U.S. Health Insurance Coverage Rates Decline
A new Commonwealth Fund report shows the uninsured rate for working-age adults climbed to 11.2% in 2026.
Updated on Oct. 22, 2026 in Insurance
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The uninsured rate for working-age adults in the United States rose from 8.9% in 2024 to 11.2% in 2026. This shift follows federal policy changes that allowed expanded ACA marketplace subsidies to expire at the end of 2025.
Why it matters
The expiration of subsidies and the end of simplified special enrollment periods were designed to reduce public coverage enrollment. These changes have created financial barriers to medical care, with half of working-age adults delaying needed treatment due to costs.
The uninsured rate among working-age adults reached 11.2% in 2026, up from 8.9% in 2024. Additionally, 30% of adults now report paying off medical or dental debt.
The players
The Commonwealth Fund
This private foundation promotes a high-performing health care system by supporting independent research on health care issues.
Trump administration
Led by the President of the United States, this executive branch administration oversees federal health policy and the implementation of the Affordable Care Act.
The details
The Trump administration ended the simplified special enrollment period for households earning under 150% of the federal poverty level while allowing ACA marketplace subsidies to expire. Consequently, ACA marketplace enrollment dropped from 8.5% in 2024 to 6.4% in 2026, leaving 73% of Americans concerned about the government's role in ensuring universal coverage.
Timeline
From 2010 to 2025, the U.S. uninsured rate fell from 16% to 8.9%.
In 2024, the uninsured rate for working-age adults was 8.9%.
In 2026, the uninsured rate for working-age adults rose to 11.2%.
By 2036, the number of uninsured individuals is projected to reach 37 million.
Market Dynamics
These policy shifts mark a notable departure from the trajectory established by the Affordable Care Act, which had previously seen the U.S. uninsured rate drop to 8.9%. This reversal reflects a broader realignment of federal support for public health coverage markets.
Rising uninsured rates and increased medical debt may influence personal savings strategies and household budgeting for millions of Americans. Individuals should prepare for higher out-of-pocket costs as marketplace subsidies expire and coverage gaps widen.
The takeaway
The recent rise in the uninsured rate underscores the vulnerability of healthcare coverage to shifts in federal subsidies and administrative policy. Consumers should prioritize reviewing their current plan details to understand the potential impact of expired subsidies on their annual premiums.
Further reading
For more on the current state of national healthcare coverage, visit United States Insurance.
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Do you believe the federal government has a primary responsibility to ensure all Americans have health coverage?
