Uninsured Americans: Key Statistics & Facts

Written By
Julija A.
July 07,2023

In the US, healthcare is non-universal and extremely expensive. In fact, thousands of uninsured Americans go into debt every year to cover necessary medical expenses.

While the situation has improved somewhat with health care programs and assistance implemented by the federal government, one-tenth of America’s population still doesn’t have access to affordable health insurance. Keep reading to learn more about what challenges emerge without appropriate health coverage.

Key Uninsured Population Statistics for 2024 - Editor’s Choice

  1. 9.6% of Americans don’t have health insurance.
  2. Before the Affordable Care Act, one in six working adults didn’t have health insurance.
  3. Medicaid is used by more than 76 million people.
  4. 15.4% of adults younger than 26 have no health insurance. 
  5. 31.4% of Hispanic adults under 65 are uninsured, making them the least insured group in the US.

Uninsured Health Care Stats & Facts

Health coverage is not only about being prepared for the worst, but also about taking advantage of preventative care. However, millions of Americans are uninsured, have gone into debt to cover medical bills, and are at risk of getting into more debt over time.

The overall rate of uninsured US citizens has been steady for a few years, but stayed high at around 10%. The uninsured rate is significantly higher in Hispanic and Black populations, residents of states that have not expanded Medicaid coverage, and people below the poverty line.

9.6% of US residents, or 31.1 million people, didn’t have health insurance in the first six months of 2021.


According to preliminary estimates from the National Health Interview Survey released by the Centers for Disease Control and Prevention, one-tenth of America’s people are still going without insurance.

Among adults under the age of 65, Hispanic adults (31.4%) were more likely than Black (14.7%), white (9.0%), and Asian (6.1%) adults to be uninsured.


Specific groups of people are more likely to be uninsured, and these numbers showcase the intersection of a socioeconomic and racial divide. In the first half of 2021, almost a third of the Hispanic population in the US didn’t have health insurance. The second least likely group to have coverage was Black people.

Workers in the farming, fishing, and forestry sector have the biggest gap in insurance coverage, with 19.4% of employees going without.


Your likelihood of having insurance coverage depends not only on your race and gender, but also your industry and what type of work you do. People employed in food preparation and serving are almost as likely to be uninsured as the least-insured group, as nearly one-fifth of them (19.3%) have no health coverage.

Reasons for Being Uninsured

Health insurance is getting to be even more expensive for a percentage of uninsured Americans. Looking back, from 2006 to 2016, total premiums for family coverage increased by 58%, and the worker’s share has increased by 78%, outpacing wage growth. This harsh reality makes healthcare unaffordable for many families.

You may be wondering how many Americans are uninsured to this day and the reasons behind this trend. One of the critical issues is that many employers don’t offer health coverage, and for many workers, it isn’t affordable even if you have a job.

Also, many lower-income adults in the US remain ineligible for financial assistance for coverage. 

While the most common reason for being uninsured in America was and continues to be the cost, some other factors come into play. For instance, some people aren’t eligible, don’t want the coverage, or find the process of signing up too difficult. Another reason there are uninsured Americans is that there aren’t plans that meet their needs.

Most uninsured people are members of low-income families and have at least one worker in the family.


Around 73% of families without insurance in 2020 had at least one full-time worker in their family. Research suggests that gaining health coverage improves care affordability and financial security among the low-income population. Those employed full-time are more likely to get coverage, but this is by no means a guarantee, as the data shows.

One in five uninsured adults in 2015 went without essential medical care because of the cost.

(Sanders Institute)

The primary reason people without coverage fail to seek out necessary medical attention is due to the cost. The potential medical bills are too expensive for the uninsured population to handle.

8.6% of all US citizens didn’t have insurance coverage for any part of 2020.

(US Census Bureau)

While this number seems low, it represents over 29 million people, during the first year of a pandemic. Getting more of the population covered remains an uphill battle.

