Fact check: Do "30 million Americans remain uninsured"?
Increasing the number of people who have health insurance is a central goal of the Affordable Care Act, the 2010 healthcare reform legislation championed by President Barack Obama.[1]
But some say the law doesn’t go far enough in expanding coverage. Physicians for a National Health Program—a progressive, nonpartisan single-issue advocacy organization—calls for replacing the current health insurance system with a universal, comprehensive single-payer plan.[2] Its proposal would shift healthcare financing from private insurers to a single public or quasi-public agency.[3]
Physician Adam Gaffney, co-chair of the working group that produced the organization’s single-payer proposal, cites continuing high uninsured rates as one reason to make the switch. He told Newsmax last month,
| “ | Despite the passage of the Affordable Care Act six years ago, 30 million Americans remain uninsured, an even greater number are underinsured, financial barriers to care like co-pays and deductibles are rising, bureaucracy is growing, provider networks are narrowing, and medical costs are continuing to climb.[4][5] | ” |
Do the data bear out Gaffney’s claim that 30 million Americans lack health coverage?
We looked into it, and his claim checks out. The uninsured rate varies substantially by state and by demographic group.[6][7][8][9] But national estimates place the total number of uninsured at approximately 30 million.
Federal estimates of the uninsured rate
Gaffney pointed Ballotpedia to two federal government sources to substantiate his claim: a report from the U.S. Census Bureau and early estimates from the [U.S. Centers for Disease Control and Prevention's (CDC) National Health Insurance Survey.[10][11]
Both sources extrapolate the number of uninsured from national surveys of the “civilian noninstitutionalized population” (people living in the U.S. who are not on active duty military service, and do not reside in an institution, such as a prison or nursing home), but each defines “uninsured” differently.[12][13] The Census, which draws its national estimate from its Current Population Survey Annual Social and Economic Supplement, classifies people as uninsured if they were without coverage for all of the previous calendar year.[14][12] The CDC’s uninsured rate captures the number who were uninsured at the time of the survey.[13]
They also cover different time periods. The Census’ tallies are for 2014 while the CDC’s estimates cover 2015.[12][13]
However, both offer estimates in the ballpark of Gaffney’s 30 million figure. The Census puts the number of uninsured at 33 million, and the CDC places it at 29 million.[12][13]
Uninsured Americans
“Americans” is sometimes used in the U.S. to refer specifically to American citizens. Ballotpedia reached out to Gaffney to check what he meant by the term, and he clarified that he was referring to the populations captured by the Census and CDC data.[15]
That data includes both citizens and noncitizens. However, even if Gaffney had intended the narrower reading of "Americans," his figure would not have been far off the mark. The CDC does not break out estimates by citizenship status in its report, but the Census does. According to its data, an estimated 26 million of the 33 million people who lacked coverage in 2014 were American citizens.[7]
A limitation of the federal estimates
One shortcoming of the federal estimates is that they lag behind the times. Although the CDC’s numbers are more up-to-date than the Census figures, neither captures the current uninsured rate.
To get a sense of whether the current number of uninsured deviates significantly from the federal agencies’ 2014 and 2015 estimates, we turned to two private polls: the Commonwealth Fund Affordable Care Act Tracking Survey and the Gallup-Healthways Well-Being Index.[16][17] Those two polls were conducted earlier this year. Like the CDC survey, they define "uninsured" in terms of coverage at the time of the survey.[16][17]
The private polls focus on a segment of the population—working-age adults—rather than the total population, so we can’t pull estimates of the total number of uninsured from them.[18] However, we can compare the private polls' numbers to federal agency estimates for the same segment of the population.
As the below table shows, the private polls’ estimates of the uninsured rate for working-age adults line up with estimates from the federal agencies. Working-age adults make up the largest share of the population and are more likely than children or older adults to lack health insurance. According to the CDC, 95.5 percent of children and 99.4 percent of seniors had coverage in 2015.[13] So, this comparison suggests that current numbers probably don't depart significantly from the federal estimates for 2014 and 2015.
