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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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  • Medicaid Beneficiaries and Access to Care

    Fact Sheet

    The health reform law relies on a large expansion of Medicaid to reach many low-income uninsured people, many of them adults. This fact sheet summarizes Medicaid beneficiaries' experience in obtaining access to care, a subject that is of keen interest in view of the planned expansion of the program. Medicaid and the Children's Health Insurance Program have substantially increased coverage among low-income Americans, especially children. Research shows that Medicaid compares favorably with private coverage in…

  • Kaiser Health Tracking Poll — December 2009

    Poll Finding

    The December Kaiser Health Tracking Poll finds a dip on several measures of public opinion on health care reform. The number of Americans who say they personally will be better off if reform passes fell to 35 percent in December, down from 42 percent last month. Meanwhile, 27 percent say they will be worse off, and 32 percent said they don’t expect to see much of a difference. Similarly, 45 percent say the country would…

  • Health Care Costs Survey – Toplines

    Poll Finding

    This document includes the toplines from the joint USA Today/Kaiser/Harvard School of Public Health survey exploring Americans’ views on health care costs. Survey Toplines (.pdf)

  • Additional Resources on Hurricane Katrina Relief

    Other Post

    U.S. Department of Health & Human Services (HHS)http://www.hhs.gov/katrina/index.html HHS Resources Targeting Minority Communitieshttp://www.os.dhhs.gov/news/press/2005pres/20050930a.html Congressional Hearings and Resources: Hearing: Hurricane Katrina: Community Rebuilding Needs and Effectiveness of Past Proposalshttp://finance.senate.gov/sitepages/hearing092805.htm Hearing: Assessing Public Health and the Delivery of Care in the Wake of Katrinahttp://energycommerce.house.gov/108/Hearings/09222005hearing1643/hearing.htm Senate Committee Reports and Other Information About Hurricane Katrinahttp://help.senate.gov/katrina.htm Centers for Medicare & Medicaid Services (CMS)http://www.cms.hhs.gov/katrina/ Social Security Administration (SSA)http://www.ssa.gov/emergency/ Federal Emergency Management Agency (FEMA)http://www.fema.gov/ Food and Nutrition Service (FNS)http://www.fns.usda.gov/disasters/disaster.htm U.S. Department of…

  • Pulling It Together: The Repeal Trap?

    Perspective

    Almost a year into an often acrimonious health reform debate, we stand poised for near certain passage of historic health reform legislation. Yet, somewhat perplexingly, there's now talk about whether a law that has not even been enacted might actually be repealed and reporters have been calling asking what the chances of repeal may be. I have a very hard time imagining any scenario for repeal unfolding. Calls for repeal have much to do with…

  • How is the Affordable Care Act Leading to Changes in Medicaid Today? State Responses to Five New Options

    Issue Brief

    This policy brief examines how states in every region have responded to five key opportunities available under the health reform law to help them prepare for the significant expansion of Medicaid in 2014. The options covered in the brief include incentives for states to get an early start on the Medicaid coverage expansion; increased federal funding to upgrade Medicaid eligibility systems; money to improve care for beneficiaries with chronic conditions by providing "health home" services;…

  • Changes in Employer-Sponsored Health Insurance Sponsorship, Eligibility, and Participation: 2001 to 2005, Full Report

    Report

    This report provides a detailed account of how employer-sponsored insurance (ESI) coverage changed between 2001 and 2005, particularly among employees (i.e., workers who are not self-employed). The report begins with a short description of the major forces driving employer-sponsored insurance: changes in the workforce and the rising costs of health insurance over the four year period. Next, the report examines the decline in ESI among employees and the reasons determining whether or not an employee…

  • Giving Voice to the People of New Orleans: The Kaiser Post-Katrina Baseline Survey

    Poll Finding

    This house-to-house survey of people living in the New Orleans area examines the ongoing struggles of residents seeking to recover from the Hurricane Katrina disaster, including a detailed look at differences in views and experiences by race. Designed and analyzed by researchers at the Kaiser Family Foundation, the survey provides a portrait of the enormous needs of the population in order to inform recovery efforts and policy development on the Gulf Coast and in Washington.…

  • NPR/Kaiser/Harvard Survey: Public Views on SCHIP Reauthorization: Chartpack

    Poll Finding

    This chartpack presents key findings from an October 2007 survey conducted jointly by NPR, the Kaiser Family Foundation, and the Harvard School of Public Health on the public’s views and opinions of the State Children’s Health Insurance Program and the pending legislation surrounding its reauthorization. Chartpack (.pdf)

  • Reports and Other Resources on Trends in Children’s Health Coverage

    Event Date:
    Event

    With Congress poised to reauthorize the State Children's Health Insurance Program (SCHIP) with a substantial increase in its federal funding, there are potentially new opportunities for reducing the estimated 9 million uninsured children nationwide. At the same time, the nation’s weak economy and growing unemployment is resulting in fewer families and children covered by employer-sponsored coverage. Against that backdrop, the Kaiser Family Foundation's Commission on Medicaid and the Uninsured (KCMU) released a package of new…