Lack of Health Coverage in US Remained Stable at 8% for 2024

The share of individuals in the US lacking health coverage held steady at 8%, or roughly 27 million people, in 2024, according to data the US Census Bureau released Tuesday.

The data show fluctuations in the uninsured rate for different demographics, although the numbers were not considered statistically significant. Working-age Black Americans’ uninsured rate ticked up from 11.1% to 12.3%, while Hispanic Americans’ uninsured rate dipped from 23.6% to 23%. Foreign-born workers were more than twice as likely to lack health insurance as native-born workers.

Coverage through public programs dropped 0.8 percentage points to 35.5%, driven by a 1.3 percentage point reduction in Medicaid enrollment. Medicaid coverage totaled 17.6% in 2024, while Medicare accounted for 19.1%.

Private market coverage covered 66.1% of Americans, with 53.8% covered by their employer. Private coverage increased 0.7 percentage points, fueled by an increase in the individual market.

The individual market covered 10.7% of Americans in 2024. Of that, the Affordable Care Act exchanges accounted for 4.3%.

Last year’s numbers come amid a series of moves President Donald Trump and Republicans made to tighten eligibility and root out fraud on the exchanges starting this November. Trump’s July 4 budget law and June rulemaking are expected to decrease enrollment by millions of people, while expiring subsidies enacted during the Covid-19 pandemic are projected to contribute to a spike in premiums by a median of 18%.

Republicans are weighing whether to extend the enhanced subsidies as they grapple with potential political fallout ahead of the midterm elections, their general opposition to Obamacare, and indications of fraudulent enrollment. Journalists have spotlighted the world of unscrupulous brokers in the ACA market, while think tank Paragon Health Institute—led by former Trump adviser Brian Blase—estimates that 6.4 million people were improperly enrolled on the exchanges.

The Congressional Budget Office cited Paragon’s work in its latest analysis, and estimated that 2.3 million people intentionally claimed subsidies they weren’t eligible for in 2025.