What It All Means

Being one of the American citizens who are uninsured means you have to pay out of pocket for any medical services, however necessary or life-saving they may be. If you don’t have access to healthcare coverage or choose not to get it, you’re also much less likely to seek the medical care you need. You simply have worse care overall than people with health insurance.

Being insured keeps you safe from unexpected expenses, protects the money you’re saving for your future, gives you peace of mind, and, most importantly, helps preserve your physical and emotional health.

Since uninsured people often have little to no savings, they can’t pay medical bills, meaning they have to choose between staying healthy and going into medical debt.

As a matter of fact, a total of 79 million Americans have medical debt problems, which is a staggering percentage of the overall population, and includes many people who do have health insurance under the current system. Another harsh reality of being uninsured is that you’re more likely to die sooner.

9.3% of children under the age of 19 and living in poverty were uninsured in 2020.

(US Census Bureau)

Any barrier to having health insurance coverage reflects on a population’s youngest, especially for the most vulnerable members of society. As a result, the uninsured rate among children below the poverty line increased by 1.6% from 2018 to 2020.

In 2020, 15.4% of young adults under 26 went without health insurance.


Young adults lack health coverage for various reasons, most of them stemming from the costs, which puts their health and quality of life at risk. With the introduction of ACA, young adults can be covered with their parents’ insurance, but it doesn’t help those without parents or those whose parents are uninsured.

Adults are at a higher risk of being uninsured than children and the elderly.


Children and the elderly are prioritized in healthcare coverage, which is good. However, adults between 18 and 64 also require affordable access to medical attention and preventative services, which they are the least likely to get.

Health Insurance in America

The fact that the US doesn’t have universal healthcare means that there are still around 30 million people without coverage. Since the cost of medical attention in the US is so high (and rising), it has kept many from getting the care they need.

Chronic illnesses add significantly to US healthcare costs, particularly during end-of-life care. The average price to see a doctor in the US ranges from $200 to $300, which means people need to spend a massive amount of money on basic healthcare. It’s even worse for those who are uninsured and need to seek medical help or attention.

With the Medicare and Medicaid expansion in 2014, the uninsured population began to decrease substantially, but has seen an uptick in the past few years. Of course, noncitizens are considerably more likely than citizens to lack insurance coverage.

Another factor that has impacted health insurance and coverage is COVID-19. About 56% of the population gets their health insurance from their employer. The pandemic has caused an increase in unemployment, which in many cases has led to a loss of health insurance coverage.

On the whole, the number of nonelderly uninsured individuals is higher now than it was back in 2016. The highest proportion of those lacking insurance is young adults, racial and ethnic minorities, and low-income populations.

More than 75 million people are currently using the expanded Medicaid program to cover medical expenses.


Medicaid helped lower the US uninsured rate, especially among low-income people, so now many more patients have the costs of most medical procedures covered compared to 10 years ago. If they don’t qualify for Medicaid under ACA, the uninsured adults’ best bet is getting insured through employers who provide coverage through health insurance companies.

Prior to the launch of the Affordable Care Act (ACA, often referred to as Obamacare), more than 50 million people had no health insurance.


ACA rollout helped reduce the number of uninsured Americans. Before former President Barack Obama signed the act into law, one out of every six people in the US had no form of health coverage.

The US has the highest uninsured rate among developed countries, yet spends the most on healthcare per capita, at $10,586.

(World Population Review, Statista)

Despite spending 17% of its GDP on healthcare, the US remains one of the worst developed countries regarding medical insurance coverage and cost. Other big spenders include Germany, Switzerland, France, and Japan, which spend between 11% and 11.7% of their GDP on healthcare, but have universal coverage.

The Cost of Not Having Insurance

Although there are no federal mandates or penalties for uninsured Americans currently, there are risks that come from missing out on being insured. The primary risk stems from the steep costs of getting care: Paying out of pocket for services is expensive, and most people increase their debt significantly when they seek medical attention.

Furthermore, hospitals often charge uninsured patients much higher rates than private health insurers and public programs.

