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How Many Uninsured Are in the Coverage Gap?

This analysis estimates that 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 tax credits that would make coverage ACA's Marketplaces affordable to them.

Key Facts about the Uninsured Population

The number of people ages 0-64 who were uninsured held steady at 25.3 million in 2023, although the number of uninsured children rose from 3.8 million to 4.0 million. Most uninsured people are in low-income families and have at least one worker in the family.

How the Unwinding Affected Enrollees

Over half who were disenrolled say they put off needed medical care while trying to renew Medicaid. Overall, 19% of adults who had Medicaid prior to the start of unwinding say they were disenrolled at some point in the past year. Of this group, a large majority (70%) were left at least temporarily uninsured.

The uninsured: How costs affect care and health, 2023

Latest Polling
8%

Percent of adults who reported not having health insurance
55%

Percent of uninsured adults who reported delaying or forgoing some form of health care due to cost
19%

Percent of uninsured adults who report that they or a family member had difficulty paying medical bills
38%

Percent of uninsured adults who reported not having a usual source of care (vs. 8% of insured adults)
Peterson-KFF Health System Tracker

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  • The Kaiser Project on Incremental Health Reform

    Other Post

    In November 1996, the Kaiser Family Foundation initiated a project to examine different strategies for expanding health insurance coverage to America's growing uninsured population.

  • The Difference Different Approaches Make: Comparing Proposals to Expand Health Insurance

    Report

    The Difference Different Approaches Make: Comparing Proposals to Expand Health Insurance This paper estimates and compares the impacts of alternative mechanisms for expanding health insurance coverage. A variety of approaches-expansions of existing public programs, direct subsidies, and tax credits-and target populations-including children, poor adults, parents of Medicaid- or CHIP-covered children, and early retirees-are considered.

  • Extending Health Insurance Through Tax Credits

    Report

    Part of the Kaiser Incremental Health Reform Project, this paper describes a generous tax credit approach to the expansion of health insurance coverage. The design features of refundable, publicly-financed tax credits for the purchase of health insurance are described for a range of sample plans.

  • An Assessment of Strategies for Expanding Health Insurance Coverage

    Report

    This paper provides a conceptual analysis of alternative mechanisms (tax credits, public programs, and direct subsidies) for expanding health insurance coverage. The paper, which is part of the Kaiser Incremental Health Reform Project, discusses the likely impacts alternative approaches on a variety of outcomes including efficiency in increasing coverage and integration with existing insurance systems.

  • Expanding Health Insurance Through Tax Reform

    Report

    This paper discusses the impacts of the Heritage Foundation proposal for expanding health insurance coverage. Under the proposed tax reform, the employer tax exclusion and all other deductions for health-related expenses would be repealed. A new refundable tax credit would be created for unreimbursed medical expenses.

  • Expansions in Public Health Insurance and Crowd-Out: What the Evidence Says

    Report

    Enactment of the Children's Health Insurance Program has been accompanied by concerns that new coverage will "crowd out" private health insurance coverage. Part of the Kaiser Incremental Health Reform Project, this paper reviews existing empirical literature on the magnitude of crowd-out and discusses implications for CHIP.