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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 >>

Data and analysis

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.

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 tax credits that would make ACA coverage affordable to them.

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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  • How Are Safety Net Hospitals Responding to Health Care Financing Changes?

    Report

    A new background report sums up how multiple trends have led to a situation where safety net hospitals are feeling more financial pressure and are challenged to subsidize the unprofitable care of theuninsured. Background Paper For a more extensive discussion read our larger report from the same study.

  • Health Centers: An Overview and Analysis of Their Experiences With Private Health Insurance

    Report

    This policy brief provides an overview of health centers, with a special focus on the relationship between health centers and private health insurance. The analysis of 10 years of national data reveals that health centers do not receive adequate reimbursement from private insurers to cover the costs of treating commercially insured patients. The cumulative shortfalls jeopardize the ability of health centers to fulfill their mission of providing access to care for low-income patients. Issue Brief…

  • Risk Selection Issues Under Medicare Reform Proposals

    Report

    This report compares the provisions designed to guard against risk selection among the Medicare population in both the Congressional Balanced Budget Act of 1995 and in the President's budget plan released in December 1995. The report also explores provisions in both that may exacerbate the potential for risk selection. Report:

  • State Variation in Medicaid Pharmacy Benefit Use Among Dual-Eligible Beneficiaries

    Report

    This study examines Medicaid pharmacy benefit use and spending among beneficiaries dually eligible for Medicare and Medicaid in 10 states by analyzing 1995 enrollment and claims data from a new 12-state database. The study finds that dual-eligibles are relatively high users of the Medicaid pharmacy benefit, with substantial variation in both drug use and spending among this population across the 10 study states. This variation appears to persist independent of beneficiaries' health status and is…

  • California Health Care Chartbook: Key Data and Trends

    Report

    This chartbook provides California and U.S. data and trend analysis on a broad range of health system and financing indicators, including demographics and health status data, insurance coverage and the uninsured, employer health insurance premiums and offer rates, Medicaid and Medicare enrollment and spending, and health care industry trends. Chartbook (.pdf)

  • Comparison of Medicaid Provisions in Deficit-Reduction Proposals

    Issue Brief

    In response to mounting concern about the nation’s rising debt and deficit, and increasing apprehension about the federal budget, prominent leaders and various commissions have come forward with recommendations to strengthen the economy and bolster the nation’s fiscal health. These proposals include both tax increases and spending reductions in discretionary programs, including defense, and in mandatory programs, such as Social Security, Medicare, and Medicaid. This document provides a brief description of the key Medicaid changes…