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2025 KFF Marketplace Enrollees Survey

If the amount they pay in premiums doubled, about one in four enrollees in ACA Marketplace health plans say they would “very likely” go without insurance in 2026, finds a KFF survey of Marketplace enrollees fielded shortly after open enrollment began in the first weeks of November 2025. One in three say they would be “very likely” to look for a lower-premium Marketplace plan.

Health Coverage Among Community Health Center Patients, 2019-2024

Community Health Center Patients, Financing, and Services

Changes to Medicaid and the ACA Marketplace included in the 2025 reconciliation law and the expiration of ACA Marketplace enhanced premium tax credits at the end of 2025 are likely to increase the number of uninsured patients and patients who cannot afford out-of-pocket costs, placing new financial burdens on community health centers.

Data and analysis

The Uninsured Population 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?

This analysis estimates that 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 coverage ACA's Marketplaces affordable to them.

Key Facts about the Uninsured Population

The number of people ages 0-64 who were uninsured held steady at 25.3 million in 2023, although the number of uninsured children rose from 3.8 million to 4.0 million. Most uninsured people are in low-income families and have at least one worker in the family.

How the Unwinding Affected Enrollees

Over half who were disenrolled say they put off needed medical care while trying to renew Medicaid. Overall, 19% of adults who had Medicaid prior to the start of unwinding say they were disenrolled at some point in the past year. Of this group, a large majority (70%) were left at least temporarily uninsured.

The uninsured: How costs affect care and health, 2023

Latest Polling
8%

Percent of adults who reported not having health insurance
55%

Percent of uninsured adults who reported delaying or forgoing some form of health care due to cost
19%

Percent of uninsured adults who report that they or a family member had difficulty paying medical bills
38%

Percent of uninsured adults who reported not having a usual source of care (vs. 8% of insured adults)
Peterson-KFF Health System Tracker

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  • Medicaid’s Role for Low-Income Medicare Beneficiaries

    Fact Sheet

    Medicaid's Role for Low-Income Medicare Beneficiaries An overview that identifies low-income Medicare beneficiaries (dual eligibles), how Medicaid can provide care for them, and the challenges to accessing care.

  • Medicare and Prescription Drug Focus Groups

    Report

    Summary Report This report, : Summary Report, produced jointly by the bipartisan team of Bill McInturff of Public Opinion Strategies and Geoff Garin of Peter D. Hart Research Associates, presents key findings from a series of eight focus groups on the Medicare program and the current debate over prescription drug coverage and Medicare reform.

  • Trends and Indicators in the Changing Health Care Marketplace 2002

    Report

    This chartbook provides information on key trends in the health care marketplace including health spending, the structure of the health care marketplace, and health plan and provider relationships. It highlights data on health plan enrollment, premiums, and benefits, and the implications of health market trends for consumers and the safety net. Chartbook (.

  • The New Challenge of the Uninsured: Coverage in the Current Economy

    Event Date:
    Event

    Diane Rowland, executive director of the Commission, testified to the House Energy and Commerce Subcommittee on Health about health coverage for the uninsured in the current economy and discussed the special challenges of providing them coverage during uncertain economic times. Please note: the video is no longer available.

  • Medicaid: Issues and Challenges

    Event

    Diane Rowland, executive vice president of the Kaiser Family Foundation and executive director of the Kaiser Commission on Medicaid and the Uninsured, testified to the U.S. House Energy and Commerce Committee's Subcommittee on Health on the issues and challenges facing Medicaid in providing health and long-term care coverage for the low-income population. Testimony (.

  • Lack of Coverage: A Long-Term Problem for Most Uninsured

    Fact Sheet

    This fact sheet, recently updated with 2002 data, describes how long the uninsured remain without coverage, who tends to go without insurance for long spells of time, and what difference time without coverage makes in terms of access to and utilization of care. Fact Sheet (.

  • Is Lack of Coverage a Short- or Long-Term Condition?

    Issue Brief

    This paper produces alternative estimates of the numbers of uninsured and explores the distribution of the duration of uninsured spells for people who lacked coverage at some time during a 12-month period.