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

    Other Post

    Part 3 What Explains the Coverage Decline? Rapidly rising health care costs-or, more precisely, employers' responses to costs-have contributed to the widespread erosion of employer coverage. As employers have shifted costs to workers, participation has dropped. Low-wage workers have been disproportionately affected by rising costs, losing access to coverage as well as finding participation more difficult. Their problems have been exacerbated by structural changes in labor markets, which have weakened the tie between jobs and…

  • Additional Resources on Hurricane Katrina Relief

    Other Post

    U.S. Department of Health & Human Services (HHS)http://www.hhs.gov/katrina/index.html HHS Resources Targeting Minority Communitieshttp://www.os.dhhs.gov/news/press/2005pres/20050930a.html Congressional Hearings and Resources: Hearing: Hurricane Katrina: Community Rebuilding Needs and Effectiveness of Past Proposalshttp://finance.senate.gov/sitepages/hearing092805.htm Hearing: Assessing Public Health and the Delivery of Care in the Wake of Katrinahttp://energycommerce.house.gov/108/Hearings/09222005hearing1643/hearing.htm Senate Committee Reports and Other Information About Hurricane Katrinahttp://help.senate.gov/katrina.htm Centers for Medicare & Medicaid Services (CMS)http://www.cms.hhs.gov/katrina/ Social Security Administration (SSA)http://www.ssa.gov/emergency/ Federal Emergency Management Agency (FEMA)http://www.fema.gov/ Food and Nutrition Service (FNS)http://www.fns.usda.gov/disasters/disaster.htm U.S. Department of…

  • Pulling It Together: Jobs, A Reason to Fast Track Coverage

    Perspective

    The two big topics in Washington right now are the economy and health care.  I've written before about how the two are linked, and in particular about how among the everyday economic problems people are having, paying for health care is a big one. But the latest numbers out from the Bureau of Labor Statistics show there is another link: Health care is one of the few relatively healthy parts of our unhealthy economy right now. Since…

  • National Health Insurance — A Brief History Of Reform Efforts In The U.S.

    Issue Brief

    This policy brief provides an overview of health reform efforts in the United States over much of the last century, from New Deal-era calls for government-subsidized health coverage to the creation of Medicare and Medicaid in the 1960s and the failed attempt at universal coverage in the early 1990s. Issue Brief (.pdf)

  • Survey of Healthy San Francisco Participants

    Poll Finding

    This survey of enrollees in Healthy San Francisco (HSF), the city’s health care access program for the uninsured, reports high rates of satisfaction and signs that the program has improved access to care for those uninsured residents who have enrolled. In 2006, San Francisco created a unique health access program to provide access to affordable basic and ongoing health care services for its uninsured residents at participating clinics and hospitals. All uninsured city residents not…

  • Summary of Coverage Provisions in the Patient Protection and Affordable Care Act

    Issue Brief

    This short summary describes the health coverage provisions contained in the final version of the Affordable Care Act signed into law in March 2010, including the individual mandate requirements, expansion of public programs, health insurance exchanges, changes to private insurance and employer requirements.

  • Protecting Children During the Recession: Spotlight on State Health Coverage Efforts

    Issue Brief

    The beginning of the recession, from December 2007 through December 2008, led to an increase in the overall number of uninsured. Despite a 1.5 million increase in the number of uninsured adults, however, the number of uninsured children declined by 800,000 during this time period. States have played a key role in this progress for children by maintaining and expanding children's coverage. This issue brief highlights seven states (Alabama, Maryland, New Jersey, New York, Oklahoma,…

  • Pulling it Together: The Most Popular Provision in the ACA?

    Perspective

    In our most recent monthly tracking poll, we asked the American people what elements of the health reform law they like and dislike. Surprisingly, the runaway favorite was a relatively obscure requirement that health plans provide consumers with a short, easy to understand description of their benefits and coverage. Sixty percent of the American people gave this requirement for greater transparency in health insurance benefits a very favorable rating, the only provision in the law…

  • Putting Men’s Health Care Disparities on the Map: Health Status Highlights

    Report

    This fact sheet provides a brief overview of racial disparities in health status among men of different races in the United States. It draws findings from the report, Putting Men’s Health Care Disparities On the Map, which uses national data sources from multiple years to generate state-level estimates on a range of indicators of health status, access, and well-being for men of different racial and ethnic backgrounds. Women and men of different races and ethnicities…