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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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  • What Is the Current Population Survey Telling Us About the Number of Uninsured?

    Issue Brief

    This brief describes the main concerns with the Census Bureau’s CPS health coverage estimates and how analysts have attempted to adjust for problems, and concludes with implications for how the CPS might be enhanced in order to improve the measurement of health insurance coverage. Issue Paper (.pdf)

  • Women and Health Care: A National Profile – Report

    Report

    Report - Women and Health Care: A National Profile Women and Health Care: A National Profile is a nationally representative telephone survey of 2,766 women ages 18 and older. A shorter companion survey of 507 men was also conducted. Full Report (.pdf) Report Highlights (.pdf) Introduction and Methods (.pdf) Chapter 1: The Demographics of Women (.pdf) Chapter 2: The Health of Women (.pdf) Chapter 3: Women and Health Insurance Coverage (.pdf) Chapter 4: Women's Access…

  • Women and Health Care: A National Profile

    Report

    A new national survey of women on their health finds that a substantial percentage of women cannot afford to go to the doctor or get prescriptions filled. Although a majority of women are in good health and satisfied with their health care, many have health problems and do not get adequate levels of preventive care. The report also examines women’s health status, health care costs, insurance, access to care, prevention, and their role in family…

  • Stresses to the Safety Net:  The Public Hospital Perspective

    Report

    The nation’s safety net financing is fragmented; consequently, providers must knit together resources from many different funding sources to create a stream of revenue to cover the costs of providing a very broad range of services. This report describes those sources of revenue, documenting that nearly 40% of all safety net revenues are from Medicaid. The report also describes challenges that safety net hospitals and health systems are experiencing as they attempt to rebound from…

  • Migrant and Seasonal Farmworkers:  Health Insurance Coverage and Access to Care

    Report

    Migrant and Seasonal Farmworkers: Health Insurance Coverage and Access to Care Nearly three million workers earn their living through migrant or seasonal farm labor. Migrant and seasonal farmworkers and their families confront health challenges stemming from the nature of their work, their extreme poverty and mobility, and living and working arrangements that impede access to health coverage and care. This brief provides an overview of migrant and seasonal farmworkers and the health challenges they face…

  • Ten Myths about the Uninsured

    Fact Sheet

    Lack of health insurance coverage among millions of Americans remains one of this nation’s most pressing social challenges, but one that is often not well understood. Common knowledge about who the uninsured are, why they are uninsured, the difference health coverage makes, as well as the impact on all our lives of having a large uninsured population — is riddled with misconceptions and myths. Basic facts about the uninsured, outlined here under the most common…

  • Health Coverage for Low-Income Adults:  Eligibility and Enrollment in Medicaid and State Programs, 2002

    Issue Brief

    Health Coverage for Low-Income Adults: Eligibility and Enrollment in Medicaid and State Programs, 2002 This policy brief provides new information on the number and characteristics of nonelderly adults eligible for Medicaid and other public coverage and on their enrollment. Because low-income adults often work at jobs that do not offer employer-sponsored coverage and individual coverage is prohibitively expensive for them, their uninsured rates are high. Although Medicaid and the State Children's Health Insurance Program (SCHIP)…

  • The President’s FY 2006 Budget Proposal:

    Report

    Overview and Briefing Charts This chartpack reviews the President’s FY 2006 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 an overview of federal surplus/deficit spending patterns dating back to 1969. It then turns to summary information on the overall composition of the Administration’s budget, followed by the President’s proposed funding for some of the major programs…

  • Navigating Medicare and Medicaid, 2005: A Resource Guide for People with Disabilities, Their Families, and Their Advocates

    Report

    This guide explains the critical role Medicare and Medicaid have come to play in the lives and the futures of roughly 20 million children, adults, and seniors with disabilities - and gives people with disabilities new information to help them get the most from these programs. Full PDF Report (.pdf) Section 1: Introduction HTML PDF Section 2: Medicare HTML PDF Section 3: Medicaid HTML PDF Section 4: Interaction Between Medicare and Medicaid HTML PDF

  • Keeping Medicare and Medicaid When You Work, 2005: A Resource Guide for People with Disabilities, Their Families, and Their Advocates

    Report

    This guide helps to explain the program rules for Medicare and Medicaid with regard to work. Medicare and Medicaid have come to play important roles in the lives and the futures of roughly 20 million children, adults, and seniors with disabilities - and this guide gives people with disabilities new information to help them get the most from these programs. Full PDF Report Section 1: Protecting Health Coverage For People With Disabilities Who Work HTML…