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How Many Americans Are Uninsured (2023)

Last modified: Mar 23, 2023

Many Americans believe that their healthcare system is flawed. Now, seeing how access to healthcare is limited to either insured individuals or those who have large amounts of cash available in case of a medical emergency, they aren’t far from the truth. On the other hand, uninsured Americans often have to go through a great deal of trouble before getting treatment.

It’s no wonder then that so many US citizens choose to postpone seeking medical treatment, whereas others are forced to go deep into medical debt. Therefore, this article is meant to highlight a series of crucial facts concerning the US health insurance industry. Some of the main topics that we will focus on include the number of uninsured Americans, recent trends concerning this number, the main factors which impact the rate of uninsured US citizens, uninsured rates by state, and more. We will also cover the impact of Obamacare over the number of insured individuals and their overall quality of life.

Overall, this article should present an objective view of the industry, outlining its drawbacks, as well as the developments that have positively influenced the American healthcare system.

How Many Americans Were Uninsured in 2020?

A series of highly-relevant statistics concerning the healthcare industry are published every year in November, by the US Census Bureau.

Here are several statistics meant to better explain the situation of Americans that are uninsured:

1. Data from the US Census Bureau indicates that a total of 27.5 million Americans had no health insurance during 2018.

Seeing how no major health policies have been implemented by the Federal Government, statistical predictions indicate that the numbers are likely to be even higher by the time the Census Bureau publishes the stats for 2019 in September next year. Consequently, the US uninsured rate will likely grow.

According to the CBO, the number of American citizens who are uninsured in 2020 is around 31 million. This number is expected to increase significantly due to the changing mindset of the population.     

2.The uninsured rate in the country in 2019 ticked up to 10.9% from 10.4% the previous year. It has been found that health insurance is not owned by around 44 million adults in the US, while 38 million do not have adequate health coverage.

The rate of uninsured US citizens increased from 25.6 million in 2016, to 27.5 million in 2017.

Based on this data, numerous researchers are trying to figure out the main factors which led to this abrupt decrease in insurance rates in the US. We will briefly discuss some of the main factors, later on, to facilitate a better understanding of why so many people are now going without health insurance. This aspect must be discussed, since uninsured individuals are at higher risk of medical complications, alongside debt accumulation.

How Do Uninsured Populations Access Medical Care?

Another reason for the expected rise in those seeking health insurance is the Affordable Care Act that has made it possible for many otherwise uninsured people to obtain Medicaid, and also marketplace coverage. 

Number Of Uninsured Americans  

Considering the number of uninsured Americans, most of those who are uninsured have one person in the family who is a worker. This also includes families that have low income who are mostly uninsured.  

The numbers reflect the fact that public coverage in many states is not easily available. This is where adults are mostly uninsured as compared to children. Further studies have revealed that Black Americans and Hispanics are likely to be uninsured. 

3. In comparison, Canada covers a series of medical treatment plans and exams, whereas additional services oftentimes require individuals to purchase some form of supplementary medical insurance. Out of 37.5 million citizens, most are insured by the government, yet 25 million Canadians have opted for additional insurance.

When considering uninsured health care stats, there is a huge discrepancy compared to the US, where millions of people are having difficulty paying their yearly premiums. Despite the high prices, numerous insurance programs do not even cover all forms of medical exams and treatment plans, thus requiring additional payment from insured citizens.

According to these statistics, we can easily conclude that the health insurance system in the US is currently flawed, and is in need of additional reform to ensure that all people have access to quality healthcare, despite their financial status.

Number of Uninsured Americans in the Last 10 Years

The table below is meant to better describe the evolution of insurance rates in the US. Before getting to it, it is important for us to briefly explain the paradox that the industry is dealing with. Namely, the increase of uninsured rates is quite surprising, judging how the US economy is not dealing with any hardships that would otherwise impact insurance premiums and the uninsured rate per year. However, rates indicate an increase in recent rates for uninsured individuals.

As you can see from the table, the percentage of Americans without insurance has varied quite a lot during the past 10 years. Uninsured rates seem to be at their highest between 2008 and 2013, whereas an abrupt decrease was spotted in 2014, as a result of Obamacare. The rate continued to drop until 2017 when an increase was spotted. The recent increase from 2018 shows that we are indeed seeing a rise in the growth rate in terms of people living without health insurance.

Deaths Due To Lack Of Healthcare

When it comes to deaths due to lack of healthcare, according to The Institute of Medicine (IOM) an average of 18,314 Americans aged between 25 and 64 years die annually due to the lack of health insurance.

