How Many Americans Are Uninsured? Health Insurance Statistics

As of the first quarter of 2024, more than 27 million Americans remain without health insurance. This reverses the trend of record-low uninsured rates that followed the COVID-19 pandemic, meaning more people are now uninsured than before.

Although many view health insurance as an extra expense, being uninsured can cost more in the long run, especially during medical emergencies. Without insurance, Americans miss out on easier access to preventive care, prescriptions and the peace of mind that comes with financial protection.

According to the National Health Interview Survey (NHIS), 8% of Americans (around 27 million people) did not have health insurance as of the first quarter of 2024. This rate is higher than in the first quarter of 2023, which was a record low. It also exceeds the annual 2023 data from the American Community Survey (ACS), which showed a rate of 26.1 million people uninsured.

At its peak, the number of uninsured Americans reached 47.2 million in 2010. The number has fluctuated since 2008, with increases often linked to economic recessions. The introduction of the Affordable Care Act (ACA) in 2010 led to a significant decrease in the number of uninsured Americans, particularly after the 2014 expansion, which made affordable health plans more accessible through the marketplace. Medicaid was also expanded in many states to include more families with low incomes.

The rate of uninsured Americans continued to decline until 2016 when 20 million more people had health coverage than before the ACA was implemented. By 2019, however, the number of uninsured Americans had risen to 28.9 million, with some Center on Budget and Policy Priorities linking this increase to policies enacted by the administration at the time.

Source: American Community Survey (ACS), National Center for Health Statistics

Texas has the highest rate of uninsured at 16%, while Massachusetts has the lowest at under 3%. Other states where the percentage of the population without health insurance is under 5% include:

• District of Columbia
• Hawaii
• Vermont
• Minnesota

The variation in uninsured rates across states can be partly attributed to differences in Medicaid expansion under the Affordable Care Act (ACA). States with expanded Medicaid, like Massachusetts and Hawaii, generally have lower uninsured rates.

Among the seven states that have not expanded Medicaid, four — Texas, Georgia, Oklahoma and Wyoming — report higher than 10% uninsured rates. The exceptions are South Carolina (9%), Kansas (8%) and Wisconsin (5%).

Source: U.S. Census Bureau

In 2023, young adults (aged 19 to 25) had the highest uninsured rate at 14%, whereas seniors (65 and older) had the lowest rate at just under 1%. These differences are likely due to differences in access to public health insurance programs.

Uninsured rates peak among young adults due to transitions in eligibility. CHIP coverage ends at 19, and many lose access to their parent's health insurance when they turn 26. Meanwhile, most adults aged 65 and older are covered by Medicare. Working-age adults don't have the same access to these public programs.

For health coverage, individuals in these age groups have three main options: employer-sponsored plans, purchasing a plan through the Health Insurance Marketplace or, for those eligible, TRICARE.

Source: Current Population Survey (CPS)

In 2023, the uninsured rate for males was 9% (14.7 million) and for females 7% (11.7 million). The trend of more men than women being without health insurance has been consistent for the past several years.

Men are more likely to be uninsured than women, partly due to the higher enrollment of women in Medicaid. Women are more likely to qualify for Medicaid under categories such as pregnancy and being the parent of children under 18. On average, women also tend to have lower incomes than men, making them more eligible for Medicaid coverage.

Source: Current Population Survey (CPS)

In the first quarter of 2024, Hispanic Americans had the highest uninsured rates at 26%. The second-highest group was people of other or multiple races, with 19% uninsured. On the other end of the spectrum, white non-Hispanic individuals had an uninsured rate of 8%, and Asian non-Hispanic individuals had the lowest rate at 5%.

The uninsured rate for Hispanic Americans remained the highest throughout 2023, peaking at 27% in the third quarter before dropping slightly to 25% by the end of the year. For people of other or multiple races, the uninsured rate ranged between 15% and 17%.

In comparison, white non-Hispanic and Asian non-Hispanic groups had much lower uninsured rates that stayed fairly steady, with small changes throughout the year.

Source: National Center for Health Statistics

The major reason Americans remain uninsured is affordability. For many, the cost of health insurance is simply too high, especially for those in poor health or between the ages of 50 and 64, who often face higher premiums. Beyond affordability, other reasons include ineligibility, confusion around the enrollment process, a belief that health insurance isn't necessary and the challenge of finding plans that match specific health care needs.

MoneyGeek answered the most commonly asked questions about health insurance access to provide more information.

MoneyGeek has several guides to help you learn more about getting and managing your health insurance.

• Guide to Health Insurance for Students and Young Adults: Statistics show that around 14% of those between the ages of 19 and 25 don't have health insurance. It's never too early to have coverage — this page explains why.
• Buying Health Insurance for the First Time: Most Americans are covered by their parent's health plan until age 26. Find out what you can do to ensure you continue having coverage after your 26th birthday.
• Where to Find Low-Cost Health Insurance: Cost is the number one reason people remain uninsured. MoneyGeek shows you how to search for more affordable health plans.
• How to Get the Most Out of Your Employer Medical Plan: Be thankful if your employer includes medical coverage in its benefits package — not all companies do. Here are some techniques to ensure you maximize this perk.
• Best Health Insurance Options for the Unemployed: Almost half the insured have access to coverage because of an employer-sponsored plan. What do you do when you lose your job? MoneyGeek provides some answers.
• Best Health Insurance Companies: There's no lack of health insurance companies, but which is best for you? MoneyGeek evaluated multiple providers to help you determine the best option for you.
• Shop for Health Insurance Quotes: Comparing estimates from several health insurance companies is always a wise choice. MoneyGeek's health insurance buying guide can help you get the best deal available.