How Many Americans Are Uninsured? Health Insurance Statistics

Over 27 million Americans were uninsured in early 2024. Texas had the highest state rate at 16% uninsured, while young adults, men and Hispanic Americans had the highest uninsured rates in their respective groups.

By Nathan Paulus

Edited by Casie McCoskey

Updated: November 21, 2024

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A man looks frustrated while reading a document, possibly a bill or financial statement, suggesting a situation where he is dealing with unexpected expenses.

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.

Key Takeaways

Roughly 27 million Americans of all ages were without health insurance in Q1 2024.

Uninsured rates vary by state. Massachusetts has the lowest rate (under 3%), while Texas has the highest (16%).

Working-age adults (ages 19 to 64) are more likely to be uninsured than those under 18 or over 65.

Hispanic Americans are the least likely ethnic demographic to have health insurance, making up 26% of those who don't have coverage.

People have different reasons for not having health insurance, but the most common obstacle is affordability.

Americans Without Health Insurance Total

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

Uninsured Rates by State

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

Uninsured Rates by Age

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)

Uninsured Rates by Gender

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)

Uninsured Rates by Race and Ethnicity

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

Reasons Why Americans May Not Have Health Coverage

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.

Reasons for Being Uninsured	Description
Unaffordable	According to the Kaiser Family Foundation (KFF), in 2022, 64% of uninsured nonelderly adults reported that high costs prevented them from obtaining health coverage. Those who aren't in good health may need to pay higher premiums than those in better health conditions. The same applies to older potential buyers — typically between 50 and 64. If you come from a low-income household but don't qualify for Medicaid, your only option is to go with a private provider.
Ineligibility	Ineligibility can come in different forms. Some individuals work for employers who do not offer health insurance as part of their benefits package. For those that do, the cost deters them from enrolling.
Does not need/want	Being young and in good health may sometimes lead people to believe that they don't need health insurance yet. They are usually the ones in good, very good or excellent health.
Confusing red tape	Enrolling in a health insurance plan may be confusing, especially for first-time buyers. You'll run into several unfamiliar terms, such as copays and co-insurance. It may leave people overwhelmed, discouraging them from signing up.
Plans do not match health care needs	Some people aren't clear about their health care objectives, which makes it challenging to find a plan that matches their needs. It often leaves them with the impression that those available aren't suited to their specific circumstances and preferences.

Americans Without Health Coverage: FAQ

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

What happens if you can't afford health care in America?

Having no health insurance means paying for all medical costs out of pocket. A health emergency might cost you thousands of dollars, which can considerably impact your credit score. At worst, it can lead to bankruptcy.

How does having health insurance affect people's access to health care?

The uninsured are less likely to catch potentially damaging health conditions early. Since they don't maximize preventive care services like screenings and labs, their health is usually in worse shape by the time doctors make a diagnosis. If they can't afford treatment, they'll delay it until their finances improve. Worst-case scenario, they won't get treated at all. All these factors lead to more negative health outcomes.

What are the most common reasons for being ineligible for health insurance?

Many Americans are uninsured because their employers do not offer health benefits or the available plans are too costly. Additionally, people in non-Medicaid expansion states have more limited access to affordable coverage options.