Percentage of uninsured Americans 2024
In a 2021 Commonwealth Fund study that assessed health care system performance among 11 high-income countries, the U.S. ranked last in all but one of the five factors considered, including access to care, health care outcomes and equity. And with a larger population than the other 10 countries combined, the U.S.’s low ranking impacts many people.
As the only high-income country without universal health insurance, the U.S. is home to many uninsured people, with nearly 10% of its population lacking health care coverage. While that number has decreased dramatically since 2010, disparities in health insurance coverage are still observed across demographics such as race, age and education level.
Nearly 28.6 million Americans, or 8.5% of the U.S. population, are uninsured.
Jump to insightThe percentage of uninsured Americans has increased from its all-time low of 7.7% in 2023.
Jump to insightThe U.S. population is projected to grow by about 4.5% from 2024 to 2031. The number of Americans without health insurance, however, is expected to grow by about 16.3% during that period.
Jump to insightAbout 62% of people in the U.S. receive coverage through private health insurance.
Jump to insightThe U.S. uninsured rate is not the same for all demographic groups, varying by factors such as age and race.
Jump to insightGeneral health insurance statistics
Private health insurance plans — such as those provided by employers, purchased via government health insurance marketplaces or bought directly from insurance companies — are the most popular forms of medical coverage in the U.S.
But despite multiple pathways to medical coverage, tens of millions of Americans remain uninsured. And from 2024 to 2031, the number of uninsured Americans is projected to increase at nearly four times the rate of the regular population increase.
Uninsured rate
The uninsured rate, which refers to the percentage of people with no health insurance, is currently 8.5% in the U.S. While this is lower than the 9.6% rate in 2019, prior to the outbreak of the COVID-19 pandemic, it’s 0.6 percentage points higher than in 2023 and 0.4 percentage points higher than in 2022. This troubling trend is expected to continue in the near future, as the uninsured rate is projected to increase to 9.5% by 2031.
Number of uninsured Americans over time
In 2010, the Affordable Care Act (ACA) was enacted, which expanded Medicaid, created insurance marketplaces run by federal and state governments and implemented an individual mandate that established a financial penalty for uninsured Americans. The ACA drove down the uninsured rate, with the effects becoming observable in 2013.
Between 2013 and 2016, the number of uninsured Americans dropped precipitously, from 44.8 million to 28.6 million. In 2017, the Tax Cuts and Jobs Act repealed the individual mandate, which caused the number of uninsured Americans to rise.
A number of factors contributed to the drop in the uninsured rate from 2019 to 2023, when the rate hit an all-time low of 7.7%. One of the main factors that contributed to this rate decrease was increased plan enrollment via health insurance marketplaces, attributed to the expansion of eligibility for premium subsidies through the American Rescue Plan Act of 2021. Requirements mandated in the Families First Coronavirus Response Act of 2020 spurred Medicaid enrollment for a few years, which also contributed to the declining uninsured rate.
But the growth trend in Medicaid enrollment was brief. The Families First Coronavirus Response Act’s continuous coverage protection was terminated in 2023, and states subsequently began to disenroll those who were no longer eligible for Medicaid. One study estimates that Medicaid enrollment will drop from its peak of 90.4 million in 2022 to 81.1 million in 2025.
Who is most likely to be uninsured?
The uninsured rate varies across different populations in the U.S., with differences observed between races, ages and education levels, among other demographic factors.
A 2022 survey found that 10.1% of Americans ages 64 and younger — i.e., those who are generally ineligible for Medicare — did not have health insurance. But Hispanic survey participants were more than twice as likely to be uninsured as the average survey participant. White survey participants, meanwhile, were far more likely to be insured than the average.
As of 2021, Americans who are either 65 years of age and older or below the age of 19 were the most likely age groups to have health insurance. Members of those age groups are eligible for certain health insurance programs, like Medicare, Medicaid and the Children's Health Insurance Program. Those aged 65 and older had an uninsured rate of 0.8% that year, which was far lower than the 5.4% rate for those below the age of 19 and the 12.2% rate for those ages 19 through 64.
The effects of age on uninsured rates were not constant across racial and ethnic groups. In 2021, among people in the U.S. identifying as American Indian or Alaska Native and not identifying as Hispanic or Latino, uninsured rates ranged from 1.7% for those aged 65 and older to an alarming 24.8% for those between the ages of 19 and 64. By comparison, for those identifying as Asian and not Hispanic or Latino, uninsured rates ranged from 2.3% to 7.2%, depending on their age.
