What are the current uninsured rates in the United States 2024?

1. Different headline numbers, same basic story

Major federal sources and independent research converge on the core finding: roughly mid-to-high single-digit uninsured rates in 2024, corresponding to about 26–27 million people. ASPE/CDC’s NHIS Q1 2024 estimate reports an 8.2% uninsured rate—about 27.1 million people ^{[1] [2]}. The Congressional Budget Office’s projection and some analyses place the 2024 uninsured share at 7.7% (about 26 million) ^[3]. Media summaries and advocacy groups also report figures clustered near 8% ^{[4] [5]}.

2. Why the numbers differ: surveys, timing and definitions

The variation reflects three technical differences: the survey used (NHIS, ACS, CPS, administrative enrollment data), the reference period (calendar year vs. a quarter), and the population definition (all ages vs. under 65). ASPE emphasizes Q1 NHIS data and notes no statistically significant change from 2023 to Q1 2024 ^[2]. The CBO’s figures stem from projection models and different baseline months, producing the 7.7% figure for 2024 ^[3]. Census/ACS and CPS estimates referenced by others may report slight differences because of methodology and timing ^{[4] [5]}.

3. Policy shifts driving short-term movement

Two policy forces explain recent dynamics. First, states resumed regular Medicaid eligibility renewals in 2023–24, producing declines in Medicaid rolls that lifted uninsured counts in some places ^{[1] [3]}. Second, enhanced ACA marketplace tax credits and expanded marketplace enrollment have offset some Medicaid losses by boosting private coverage—keeping the overall uninsured rate near its recent low ^{[5] [3]}. Analysts warn expiration of enhanced subsidies after 2025 would raise uninsurance again ^[3].

4. Uneven impact across states and groups

The distribution of the uninsured is highly uneven. The CBO and CDC highlight much higher uninsured shares in non‑Medicaid‑expansion states and among Hispanic and younger adults: for example, adults 18–64 in nonexpansion states had uninsured rates near 17.4% vs. 9.3% in expansion states in CDC analyses ^[6]. The CBO and Census note state-by-state increases in uninsured rates between 2023 and 2024 in multiple jurisdictions ^{[7] [8]}.

5. What the aggregate figures hide

National percentages mask important subtleties: several reports show gaps by age, race/ethnicity and immigration status. Noncitizens represent a disproportionate share of the uninsured in some studies, and younger adults frequently have the highest uninsurance rates ^{[9] [3]}. The Commonwealth Fund’s 2024 survey found 9% of adults uninsured and 12% with a gap in coverage over the prior year—measures not captured by point‑in‑time rates ^[10].

6. Projections and near-term risks

Forecasts see the uninsured rate edging up over the coming decade absent policy changes. The CBO projects a rise from roughly 7.7% in 2024 to 8.9% by 2034, driven by immigration, the end of some pandemic protections, and the planned expiry of enhanced marketplace subsidies ^{[3] [7]}. Analysts warn that if enhanced premium tax credits lapse after 2025, marketplace enrollees and overall coverage could deteriorate ^{[3] [5]}.

7. How to read headlines responsibly

When you see a single percent figure for “the uninsured rate,” check the source and method: is it ACS, CPS, NHIS, or a projection? ASPE’s NHIS Q1 2024 release gives 8.2% (27.1 million) and stresses no statistically significant change from 2023 ^{[1] [2]}. The CBO/Health Affairs figures give 7.7% (about 26 million) as a projected 2024 value ^[3]. Both are defensible; neither alone captures every nuance.

Limitations and final note

Available sources use differing surveys and time frames, so precise rounding and month-to-month shifts can produce divergent headline numbers; these methodological differences explain the spread between 7.7% and 8.2% ^{[2] [3]}. For state-level, demographic or policy impact detail, consult the underlying NHIS, ACS/CPS and CBO reports cited above ^{[1] [4] [3]}.