| Estimates of the national uninsured rate in the United States[19] | ||||
|---|---|---|---|---|
| Source | Age range | Time period | Uninsured rate | Number of uninsured |
| U.S. Census Bureau[12] | All ages | 2014 | 10.4 percent | 33 million |
| U.S. Centers for Disease Control and Prevention[13] | All ages | 2015 | 9.1 percent | 29 million |
| U.S. Census Bureau[12] | 18-64 | 2014 | 14.2 percent | 28 million |
| U.S. Centers for Disease Control and Prevention[13] | 18-64 | 2015 | 12.8 percent | 25 million |
| Commonwealth Fund[16] | 19-64 | February-April 2016 | 12.7 percent | 24 million |
| Gallup-Healthways[17] | 18-64 | January-March 2016 | 12.9 percent | Unavailable[20] |
Conclusion
Gaffney calls for replacing the current health insurance system with a universal, comprehensive single-payer system. In arguing for the switch, he posits that an estimated 30 million people in the U.S. still lack health coverage. Do the data bear out Gaffney’s claim that, despite the passage of the Affordable Care Act, 30 million Americans lack health coverage?
That claim is supported by the data. Measures of the uninsured rate vary, but they converge on a similar range; federal estimates put the number of uninsured at approximately 30 million.
See also
Launched in October 2015 and active through October 2018, Fact Check by Ballotpedia examined claims made by elected officials, political appointees, and political candidates at the federal, state, and local levels. We evaluated claims made by politicians of all backgrounds and affiliations, subjecting them to the same objective and neutral examination process. As of 2025, Ballotpedia staff periodically review these articles to revaluate and reaffirm our conclusions. Please email us with questions, comments, or concerns about these articles. To learn more about fact-checking, click here.
Sources and Notes
- ↑ U.S. Department of Health & Human Services, "Strategic Goal 1: Strengthen Health Care," accessed June 2, 2016
- ↑ Physicians for a National Health Program, "Who Is PNHP," accessed June 2, 2016
- ↑ Physicians for a National Health Program, "Beyond the Affordable Care Act: A Physicians' Proposal for Single-Payer Health Care Reform," accessed June 2, 2016
- ↑ Newsmax Health, "Doctors Call for Single-Payer Alternative to Obamacare," May 5, 2016
- ↑ Note: This text is quoted verbatim from the original source. Any inconsistencies are attributable to the original source.
- ↑ U.S. Census, "Uninsured Rate by State: 2014," accessed June 2, 2016
- ↑ 7.0 7.1 U.S. Census, "Percentage of People by Type of Health Insurance Coverage by Selected Demographic Characteristics: 2013 and 2014," accessed June 2, 2016
- ↑ The New York Times, "We Mapped the Uninsured. You'll Notice a Pattern," October 30, 2015
- ↑ FiveThirtyEight, "33 Million Americans Still Don't Have Health Insurance. Here's Who They Are," September 28, 2015
- ↑ Karen Shanton, "Email correspondence with Dr. Adam Gaffney," May 31, 2016
- ↑ The Census conducts data collection for the National Health Interview Survey, but the survey is a program of the CDC's National Center for Health Statistics.
- ↑ 12.0 12.1 12.2 12.3 12.4 12.5 U.S. Census, "Health Insurance Coverage in the United States: 2014," September 2015
- ↑ 13.0 13.1 13.2 13.3 13.4 13.5 13.6 Centers for Disease Control and Prevention, "Health Insurance Coverage: Early Release of Estimates From the National Health Interview Survey, 2015," May 2016
- ↑ The report also draws on the agency’s American Community Survey. However, the Census recommends using Current Population Survey numbers for national analysis of the uninsured rate.
- ↑ Karen Shanton, "Email correspondence with Dr. Adam Gaffney," June 2, 2016
- ↑ 16.0 16.1 16.2 The Commonwealth Fund, "Americans' Experiences with ACA Marketplace and Medicaid Coverage: Access to Care and Satisfaction. Findings From the Commonwealth Fund Affordable Care Act Tracking Survey, February-April 2016," May 2016
- ↑ 17.0 17.1 17.2 Gallup-Healthways Well-Being Index, "U.S. Uninsured Rate at 11.0%, Lowest in Eight-Year Trend," April 7, 2016
- ↑ The Gallup-Healthways Well-Being Index surveys all adults. We focused on working-age adults in our comparison because the Commonwealth Fund Affordable Care Act Tracking Survey surveys only that group, and the Gallup-Healthways Well-Being Index breaks out estimates for that group from its full dataset.
- ↑ This table was compiled by Karen Shanton using data from the cited sources.
- ↑ This data is not available in the public report. We have requested it from the organization and will update this article to include it if we receive a response.
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