The U.S. uninsurance rate has risen to 11%, up from 8.9% in 2024, according to a new report from the Commonwealth Fund. This increase comes as upcoming Medicaid work requirements are expected to further reduce coverage.
Healthcare affordability is also declining. The report found more adults are skipping care due to costs, a problem affecting both insured and uninsured individuals. The Commonwealth Fund surveyed over 9,300 adults aged 19-64 for its findings, revealing a significant worsening of financial barriers to accessing medical services.
Millions Face Inadequate Coverage
Almost half of working-age adults now have inadequate insurance. This group includes those who are uninsured, had a gap in coverage, or have unaffordable plans. The report breaks down the numbers: 11% are uninsured, 12% experienced a coverage gap, and 23% are underinsured, highlighting the widespread nature of coverage inadequacy.
These trends are linked to two major changes. The Affordable Care Act premium subsidies have ended, and pandemic-era Medicaid protections have lapsed. As a result, fewer adults are enrolled in exchange plans and Medicaid, contributing directly to the rise in the uninsurance rate.
Medicaid Work Requirements Expected to Worsen Crisis
More cuts to Medicaid are coming. Starting next year, enrollees will need to log 80 hours of work, schooling, or volunteering each month to keep their coverage. This first national work requirement program, combined with more frequent eligibility checks, could cause up to 10 million people to lose their insurance.
The loss of coverage will likely deepen the affordability crisis. Sara R. Collins, the lead study author and a senior scholar at the Commonwealth Fund, warned that stripping insurance from millions of people will leave more individuals without care or facing medical debt.
The report shows that cost barriers are severe. 72% of those without coverage skipped or delayed care due to cost in 2026. Even for people with insurance, the rate of delayed or avoided care rose from 46% in 2022 to 50% in 2026, demonstrating that financial concerns are a universal challenge.
Nearly three-quarters of survey respondents said it is incumbent on the government to address coverage losses and affordability issues. Collins stated that Congress needs to restore enhanced marketplace premium tax credits and reverse Medicaid cuts to prevent more people from losing coverage, emphasizing that without such action, millions of families will face the cost of getting sick with no insurance at all.