Health Care Facts   

The high cost of insurance is the reason for many people today not to buy health insurance despite the creation of the ACA. In fact, around 73% of those who were uninsured in 2019 claimed that it was because of the high cost of health insurance.

Health Insurance For Uninsured  

Individuals with income below 200% of the Federal Poverty Level (FPL) are at the highest risk of being uninsured. Premiums for family insurance had increased by around 55% over the last decade.

Key Facts About The Uninsured Population

The uninsured rate among children was 5.6% in 2019, which is less than half the rate of the non-elderly adults. In 2019, over seven from ten of the uninsured (73%) had at least one full-time worker in their family and an additional 11.5% had a part-time worker in their family.

Healthcare For Uninsured

Non-seniors were more likely to have difficulties paying for health coverage as compared to those who had private insurance coverage.

Lack Of Health Insurance

Medical bills can put great strain on the uninsured and threaten their financial well-being

What Impacts the Rate of Uninsured People in the US?

At the moment, it is widely believed that Government-sponsored policies represent the main factor of influencing health insurance rates both in the US, but also in most of the world’s countries.

4. An overview of the Affordable Care Act, or Obamacare

With this in mind, it’s worth noting that the overall number of uninsured Americans first started improving back in 2011. As such, the most recent and most significant policy change was made in 2010 when President Obama fought to get the Affordable Care Act signed into law. The official version of the act is 906 pages long — hence why we will try to offer a brief overview of the law, outlining its main goals, how it plans to achieve them, while also offering several Obamacare statistics. Before anything else, it is important to keep in mind that Obamacare was incredibly successful in increasing the rates of insured Americans and it has managed to achieve such an impact within only a few years.

5. The main goals of Obamacare

  • Improving the healthcare system throughout the US, to help provide citizens with a more efficient, effective, and overall better healthcare solutions;
  • Positively influencing how many Americans have health insurance;
  • Offering Americans that are not insured access to affordable insurance policy choices;
  • Granting people that dislike their current insurance plan access to other affordable choices with no actual disadvantages when requesting a policy change;
  • Introducing a regulatory framework meant to ensure the fact that both healthcare providers and insurers are transparent and honest about their work;
  • Giving small businesses access to government-sponsored incentives if they choose to offer health insurance plans to their employees. This strategy was also meant to help reduce the percentage of Americans without health insurance;
  • Completely reshaping the way healthcare providers and insurers provide their services, in order to facilitate the development of a more streamlined medical process;
  • Reducing overall spending of the health insurance and healthcare industry.

Relevant statistics concerning Obamacare

6. Reports indicate that in 2016, roughly 1 out of 10 Americans did not have access to health insurance yet, meaning that roughly 91.5% of Americans were enrolled with a health insurance provider. This statistic helps illustrate the success of ACA in reducing the number of Americans without health insurance;

  • A total of 39 million beneficiaries of Obamacare and Medicare were offered free and unrestricted access to several preventive medical services, such as screenings or vaccines;
  • Following the introduction of the Affordable Care Act, a White House report revealed that the price of healthcare services rose at the lowest rate within the last five decades. This stat helps portray that the ACA has indeed made several steps towards fulfilling its goal of stopping price increases in an already-inflated industry. This also indirectly helps those that need healthcare without insurance, since lower prices are always a welcome addition;
  • As outlined above, the ACA introduced several guidelines concerning transparency. Research shows that 170 million were helped to better understand the extent of their health insurance coverage, alongside the benefits that they are entitled to;
  • Research efforts reveal that the introduction of health insurance marketplaces helped 7.8 million Americans purchase health coverage, reducing the number of uninsured Americans;
  • However, the Obamacare policy cannot help each and every individual living on US soil; immigrants without any valid documentation are not eligible to access these programs. In case of a medical emergency, they will likely have to pay for the services out of their own pockets;
  • Policies concerning the quality of healthcare introduced by Obamacare seem to have also reduced the number of infections acquired without a medical facility. Apart from this, the rate of avoidable readmissions has also been reduced as all facilities have to respect a specific set of guidelines. As such, healthcare before Obamacare was of a lower quality according to these statistics. The overall quality of the healthcare system is what matters most, as no person wishes to get the wrong medical treatment or catch a hospital-based infection.
  • Last but not least, it is important for us to briefly discuss Obamacare enrollment numbers. A Reuters report has pointed out that a 4% decrease in enrollment numbers was seen last year. So, how many people have Obamacare? Estimates suggest that 8.5 million people have enrolled in the program in 2019.

