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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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  • Summary Of Early Observations Of The Transition Of Immigrant Families From A Medicaid Look-Alike Program To Basic Health In Washington State

    Issue Brief

    In 2002, the state of Washington eliminated state-funded Medicaid look-alike coverage for certain immigrant families. These families then became eligible for more limited coverage in the state's Basic Health program. This report details the process of this transition and the outcomes for coverage and access for these individuals. Research Brief (.pdf)

  • Managed Care For Low-Income Populations with Special Needs: The Tennessee Experience

    Report

    This paper provides a targeted review of Tennessee's experience providing health care to individuals with special needs under TennCare, its Medicaid managed care initiative. The first part reviews the experience of TennCare Partners, the behavioral health carve-out program created in 1996. The second part reviews how TennCare's structure affects the disabled and chronically ill.

  • Responding to the Threat of Bioterrorism:  Is California’s Public Health System Ready? — Issue Brief

    Issue Brief

    Responding to the Threat of Bioterrorism: Is California's Public Health System Ready? -- Issue Brief A 4-page issue brief which looks at the threat of bioterrorism and the public health system s role in responding to such an attack. The issue brief also addresses what can be done nationally and in California to prepare for a possible bioterrorist attack. The brief lists the panel for a California Health Policy Roundtable to be held in Sacramento,…

  • Urban Indian Health

    Report

    More than half (57%) of the 2.5 million people who identify themselves solely as American Indian and Alaska Native in the 2000 Census live in metropolitan areas. This issue brief describes the large and growing urban Indian population, their health status, and the major federal health programs and federal-state programs that are available to improve Native Americans' access to needed health services. Report Introductory Letter  

  • Health Centers: An Overview and Analysis of Their Experiences With Private Health Insurance

    Report

    This policy brief provides an overview of health centers, with a special focus on the relationship between health centers and private health insurance. The analysis of 10 years of national data reveals that health centers do not receive adequate reimbursement from private insurers to cover the costs of treating commercially insured patients. The cumulative shortfalls jeopardize the ability of health centers to fulfill their mission of providing access to care for low-income patients. Issue Brief…

  • Medicaid, SCHIP and Economic Downturn: Policy Challenges and Policy Responses

    Report

    Medicaid, SCHIP and Economic Downturn: Policy Challenges and Policy Responses A new analysis conducted for the Kaiser Family Foundation's Commission on Medicaid and the Uninsured examines the implications of a downturn for health coverage and state programs and projects the impact of one percentage point rise in the national unemployment rate on Medicaid and SCHIP and the number of uninsured individuals. The analysis also documents how federal fiscal relief during the last economic downturn of…

  • Employer-Sponsored Health Insurance in California: Current Trends, Future Outlook, and Coverage Expansions — Issue Brief

    Issue Brief

    A 4-page issue brief that looks at trends in employer-sponsored health insurance coverage in California. The brief also includes public and private sector strategies for expanding employment-based coverage, and discusses how other states have implemented incremental coverage expansions using public programs and financial incentives, with emphasis on New York State. The brief lists the panel for a California Health Policy Roundtable held in Sacramento, California on May 4, 2001. Issue Brief

  • Covering the Low-Income Uninsured: Assessing the Alternatives

    Report

    This issue brief describes and analyzes expansions of Medicaid and SCHIP, tax credits for individually-purchased insurance, and tax credits for employment-based health insurance as options to expand health coverage of the low-income population. Issue Paper