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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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821-830 of 1,313 results

  • 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

  • Managed Care and Low-Income Populations: Four Years’ Experience with the Oregon Health Plan

    Report

    This report updates an earlier study of Oregon's experience with restructuring their Medicaid programs. It is one of a series of reports from The Kaiser/Commonwealth Low-Income Coverage and Access Project. This project examines how changes in the Medicaid Program have affected health insurance coverage and access to care for the low-income population in eight states: Maryland, California, Florida, Minnesota, New York, Oregon, Tennessee and Texas. Report

  • 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…

  • The Medicaid Eligibility Maze: Coverage Expands, but Problems Persist

    Report

    This report examines Medicaid eligibility policies and operations in five states - California, Colorado, Florida, Minnesota and Wisconsin - following initial changes introduced by the Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA) of 1996 and the new Children's Health Insurance Program (CHIP). The study findings suggest that eligibility policy expansions alone may not prevent Medicaid enrollment declines. The report discusses several problem areas affecting Medicaid eligibility and enrollment operations including challenges in severing Medicaid…

  • 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…

  • Comparison of Medi-Cal and Healthy Families Programs for Children in California

    Report

    A new side-by-side examination of California's Medicaid program (Medi-Cal) and CHIP program (Healthy Families) shows how these two low-income health coverage programs differ in structure, eligibility, enrollment process, service delivery and scope. This California case study helps to illustrate differences between Medicaid and CHIP. SIDE-BY-SIDE Download

  • Medicare Restructuring: The FEHBP Model – Report

    Report

    Medicare Restructuring: The FEHBP Model Executive Summary As policymakers consider measures to assure the long-range solvency of Medicare, one option that has received increasing attention is a "premium support" system. Under such a system beneficiaries would choose between the original Medicare fee-for-service program and a variety of competing health plans. They would receive a fixed government contribution toward the plan of their choice and would pay any remaining costs themselves. Proponents of a premium support…