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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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  • A Profile of American Indians and Alaska Natives and Their Health Coverage

    Issue Brief

    A Profile of American Indians and Alaska Natives and Their Health Coverage This brief examines the health coverage, access to care and health status of American Indians and Alaska Natives across the country. Although the U.S. government has an established responsibility through tribal agreements to provide health care services to members of federally recognized Indian tribes, many American Indians and Alaska Natives lack access to health care. The brief gives an overview of the some…

  • 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…

  • With Federal Support, States Hold Steady in Medicaid and CHIP Coverage Policies for Low-Income Children and Families Despite Recession

    News Release

    New 50-State Survey Finds Some States Make Targeted Expansions to Strengthen Coverage and Achieve Efficiencies as They Prepare for Health Reform WASHINGTON -- Despite tight budgets, nearly all states maintained or made targeted expansions or improvements in their Medicaid and Children’s Health Insurance Programs (CHIP) eligibility and enrollment rules in 2010, preserving the programs’ ability to provide coverage to millions of low-income Americans who otherwise lack affordable options, according to a new survey released today…

  • Determining Income for Adults Applying for Medicaid and Exchange Coverage Subsidies: How Income Measured With a Prior Tax Return Compares to Current Income at Enrollment

    Issue Brief

    A major goal of the Patient Protection and Affordable Care Act (ACA) is to significantly expand coverage and reduce the number of uninsured. Beginning in 2014, the ACA will establish a new continuum of coverage that will provide assistance to individuals with incomes up to 400% of poverty through a broad expansion in Medicaid and by making premium tax credits available to eligible individuals to purchase coverage through new Health Insurance Exchanges. The law standardizes…

  • New Publications on Immigrant Health Care and Linguistic Access

    Fact Sheet

    In 2000, there were over 32 million foreign-born residents in the U.S. Immigrants often face barriers to health coverage and health services. The disparities confronting immigrants can be similar to those faced by low-income working families generally, but immigrants also face other barriers, including linguistic issues and eligibility changes that have limited their ability to qualify for Medicaid. These new or updated publications address issues related to how race, immigration status, and language affect insurance…

  • Health Care Coverage and Access for Hispanics: How Does It Differ Across America

    Event Date:
    Event

    A new report from the Foundation's Kaiser Commission on Medicaid and the Uninsured finds that as the Hispanic population grows and moves beyond urban centers, Hispanics in "new growth communities" face greater barriers to health care than those in cities considered "major Hispanic centers." By 2003, the uninsured rate for Hispanics in new growth communities rose to a level equal to that of Hispanics in major centers. However, less than half (43%) of the Hispanic…

  • Health Savings Accounts and High Deductible Health Plans: Are They An Option for Low-Income Families?

    Issue Brief

    Health Savings Accounts (HSAs) are a type of medical savings account that allow consumers to save for medical expenses on a tax-fee basis. They are linked with high deductible health plans (HDHPs), and together these insurance and savings options represent a new approach to health care, commonly referred to as consumer-directed care. This brief, based on analyses of available data and research, finds that most low-income families would not benefit from HSA-HDHPs due to an…

  • Toplines: The Public’s Health Care Agenda

    Poll Finding

    These toplines provide the complete survey questions and findings from The Public’s Health Care Agenda for the New Congress and Presidential Campaign, conducted jointly by the Kaiser Family Foundation and the Harvard School of Public Health between November 9 and 19, 2006. The survey looks at the public’s priorities and views on health issues as a new Democratic majority takes the leadership of Congress and as the 2008 presidential campaign begins to take shape. It…

  • New Publications Examine SCHIP Experience; Trends in Access to Medicaid and SCHIP Coverage

    Fact Sheet

    Maintaining and expanding health coverage for children and parents will likely be in the forefront of health care policy debates in Washington and state capitols in 2007. With states generally in better financial shape since the fiscal crisis earlier in the decade, many have expressed interest in improving access to their Medicaid and State Children's Health Insurance Programs (SCHIP). A new 50-state survey shows that one-third of states (17) increased access to health coverage in…

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

    Poll Finding

    This May 2007 Kaiser Family Foundation report is the first of several that will track the progress and challenges facing people living in the New Orleans area in the aftermath of Hurricane Katrina. To conduct the study, a team of 41 interviewers visited 456 randomly selected census areas, documented the physical condition of nearly 17,000 housing locations and completed interviews with 1,504 randomly chosen adults living in the four parishes between September and November 2006.…