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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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  • The President’s FY 2007 Budget Proposal: Overview and Briefing Charts

    Report

    This chartpack reviews the President’s FY 2007 budget request to Congress and highlights overall budget assumptions and funding for major health programs. It begins with a description of the federal budget process, followed by summary information on the overall composition of the Administration’s budget. Overall, the budget includes net reductions for Medicare, Medicaid, and other health programs administered by the Department of Health and Human Services. The budget also includes additional expenditures for proposals to…

  • Private Long-Term Care Insurance: A Viable Option for Low and Middle-Income Seniors?

    Issue Brief

    In the Deficit Reduction Act of 2005, the federal government made it harder for individuals to qualify for Medicaid nursing home benefits by increasing penalties on individuals who have transferred assets for less than fair market value during the past five years and by making individuals with home equity above $500,000 ineligible for nursing home benefits. The legislation also lifts the moratorium on the number of states that may operate Long-Term Care (LTC) Partnership Programs,…

  • The Implications of a Loss in Public Health Coverage

    Event Date:
    Event

    A new Health Affairs article and a policy brief examine the implications of cuts to public coverage programs like Medicaid and SCHIP. The Health Affairs article finds that Medicaid and SCHIP cuts would increase emergency department visits by the uninsured, suggesting that cost containment actions on public coverage programs would shift costs to hospital uncompensated care. The policy brief examines the share of current enrollees in public programs who would have other coverage options if…

  • What Happens When Public Coverage Is No Longer Available?

    Issue Brief

    This policy brief examines national data to determine the share of current enrollees of public health coverage programs who would have alternate coverage options if public coverage were no longer available. The authors estimate that no more than 9 percent of low-income adults would have access to an alternative source of insurance in the absence of public coverage. This research suggests that the vast majority of current enrollees affected by cutbacks in eligibility for public…

  • A Pre-Katrina Look At the Health Care Delivery System For Low-Income People In New Orleans

    Issue Brief

    A Pre-Katrina Look At the Health Care Delivery System For Low-Income People InNew Orleans This issue brief offers a retrospective look at how care was provided to poor residents in New Orleans before Hurricane Katrina hit. It describes the structure of the public safety net and briefly discusses the challenges facing the system as it tries to rebuild. Issue Brief (.pdf)

  • Uninsured and Their Access to Health Care, 2005

    Fact Sheet

    The Uninsured and Their Access to Health Care This fact sheet describes the characteristics of the uninsured population, the difference health insurance makes, and why there is a large uninsured population. Fact Sheet (.pdf)

  • 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…

  • Health Coverage in America, 2004 Data Update

    Report

    This chartbook provides 2004 data on health insurance coverage, with special attention to the uninsured. It includes trends and major shifts in coverage and a profile of the uninsured population. Report (.pdf)