Differences in uninsured rates also exist across levels of educational attainment, with higher levels of education corresponding to lower uninsured rates. In 2021, the uninsured rate for Americans ages 25 to 64 who had not completed high school was 30.4%, while the uninsured rate for those in that age range who had at least a bachelor's degree was only 4.7%. These differences varied by race and ethnicity. For Americans in that age range with at least a bachelor’s degree who identified as American Indian or Alaska Native and not Hispanic or Latino, the uninsured rate was 12.5%. Meanwhile, non-Hispanic white adults who fit that same age and educational profile had an uninsured rate of only 3.5%.
The future of health insurance in the U.S.
America’s senior population is growing, and Americans over the age of 65 are expected to make up nearly 21% of the U.S. population by 2030. But although a large share of the population will soon age into Medicare eligibility, the percentage of uninsured Americans is nonetheless expected to increase in the coming years.
That said, as evidenced by the legislative changes in both 2010 and 2017, the landscape of health insurance in the U.S. is unpredictable. Further policy adjustments may yet be made to reverse the trend and broaden access to health care.
FAQ
How many Americans are uninsured?
An estimated 28.6 million people in the U.S., or about 8.5% of the population, do not have health insurance.
What impact did the COVID-19 pandemic have on the U.S. uninsured rate?
The Families First Coronavirus Response Act of 2020 helped to temporarily increase Medicaid enrollment, which initially lowered the percentage of Americans who did not have health insurance. But the Act’s continuous coverage protection was terminated a few years later, and the uninsured rate has since grown.
Is the U.S. uninsured rate rising or falling?
The number of people in the U.S. who do not have health insurance has been on the rise since hitting a low in 2023, when the uninsured rate was 7.7%. The uninsured rate is expected to grow from 8.5% to 9.5% between 2024 and 2031.
References
- Sullivan J, Orris A, Lukens G. “Entering Their Second Decade, Affordable Care Act Coverage Expansions Have Helped Millions, Provide the Basis for Further Progress.” Center on Budget and Policy Priorities. Evaluated April 20, 2024.Link Here
- Keehan SP, Fiore JA, Poisal JA, et al. “National Health Expenditure Projections, 2022–31: Growth To Stabilize Once The COVID-19 Public Health Emergency Ends.” Health Affairs. Evaluated April 20, 2024.Link Here
- Spitalnic P. “Certification of Rates of Uninsured.” Department of Health and Human Services. Evaluated April 20, 2024.Link Here
- Centers for Medicare and Medicaid Services. “National Health Expenditure Projections 2022-2031.” Centers for Medicare and Medicaid Services. Evaluated April 20, 2024.Link Here
- Vankar P. “Number of people without health insurance in the United States from 1997 to 2022.” Statista. Evaluated April 20, 2024.Link Here
- Vankar P. “Percentage of people without health insurance in the United States from 2010 to 2022, by ethnicity.” Statista. Evaluated April 20, 2024.Link Here
- Branch B, Conway D. “Health Insurance Coverage by Race and Hispanic Origin: 2021.” U.S. Census Bureau. Evaluated April 20, 2024.Link Here
- Branch B. “Differences in Uninsured Rates by Race and Ethnicity Persist Even Among Those With Higher Educational Attainment.” U.S. Census Bureau. Evaluated April 20, 2024.Link Here
- Schneider EC, Shah A, Doty MM, Tikkanen R, Fields K, Williams RD II. “MIRROR, MIRROR 2021 Reflecting Poorly: Health Care in the U.S. Compared to Other High-Income Countries.” The Commonwealth Fund. Evaluated April 20, 2024.Link Here
- Central Intelligence Agency. “Country Comparisons — Population.” Central Intelligence Agency. Evaluated April 20, 2024.Link Here
- Jindal B. “4 ways to repeal Obamacare.” Fox News. Evaluated April 20, 2024.Link Here
- Department of Health and Human Services. “Category: Medicare and Medicaid.” Department of Health and Human Services. Evaluated April 23, 2024.Link Here
- U.S. Census Bureau. “2023 National Population Projections Tables: Main Series.” U.S. Census Bureau. Evaluated April 23, 2024.Link Here
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