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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 >>

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  • Designing Health Purchasing Alliances/Cooperatives: Federal Policy Issues and Options

    Other Post

    A comparison of the key features of alliance design in the Clinton, Chafee/Thomas, and Cooper/Breaux health reform proposals of 1994, examining the trade-offs inherent in alternative alliance design.(For more information about alliances, see #2063, Permitting Voluntary Enrollment in Regional Alliances Under the Health Security Act: The Impact on Spending for Employers and the Federal Government.) Note: This publication is no longer in circulation. However, a copy may still exist in the Foundation's internal library that…

  • Key Facts: Women and Medicare

    Report

    Medicare is a critical source of health insurance coverage for virtually all older women in the U.S. and for many younger women who have permanent disabilities. Today, 22 million women one in five adult women rely on Medicare for basic health insurance protection. In fact, women comprise 57% of the Medicare population. Medicare helps to make health care more affordable for older women at a time in their lives when they are most likely to…

  • Medicaid and Managed Care

    Fact Sheet

    This fact sheet provides an overview of the Medicaid program's increasing reliance on managed care to deliver services. Fact Sheet

  • Directions for Health Reform: Testimony before the Committee on Labor and Human Resources, United States Senate

    Event Date:
    Event

    This testimony presents a brief overview of the uninsured and health insurance coverage in the United States. The testimony describes the important role that the Medicaid program has come to play in providing health insurance coverage for 32 million low-income Americans, and it provides some perspective on policy options for consideration in the debate on the future direction of health reform.

  • Pulling it Together: On Health Reform, Will All Roads Meet in the Middle?

    Perspective

    A few weeks ago a small group of upset single-payer advocates followed Senator Baucus into the parking garage of our D.C. building as he was arriving to do one of our health reform newsmaker breakfasts, cosponsored by Families USA and the National Federation of Independent Business. They were angry because they feel that single payer is not receiving enough attention in the current debate, and it is true that it is not getting a lot…

  • Pulling it Together: Last Week’s Health Reform “Shocker”

    Perspective

    Last week we learned that health reform could cost the federal government at least a trillion dollars over ten years, and that it will be really difficult to forge bipartisan agreement on legislation and keep major interest groups on board. This obviously brought more angst to the deliberations, several Republicans seized the moment to criticize the Democrats' plans, and the press was all over it, with many commentators declaring health reform in dire straits. But…

  • Rewarding Healthy Behaviors: Variation in Health Risk Across Industries Among American Workers

    Issue Brief

    Faced with an unsustainable growth in health care costs, both employers and policymakers have begun to consider the potential savings that might be achieved by investments in health promotion and better access to preventive care. There has also been public discussion about the potential of building financial incentives for healthy behaviors and the use of prevention services into health plans. Creating the right incentives is a challenge however, because experience is so limited and healthy…

  • Expanding Medicaid under Health Reform: A Look at Adults at or below 133% of Poverty

    Issue Brief

    This issue brief from the Kaiser Commission on Medicaid and the Uninsured examines the key characteristics of the 17.1 million low-income uninsured adults who currently have incomes that would qualify them for Medicaid under the expansion of the program in health reform. The planned expansion of Medicaid to all individuals with incomes at or below 133 percent of the federal poverty level will establish a national foundation of coverage based on income. Adults whose incomes…

  • Changes in Employees’ Health Insurance Coverage, 2001-2005

    Issue Brief

    This paper examines the underlying reasons behind the decline in employer coverage among employees from 2001 to 2005. The paper finds that almost half of the decline in employer-sponsored coverage was due to a loss of employer sponsorship. Another quarter of the decline was due to lost eligibility for benefits or losing access as a dependent of another employee. The remaining quarter of the decline was due to employees not participating in the offer of…

  • 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…