Not being insured directly impacts your quality of life and finances. The worst-case scenarios (i.e., the costliest) are hospitalizations and medical emergencies. Even once you factor in the monthly premiums, health insurance coverage drastically reduces spending for the average person.

46% of adults find dental care the most challenging healthcare expense to cover.


Besides dental, hearing aids, and eyeglasses are the next largest expenditure, with 33% of people finding it difficult to cover that out-of-pocket, on par with mortgage payments.

15% of Americans have cut spending for essential household items to pay for necessary medical expenses.


The data also shows that more than 15% of Americans owe more than $10,000, of whom 33% still have a student loan to pay off. In 2019, 9% of people increased their credit card debt to pay for medical services, which may force them to use credit card debt consolidation in the future, saddling them with yet another loan to pay off. 

Looking to the Future

The state of health care coverage was affected by the pandemic and the confusion and job losses that came with it - yet another reason for the increase in the number of uninsured Americans in the past few years. Around 6% of working-age adults lost their employer health coverage because of pandemic-related job loss. The pandemic has also caused problems paying medical bills and higher debt rates.

On top of this, many people have seen their income fall during the pandemic, which is hard when health care costs continue to rise. Over the past year, Black respondents and lower-income respondents have reported medical bills and debt problems at the highest rates.

Some solutions to consider may be to insure more people and make insurance more comprehensive. Some ideas include having an auto-enrollment mechanism in place, so people are more likely to keep coverage, and rein in deductibles and out-of-pocket costs in plans, so there aren’t as many high costs even when insured. 

Generally speaking, young adults are the most likely to go without coverage. While it may be because it’s expensive, they may also think they don’t need it because they’re young. It’s less likely a young adult will be uninsured if they’re married and raising kids. Additional factors to consider are socioeconomic status and participation in the workforce.

When premiums rise, healthier people tend to drop out, which shrinks the insurance pool and leaves an insured population that is more ill and costs more to take care of, which drives premiums up even higher.


What percentage of US citizens were uninsured in 2021?


An estimated 9.6% of US residents, or 31.1 million people, lacked health insurance when surveyed in the first six months of 2021.

How many Americans have medical debt?


Half of Americans now carry medical debt, up from 46% in 2020.

Why are some US citizens without health insurance?


A number of factors come into play to explain this lack of coverage, including rising health care costs, the economic downturn, erosion of employer-based insurance, and public program cutbacks.

Why is healthcare in America a problem?


Due to the high cost of healthcare, access is complicated for many people. It’s not universal, so the cost of getting medical attention is practically unaffordable for uninsured people. This is compounded by the fact that populations underprivileged in terms of race and socioeconomic status are more likely to be uninsured.

Is there still a penalty for being uninsured?


The previous tax penalty was eliminated after the end of 2018, under the Tax Cuts and Jobs Act of 2017. While the individual mandate itself is still in effect, there’s no longer a penalty for not enforcing it.

How many Americans were uninsured before the Affordable Care Act?


Prior to 2010, when ACA was initially introduced, estimates show that nearly 50 million Americans had no health insurance.

Which particular state has the highest rate of uninsured people?


A 2019 report shows that the state of Texas has the highest rate of uninsured Americans, at 18.4%.

How has the pandemic impacted insurance?


The significant hike in firings caused by the pandemic has also caused many people to lose employment-guaranteed health insurance. As a result, the lack of health coverage created obstacles for people who needed care and led to worse health outcomes for those affected by the virus, as well as those with conditions unrelated to COVID who still couldn’t get access to medical attention due to lack of insurance.


About author

Albert Einstein is said to have identified compound interest as mankind’s greatest invention. That story’s probably apocryphal, but it conveys a deep truth about the power of fiscal policy to change the world along with our daily lives. Civilization became possible only when Sumerians of the Bronze Age invented money. Today, economic issues influence every aspect of daily life. My job at Fortunly is an opportunity to analyze government policies and banking practices, sharing the results of my research in articles that can help you make better, smarter decisions for yourself and your family.

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