How Many Americans Have No Insurance? (2026 Data)

The uninsured rate in America is at a historic low, and that sentence is doing a lot of work. Eight percent of a country of 335 million people is about 26 million human beings with no coverage at all, in a system where an ambulance ride costs more than a week's wages and a night in intensive care costs more than a car. No other wealthy nation reports a comparable number, because no other wealthy nation allows it.

Here is where the number came from, who is in it, why it stopped falling, and what is scheduled to push it back up.

What is the uninsured rate in America right now?

Roughly 26 to 27 million, or about 8% of the population, per the Census Bureau's 2023 and 2024 surveys.

Those figures count people uninsured at the time of the survey. Count anyone who went without coverage for any part of the year and the number roughly doubles, because coverage in the United States is tied to jobs, and jobs end. Someone who lost employer coverage in March and picked up a marketplace plan in June is insured on survey day and was uninsured for three months.

Source: U.S. Census Bureau, Current Population Survey and American Community Survey. Figures rounded; the two surveys differ by a few tenths of a point.

The drop from 16% to 8% is the Affordable Care Act. Medicaid expansion covered adults up to 138% of the poverty line in states that took it, and subsidized marketplace plans covered people above that. The rate has been stuck near 8% since 2016 because the remaining uninsured are the people those two programs were designed around, not for.

Who are the uninsured?

Working adults, in the South, earning too much for Medicaid and too little to buy a plan.

KFF's profile of the uninsured under 65 is consistent year to year. The large majority live in a family with at least one worker, and most of those have a full-time worker. Most are adults between 19 and 64, since children have broad access to Medicaid and CHIP and seniors have Medicare. Compared with the insured, they are more likely to be low income, Hispanic, and living in the South and Southwest.

Asked why, most uninsured adults give the same answer: coverage costs too much. The average employer family premium passed $25,000 a year in 2024 per KFF, with the worker's share above $6,000, and a worker at a small business that offers no plan faces marketplace premiums that can top $500 a month for one person before subsidies. Subsidies shrink as income rises, and the person earning $55,000 in a high-cost city who does not qualify for much help is a common face of the uninsured.

Then there is the coverage gap. In the ten states that had not expanded Medicaid as of 2024, an adult without children who earns $10,000 a year is too poor for marketplace subsidies, which begin at the poverty line, and ineligible for Medicaid, which in those states covers almost no childless adults. KFF puts the number of people in that gap at well over a million, most of them in Texas, Florida, and Georgia.

Which states have the highest uninsured rates?

The ones that declined Medicaid expansion, with Texas at the top.

Texas alone accounts for roughly one in five uninsured Americans. Its rate is about double the national figure and more than five times the rate in Massachusetts, which passed a state-level coverage law in 2006 that became the model for the ACA. The two states have similar economies in the sense that both have plenty of jobs. The difference is that one state decided coverage was a public responsibility and the other decided it was the worker's problem.

Why did the uninsured rate stop falling?

Because the remaining 26 million are uninsured for reasons the ACA did not address, and because the policies that pushed the rate down are being reversed.

During the pandemic, Congress barred states from dropping anyone from Medicaid, and enrollment climbed past 90 million. When that protection ended in 2023, states began the "unwinding," re-checking eligibility for every enrollee. KFF's tracker counted roughly 25 million people disenrolled by the time most states finished in 2024, a majority of them for paperwork reasons, meaning the state could not reach them or they missed a deadline, rather than because they earned too much. Many re-enrolled or found other coverage. Many did not.

Two more changes are scheduled to push the number up. The enhanced marketplace subsidies enacted in 2021, which cut premiums for millions of middle-income buyers, lapsed at the end of 2025; the Congressional Budget Office projected several million more uninsured over the decade without them. And the 2025 federal budget law added Medicaid work-reporting requirements, more frequent eligibility checks, and tighter marketplace enrollment rules; CBO estimated those provisions would leave about 10 million more people uninsured by 2034.

Set the arithmetic against the record low and the trend is clear. The 8% floor was reached with the help of temporary measures. The permanent structure is set to move the rate back toward 10% or higher over the next several years, which would be the first sustained increase in uninsurance since the ACA took effect.

What does being uninsured cost?

Your health first, then your savings.

Uninsured adults are far more likely to skip care because of cost, to go without a regular doctor, and to be diagnosed with cancer and other serious conditions at later stages. When they do get care, they pay list price, the chargemaster rate that insurers negotiate down and individuals cannot. A single emergency room visit at list price can exceed $1,000 before any treatment, and an admission can run into five figures. That is the pipeline from uninsurance into medical debt: uninsured adults report health care debt at the highest rate of any group in KFF's surveys.

The rest of the country pays too. Hospitals shift uncompensated care into the prices they charge insurers, and public programs absorb the cost of conditions that were cheaper to treat early. Every peer nation that covers everyone spends less per person on health care than the United States does while covering 8% of its people not at all.

Eight percent is a decision, not a floor

Every other wealthy democracy answers the question in this article's title with a number close to zero. The United States answers it with 26 million, a figure that counts as a success only against its own history. Those 26 million are not idle, and they are not careless. Most of them work, most of them work full time, and most of them are uninsured because the plan their job did not offer costs more than a living wage leaves room for.

That is the affordability crisis in one number. Wages that stalled while premiums quadrupled; a federal minimum wage stuck at $7.25 since 2009 while family coverage passed $25,000 a year; and a coverage system that treats the gap between the two as the worker's problem. What happens to the people who fall through is in medical debt in America and in what that debt does to your mental health, and the hospital charity care that is supposed to catch them reaches a fraction. The full accounting of what stopped adding up is in the American dream is broken.