Consequently, we can all conclude that healthcare access was quite difficult for Americans with average and below-average wages, and especially for those living below the federal poverty line. Similarly, the sheer number of Americans that were uninsured dropped considerably since the implementation of this act. What’s more, numerous studies show a great difference in terms of the number of uninsured before and after Obamacare.

However, as we will see later on, the new Trump administration does not believe in the benefits offered by Obamacare and is, therefore, doing its best to dismantle the system and return to traditional healthcare regulations.

Understanding Trump’s initiative to abolish the Affordable Care Act, and its overall impact on American health insurance

One of Trump’s first moves as President of the United States was to sign an executive order which instructed officials to do all that’s in their power to waive, delay, and defer the implementation of instructions outlined in the ACA. It is believed that this initiative is a direct reason why the rates of uninsured Americans have increased over the last couple of years.

So far, President Trump has not managed to stop the program in its entirety, yet several changes have already been implemented. These include, but are not limited to:

7. The elimination of the individual mandate

Obamacare necessitates that all US residents must have some form of health insurance — failure to do so would lead to a penalty. The purpose of this policy was to get as few uninsured Americans as possible to help keep insurance premiums low since more people actively contributed to the health insurance fund.

8. Sponsoring a law that would allow states to implement work requirements

The ACA was designed to be all-inclusive for US citizens, yet if approved, this policy change would make it obligatory for residents of certain states to prove that they are an employee, or in school. This makes access less inclusive and theoretically goes against the original ACA uninsured definition.

9. Cost reduction subsidies are no longer given to insurers as a form of incentive for participating in the ACA program

10. The administration also cut funding to several other programs including HealthCare.gov

Likewise, the end plan is a complete rework of the Obamacare program, meant to suit the current interests of the US Government. Regardless, the best solutions can only be analyzed over-time, so the impact of these new policies is not yet known. Nevertheless, when considering how many Americans don’t have health insurance, the numbers are definitely increasing, as we have seen earlier on.

The impact of Trump’s efforts to abolish the ACA

First off, we must point out the fact that a study carried out in 2017 concluded that 49% of US citizens were sure that the abolishment of the Affordable Care Act, would likely lead to losing their health insurance coverage.

The market had to deal with the recent changes pushed by the Trump Administration that introduced several policies meant to limit private insurance policies on the marketplaces created by Obamacare. Similarly, enrollment has now been limited once again to Medicaid. Therefore, Americans now need to respect different criteria to be eligible for enrollment with an insurance provider, thus influencing the uninsured rate. The luckiest individuals, in this case, are those who receive health insurance as part of their employment.

An important aspect worth considering is that any policy change (regardless of whether it is positive or negative), is bound to affect the popularity of the respective policy, judging how most people have a hard time adapting to change. Over the last couple of years, numerous policy changes have been introduced to the US healthcare market, creating unnecessary public confusion and making it more difficult for people to make the right choice.

The Rate of Uninsured Americans by State

The quality of life and access to quality healthcare tend to vary across the US states. The chart below is meant to present the numbers for 2018, in each of the states.

The highest rates for uninsured individuals seem to be in Texas, where the US Census Bureau shows a rate of 20.23% uninsured adults. Texas also features a considerable change in the number of insured individuals between 2010 and 2018, estimated at −6%. Other states have gone through significantly stronger trends; some of the other states with low insurance numbers include Oklahoma, Georgia, Florida, Alaska, Mississippi, Nevada, Idaho, North Carolina, Arizona, and South Carolina, as indicated by the percentage of Americans without health insurance.

On the other side of the spectrum, we have states where insurance rates for adults are considerably higher. The state with the lowest rate of uninsured adults is Massachusetts where studies indicate that only 3.19% of adults remain uninsured. Children are also well covered in this area; only 1.22% of children remain uninsured as of now. Despite the high numbers, Massachusetts has also gone through a small decline in the number of insured Americans, between 2010 and 2018, estimated at −1.65%. Honorary mentions include states well-known for their low rates of uninsured citizens such as Vermont, Hawaii, Rhode Island, Minnesota, Iowa, Connecticut, New York, Michigan, and Wisconsin.

How Many People Are on Obamacare in 2020?

The US government published a report stating that a total of 8.5 million people signed up for the Affordable Care Act in 2018, for the year 2019. This is a decrease when compared to past years, and reasons tend to differ. Some of the main arguments quoted by officials include the fact that more Americans are now employed, thus receive health insurance coverage through their employers. Some of the other reasons include budgetary cuts associated with the promotion of the program, but also the appearance of numerous other insurance options that are deemed as competitive.

