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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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  • Putting Men’s Health Care Disparities On The Map: Access and Utilization Highlights

    Fact Sheet

    This fact sheet provides a brief overview of racial disparities in health access and utilization among men of different races in the United States. It draws findings from the report, Putting Men’s Health Care Disparities On the Map, which uses national data sources from multiple years to generate state-level estimates on a range of indicators of health status, access, and well-being for men of different racial and ethnic backgrounds. Men and women use health care…

  • Health Challenges Facing the Nation

    Event

    Diane Rowland, executive vice president of the Kaiser Family Foundation and executive director of the Kaiser Commission on Medicaid and the Uninsured, testified to the Joint Economic Committee of the U.S. Congress on health insurance coverage and how the uninsured population remains one of the nation's most pressing health care challenges. Testimony (.pdf)

  • Medicare Cost-Sharing: Implications for Beneficiaries

    Event Date:
    Event

    Tricia Neuman, Vice President and Director of the Medicare Policy Project, testified on behalf of herself and Thomas Rice, Ph.D., of UCLA's School of Public Health, before the House Ways and Means Subcommittee on Health on cost-sharing requirements under Medicare and supplemental Medigap policies. The statement reviews Medicare beneficiaries' current cost-sharing responsibilities, the evidence on the impact of out-of-pocket costs on health-care utilization, and the implications for proposals that would modify Medicare's cost-sharing structure.

  • Retiree Health Trends and Implications of Possible Medicare Reforms

    Fact Sheet

    The availability of employer-sponsored retiree health benefits from large companies has declined since 1991, according to a new study conducted for the Kaiser Family Foundation by Hewitt Associates LLC. The study also shows that the number of big businesses charging premiums, tightening eligibility requirements, encouraging use of managed care, and placing dollar caps on coverage increased. In addition, the report concluded that potential changes in the Medicare program, such as a higher eligibility age, could…

  • The Role of Health Coverage for People with Disabilities

    Event Date:
    Event

    People with disabilities are at risk in the health-care system because of their wide-ranging health-care needs, their relatively heavy use of prescription drugs, health-care and support services, and typically low incomes. A new survey of people with permanent mental and/or physical disabilities explores their health-care experiences and challenges in accessing and paying for care. Report Chartpack Health Affairs Article-- "Uncovering the Health Challenges Facing People with Disabilities: The Role of Health Insurance"

  • The President’s FY 2005 Budget Proposal:  Overview and Briefing Charts

    Report

    The President's FY 2005 Budget Proposal: Overview and Briefing Charts The overview and briefing charts present information on the President's FY 2005 budget proposal to Congress beginning with federal surplus/deficit spending historical data and a summary of the overall composition of the Administration's budget request. The charts then detail information on the President's funding proposals for major health programs. Overview & Briefing Charts (.pdf)

  • 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)…

  • 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)