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Report: U.S. Uninsured Rate Climbs Ahead of 2027 Medicaid Cuts

October 23, 2026

The nation’s uninsured rate among working adults rose from 8.9 percent to 11.2 percent during 2026, according to a new survey.

The survey on uninsured adults, released by the Commonwealth Fund this week, comes ahead of significant changes to Medicaid that take effect next year and are likely to mean even more uninsured adults.

“The country is on the brink of undoing years of progress in health coverage,” said Sara R. Collins, lead study author.

Here’s what you need to know:

Key takeaways: The share of adults with Affordable Care Act plans dropped from 8.5 percent to 6.4 percent; working adults on Medicaid fell from 15.5 percent to 13 percent; and the uninsured rate among people within 200 percent of the federal poverty level increased from 14 percent to 17 percent.
Driving forces: The expiration of enhanced premium tax credits in 2025 increased the out-of-pocket costs for individual coverage. The rise in uninsured adults also comes ahead of larger changes to Medicaid (work requirements, more frequent eligibility checks) that will drive up uninsured rates and uncompensated care.
Under-covered: About 46 percent of working-age adults did not have adequate health insurance during 2026.
- Eleven percent were uninsured when surveyed, and 12 percent had insurance but had gone without coverage at some point during the previous 12 months.
- Another 23 percent were underinsured, meaning their out-of-pocket costs were high relative to their income.
The basics: The survey, fielded from May–July 2026, reviews changes in coverage and access over the past four years among people between 19 and 64.
Quotable: “Our survey shows that most Americans are struggling to get the health care they need, and things are getting worse,” said Joseph R. Betancourt, MD, Commonwealth Fund president.