Uninsured Women in United States

United States

Health insurance is crucial for ensuring women receive the preventive and acute medical care they need to achieve and maintain good health. Coverage also protects against high medical expenses. Around 10% of women ages 19-64 in the United States are uninsured as of 2023. 

Compared with insured women, uninsured women often have more health challenges, including:

• Inadequate access to care.
• Lower quality of care.
• Higher rates of avoiding or delaying needed medical care due to cost.
• Lower use of recommended preventive services, such as mammograms and Pap tests for cancer screening.
• Poorer health outcomes, such as higher rates of cancer mortality and a greater risk of a late-stage cancer diagnosis.

Since the implementation of the Affordable Care Act in 2010, the proportion of women of reproductive age who are uninsured has declined, and health coverage stability has improved. States that have expanded Medicaid have uninsurance rates half that of states that have not expanded Medicaid (14.1% compared with 7.6%).

A 2020 study found that women are more likely than men to be uninsured because of ineligibility. According to KFF estimates, the uninsured rate is also higher among:

• Single mothers compared with mothers in two-parent households.
• Hispanic and American Indian/Alaska Native women compared with Asian and white women. More than 1 in 5 Hispanic and American Indian/Alaska Native women are uninsured.
• Women with incomes below 200% of the federal poverty level, compared with women who have higher incomes. 
• Women living in the U.S. without citizenship compared with citizens.

Common reasons for being uninsured include being unable to afford insurance, lack of knowledge about eligibility for free or reduced-cost insurance, difficulty or confusion when signing up for coverage and falling into the coverage gap. In 2020, an estimated 2 million uninsured women were eligible for Medicaid but not enrolled, and 1 million women were in the Medicaid coverage gap, meaning their incomes were too high for Medicaid eligibility but still below the poverty level. Medicaid expansion under the Affordable Care Act increases eligibility for nearly everyone in this group, but not all states have adopted the expansion.

Policy changes that have been effective at reducing the rate of uninsured women include:

• Expanding Medicaid to bridge the coverage gap. The Affordable Care Act has made significant strides in increasing access to and quality of care for low-income women and those who would otherwise lack coverage. Expanding Medicaid eligibility will reduce the proportion of uninsured women. 
• Pregnancy-related Medicaid. Pregnancy care through Medicaid covers maternity care, delivery and postpartum care for 60 days after childbirth, and is available in all 50 states. Women can enroll in pregnancy-related Medicaid at any time during pregnancy, but must meet their state’s income requirements to be eligible. The National Health Law Program answers frequently asked questions about eligibility for pregnancy-related Medicaid. States can now expand Medicaid postpartum coverage from 60 days to 12 months through provisions in the American Rescue Plan Act of 2021.

Healthy People 2030 has several health insurance-related objectives, including increasing the proportion of people with health insurance and reducing the proportion of people who can’t get medical care when they need it.

Cervantes, Sammy, Clea Bell, Jennifer Tolbert, and Anthony Damico. How Many Uninsured Are in the Coverage Gap and How Many Could Be Eligible If All States Adopted the Medicaid Expansion? Issue Brief. KFF, February 25, 2025. https://www.kff.org/medicaid/issue-brief/how-many-uninsured-are-in-the-coverage-gap-and-how-many-could-be-eligible-if-all-states-adopted-the-medicaid-expansion/.

Cha, Amy, and Robin Cohen. Reasons for Being Uninsured Among Adults Aged 18-64 in the United States, 2019. NCHS Data Brief, No. 382. Hyattsville, MD: National Center for Health Statistics, September 2020. https://www.cdc.gov/nchs/data/databriefs/db382-H.pdf.

Garfield, Rachel, and Kendal Orgera. The Uninsured and the ACA: A Primer — Key Facts About Health Insurance and the Uninsured Amidst Changes to the Affordable Care Act. KFF, January 2019. https://www.kff.org/report-section/the-uninsured-and-the-aca-a-primer-key-facts-about-health-insurance-and-the-uninsured-amidst-changes-to-the-affordable-care-act-how-does-lack-of-insurance-affect-access-to-care/.

Gunja, Munira Z., Sara R. Collins, Michelle M. Doty, and Sophie Beautel. How the Affordable Care Act Has Helped Women Gain Insurance and Improved Their Ability to Get Health Care: Findings from the Commonwealth Fund Biennial Health Insurance Survey, 2016. Issue Brief. Commonwealth Fund, August 2017. https://doi.org/10.15868/socialsector.28134.

Ranji, Usha, Karen Diep, Ivette Gomez, Laurie Sobel, and Alina Salganicoff. “Health Policy Issues in Women’s Health.” In KFF’s Health Policy 101, edited by Drew Altman. KFF, 2025. https://www.kff.org/health-policy-101-health-policy-issues-in-womens-health/.

Report. The Importance of Health Coverage. American Hospital Association, October 2019. https://www.aha.org/system/files/media/file/2019/10/report-importance-of-health-coverage_1.pdf.

Sugar, Sarah, Joel Ruhter, Sarah Gordon, Amelia Whitman, Christie Peters, Nancy De Lew, and Benjamin D. Sommers. Health Coverage for Women Under the Affordable Care Act. Issue Brief. No. HP-2022-09. Washington, D.C.: U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation, March 21, 2022. https://aspe.hhs.gov/sites/default/files/documents/9082fc42757552c429d8b1c3c8949595/aspe-womens-coverage-ib.pdf.

Tolbert, Jennifer, Sammy Cervantes, Clea Bell, and Anthony Damico. Key Facts about the Uninsured Population. Issue Brief. KFF, June 16, 2026. https://www.kff.org/uninsured/issue-brief/key-facts-about-the-uninsured-population/.

Zhao, Jingxuan, Xuesong Han, Leticia Nogueira, Stacey A. Fedewa, Ahmedin Jemal, Michael T. Halpern, and K. Robin Yabroff. “Health Insurance Status and Cancer Stage at Diagnosis and Survival in the United States.” CA: A Cancer Journal for Clinicians 72, no. 6 (November 2022): 542–60. https://doi.org/10.3322/caac.21732.