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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 >>

Latest News

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  • Approaches to Covering the Uninsured: A Guide

    Issue Brief

    The guide explains the key strategies for expanding coverage to the nation's 45 million uninsured people and explains and how different policy options can be combined to form comprehensive reform proposals. It organizes the various policy strategies under four overall approaches: strengthening current coverage arrangements, improving the affordability of coverage, improving the availability of coverage and changing the tax treatment and financing of health insurance. Guide (.pdf)

  • Turning to Medicaid and SCHIP in an Economic Recession: Conversations with Recent Applicants and Enrollees

    Issue Brief

    This issue brief illuminates the emotional and pocketbook struggles of families who have suffered financial reversals and lost health coverage in the economic recession forcing many to juggle bills, skip prescription medications and postpone visits to the doctor while they scramble to find a new job. Many who once had steady employment and incomes have had to turn to Medicaid and the State Children’s Health Insurance Program for the first time, even as those programs…

  • Covering Uninsured Children: Reaching and Enrolling Citizen Children With Non-Citizen Parents

    Issue Brief

    This issue brief examines health insurance coverage for low-income citizen children whose parents are not citizens and some of the specific barriers to enrolling these children in Medicaid and the State Children's Health Insurance Program. It is based on findings from the Kaiser Survey of Children's Health Coverage, a telephone survey of parents conducted in 2007 to learn more about children’s access to coverage and care and the health care cost-related pressures facing their families.…

  • Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA)

    Fact Sheet

    This fact sheet provides an overview of provisions of the Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA), which was signed into law in February 2009. The Act extends and expands the State Children's Health Insurance Program (now referred to as CHIP, not SCHIP) that was enacted with bipartisan support a decade ago as part of the Balanced Budget Act of 1997 (BBA). Fact Sheet (.pdf) Fact Sheet: State Adoption of Coverage and Enrollment…

  • Snapshots from the Kitchen Table: Family Budgets and Health Care

    Report

    This report from the Kaiser Family Foundation’s Commission on Medicaid and the Uninsured (KCMU) illustrates the financial struggles of many families in the United States and shows the central role of health care costs and coverage in a household's economic stability. The report, , is based on interviews with 27 families from six cities across the U.S.. It finds pervasive uncertainty over job security and households teetering on the financial brink, stretching to pay for…

  • CHIP TIPS Series Focuses On New Opportunities For Covering Children Under Medicaid and CHIP

    Issue Brief

    This series of implementation briefs called “CHIP Tips” examines new opportunities for covering children following the reauthorization and expansion of CHIP in February 2009. Together Medicaid and CHIP provide coverage for more than one in four children in the U.S., yet many others remain eligible but uninsured. The series, which explores a range of topics, is jointly produced by the Kaiser Family Foundation’s Commission on Medicaid and the Uninsured and the Center for Children and…

  • Pulling it Together: This Could Be the Next Big Issue in Health Reform

    Perspective

    No, this is not about “death panels.” The town hall meetings.  The media coverage of the town hall meetings.  Media polls about how the American people feel about the town hall meetings.  And even the media myth busting and fact checking about the most extreme claims made at the town hall meetings and the Administration's daily efforts to set the record straight.  All these things have focused attention on a few hot button issues that…

  • Ensuring Access to Care in Medicaid Under Health Reform

    Issue Brief

    This paper examines the key issues raised in a December 2010 roundtable discussion of federal and state officials and experts convened by the Kaiser Commission on Medicaid and the Uninsured to examine important issues related to ensuring access to care in Medicaid under the Patient Protection and Affordable Care Act (ACA). The ACA expands Medicaid to reach millions of low-income uninsured Americans and, recognizing current serious access problems system-wide, takes significant steps to build capacity…

  • 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…

  • New Reports Profile the Growing Uninsured Population and Portray the Health Care Safety Net as Increasingly Strained

    Event Date:
    Event

    Five Kaiser Commission on Medicaid and the Uninsured reports released at a policy briefing profile the growing uninsured population and portray the health care safety net as increasingly strained to meet uninsured people’s needs. News Release Covering the Uninsured: Growing Need, Strained Resources Federal Spending on the Health Care Safety Net from 2001-2004: Has Spending Kept Pace with the Growth in the Uninsured? Health Affairs article, Changes in Economic Conditions and Health Insurance Coverage, 2000-2004…