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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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801-810 of 1,312 results

  • Pulling It Together: Writing Regulations

    Perspective

    Not since Geraldo Rivera revealed the secret contents of Al Capone's vault on national TV in the mid-80s, or more recently, sports fans awaited the LeBron James "decision" about where he would play next, have we so anxiously awaited anything as much as the draft health exchange regulations just published by HHS. Well, okay, I exaggerate for effect, but the regulations on health insurance exchanges were anxiously awaited by the health policy community. The hallmark…

  • The Adequacy of Health Insurance

    Event Date:
    Event

    Testimony by Diane Rowland, executive vice president and executive director of the Kaiser Family Foundation’s Commission on Medicaid and the Uninsured, at a congressional hearing, titled “Addressing Underinsurance in National Health Reform,” held Feb. 24, 2009, by a special task force of the Senate Committee on Health, Education, Labor, and Pensions. Rowland discussed the status of health insurance coverage in America and the gaps and limits to coverage that leave millions of Americans poorly protected…

  • 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…

  • Emergency Departments Under Growing Pressure

    Issue Brief

    This issue brief relies on interviews with practicing clinicians to explore the impact of the recession on hospital emergency departments that are under growing pressure as patient volume increases, health coverage declines and medical costs present new challenges to unemployed families. Issue Brief (.pdf)

  • How Will Uninsured Children Be Affected By Health Reform?

    Issue Brief

    This brief examines uninsured children and how they could be affected by health reform, including estimates of how many might qualify for coverage under a Medicaid expansion, how many would be eligible for subsidies and how many would not be eligible for such help. Issue Brief (.pdf)

  • Medicaid and SCHIP Eligibility for Immigrants

    Fact Sheet

    Immigrants in the U.S. face increasing challenges securing health care coverage. They have less access to employer-sponsored insurance than native citizens and face tighter restrictions on their eligibility for Medicaid and SCHIP, the nation’s major public health coverage programs for low-income children and families. This fact sheet provides an overview of the current rules on immigrants' eligibility for Medicaid and the State Children's Health Insurance Program. Fact Sheet (.pdf)

  • The Role of Employer-Sponsored Health Coverage for Immigrants: A Primer

    Issue Brief

    Access to employer-sponsored health insurance is declining for all families living in the United States, and this problem is especially acute for immigrant families. Employer-sponsored coverage is a particularly important source of insurance for immigrant families since their eligibility for public coverage through Medicaid and the State Children’s Health Insurance Program (SCHIP) is restricted. This primer examines the role of employer-based coverage for immigrants and the specific hurdles they face in obtaining this coverage. Issue…

  • Useful Resources as the New U.S. Census Numbers on Health Coverage are Released

    Other Post

    With the U.S. Census Bureau releasing its annual update on health insurance coverage and the number of uninsured Americans shortly, Kaiser Family Foundation resources may be helpful. The Foundation and its largest program area, the Kaiser Commission on Medicaid and the Uninsured, produce several informational resources that analyze America's health insurance coverage, as well as the policy issues and public opinion regarding the uninsured. The Cost of Not Covering the Uninsured Project is an ongoing…

  • Eroding Access among Nonelderly Adults with Chronic Conditions: Ten Years of Change

    Report

    A Kaiser study published as a Health Affairs web-exclusive article finds the number of working-age adults who have major chronic conditions grew by 25 percent between 1997 and 2006 and those without health coverage in this group experienced substantial erosion in access to health care. The study also reveals that finds the cost of prescription drugs more of a problem today for all with chronic conditions, regardless of insurance coverage status. Health Affairs Abstract Health…