Obamacare statistics reveal that the number of insured Americans will continue to drop if the Trump administration refuses to further promote the Affordable Care Act. This is unlikely to happen, but people throughout the US are now actively hoping that a new insurance regulatory framework will be released, for the purpose of increasing access to the healthcare system and ensuring that people throughout the country are eligible for quality and cheap medical services.

Studies have also shown that the healthcare industry in the US is quite inflated in terms of its price. Countries with different healthcare systems, such as universal healthcare, report lower spending and equal, if not higher, quality of medical practices. As a result, they don’t have the US uninsured rate to worry about.

There are also other factors including population density, quality of life, etc. For a quick comparison, the universal healthcare system is based on obligatory health taxes for the entire population. Whenever a person has a medical emergency, it is likely there will be enough funding to ensure that appropriate medical services can be provided. However, the universal healthcare system isn’t perfect either; many citizens of such countries complain that they have to schedule their doctors’ appointments weeks in advance to ensure that the service is free of charge. This quickly led to the appearance of private insurance providers, who make bank by offering priority medical services, alongside access to all forms of treatment and preventive services.

Lack of Access to Healthcare by Demographics and Gender

There are significant discrepancies for accessing healthcare, between various demographics and gender.

KFF report shows that 24% of Hispanics did not see a doctor because of cost concerns. This demographic scores the highest when compared to other races. The same statement applies to 21% of blacks, 19% of American-Indian Natives, 15% of Native Hawaiians and other pacific islanders, 14% for whites, and 11% for Asians. Hence, medical cost concerns are highest for Hispanics and lowest for Asians.

The same report reveals the percentage of adults (in terms of ethnicity/race) who had any type of doctor’s visit within the last 12 months, giving a rough estimate of ethnicities living without health insurance in the US. The numbers go as follows: 84% of whites visited a doctor, followed by 81% of blacks, 79% of American-Indian Natives, 78% of Asians, and 70% of Hispanics.

In terms of gender access to healthcare, in the US, rates regarding access to healthcare remain similar for both men and women, although the balance is slightly tilted in favor of men. Trends suggest that things are changing. Therefore, gender equality is closer to being achieved in the realm of healthcare as well.  The trends should be re-examined by considering how many people lost health insurance because of Obamacare policy changes.

How Being Uninsured Affects Your Life Quality and Finance

Several studies have been conducted to determine how being uninsured is bound to affect the quality of life of individuals, including their overall financial well-being.

A healthy life entails regular visits to the doctor, to determine whether there is any pre-existing condition bound to cause trouble later down the road. Hence, being uninsured is bound to cause quite a bit of trouble. This is also due to the expensive costs associated with preventive and investigatory services.

However, being uninsured is worse in the case of a medical emergency that entails in-depth treatment and hospitalization. In situations like this, uninsured Americans often find themselves deep in medical debt that is difficult to repay; health insurance can play a vital role in drastically reducing spending, despite the monthly premiums.

Quality of life is linked to healthcare access; lack of health insurance also leads to increased stress and anxiety over what-if’s, as compared to people who are guaranteed medical coverage.

Bottom Line

The medical system in the US can be described as awesome for people who receive coverage through their employers.

However, the lack of insurance can have considerable consequences on the quality of life, and the financial well-being of a large number of uninsured Americans. It is essential for the government to work on improving the medical system and the insurance industry to sustain America’s healthcare needs and assist every American in getting affordable health insurance plans.



How many people were uninsured in the US in 2020?

The current number of American citizens who were uninsured in 2020 was around 31 million.

Who is most likely to be uninsured?

A study published by KFF has concluded that, at this time, the majority of uninsured Americans come from low-income households. Adults are at a higher risk of being uninsured compared to children and the elderly, as are people of color when compared to whites.

How many Americans were uninsured before the ACA?

Most major policies associated with the Affordable Care Act were implemented during 2013/2014. Before then, estimates show that roughly 44 million Americans had no health insurance.

Which state has the highest uninsured rate?

According to a 2018 report published by the US Census Bureau, it seems like the state of Texas holds the highest rate for the number of uninsured Americans.

Did Obamacare increase healthcare costs?

The short answer is that we are in the presence of a slight increase. The general effect was a decrease in out-of-pocket health-related spending, yet a small increase in terms of the monthly insurance premiums paid by Americans.

What percent of the US citizens do not have health insurance?

Around 8.5% of people were seen not to have health insurance during the year.

What are the laws for people that can’t afford healthcare in the US?

Those who do not have health insurance for a 3-month period or more could face penalties from the government in the form of an “individual shared responsibility payment,” which is a part of the Affordable Care Act.

How many Americans have medical debt?

A total of 79 million Americans have medical debt problems.

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