility for the health of the populations they serve. Their relationships are particularly important in the area of STDs. This study analyzes the evolving relationships between managed care organizations and public health agencies in how they manage the prevention, treatment, and tracking of STDs. Report

  • Expansions in Public Health Insurance and Crowd-Out: What the Evidence Says

    Report

    Enactment of the Children's Health Insurance Program has been accompanied by concerns that new coverage will "crowd out" private health insurance coverage. Part of the Kaiser Incremental Health Reform Project, this paper reviews existing empirical literature on the magnitude of crowd-out and discusses implications for CHIP. Issue Paper

  • Issues in the 2000 Election:  Health Care

    Poll Finding

    Issues in the 2000 Election: Health Care The Washington Post/Henry J. Kaiser Family Foundation/Harvard University national survey on "Issues in the 2000 Election: Health Care" is the second in a series of surveys examining policy issues in the 2000 national elections. This survey, conducted July 5-18, 2000, of a nationally representative sample of registered voters also included an oversample of "health care or Medicare-oriented" registered voters. This survey and all surveys in this series, are…

  • Subsidizing COBRA: An Option for Expanding Health Insurance Coverage

    Report

    This paper examines a method for making health insurance more affordable to people who may lose health insurance when they lose or change jobs. A proposal for subsidizing the purchase of group health insurance through COBRA for employees and their dependents who lose their health insurance coverage when the employee leaves a job that provides such coverage. This paper is part of the Kaise Incremental Health Reform Project. Issue Paper

  • Employment-Based Health Insurance Coverage and its Decline:-2134

    Report

    Employment-Based Health Insurance Coverage and its Decline:The Growing Plight of Low-Wage Workers This background paper examines the increase in uninsured workers and the growing disparity in health insurance coverage between low- and high-wage workers. While a larger proportion of higher wage workers had health coverage in 1996 than a decade before, coverage deteriorated for low-wage and less-educated workers, especially young men. The paper explores many explanations for this widening disparity. The primary cause is that…

  • Access To Health Care:

    Report

    Promises and Prospects For Low-Income Americans This book explores critical issues affecting access to health care for low-income Americans by assessing the importance of expansions of health coverage for the poor, the emerging challenges providers who serve low-income and uninsured populations face in a rapidly evolving health care delivery system, and the effects of these changes on particularly vulnerable populations. Articles include: IntroductionMarsha Lillie-Blanton, Rose Marie Martinez, Barbara Lyons, Diane Rowland A Review Of The…

  • Tax Subsidies for Health Insurance: Evaluating the Costs and Benefits

    Other Post

    This technical report provides 1) a description of the detailed simulation model and the assumptions used to analyze the effects of different tax subsidies for the purchase of health insurance coverage, and 2) the results of this analysis. The analysis includes the number of people who gain coverage, overall costs to the government, how much is spent on the currently insured vs. uninsured, and the effects on low-income groups. The results of this report were…

  • 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…