1

About 25 percent of adults 18–64 

years old report being uninsured 

for at least part of the past 12 

months (Jan-March 2010 survey). 

7x

Adults 18–64 years old with 

no health insurance at all 

in the past 12 months were 

7 times more likely to skip 

medical care for cost reasons, 

compared with those 

continuously insured 

(2009 survey).

Access to 

Health Care

1 in 3

About 32 percent of adults 

18–64 years old living in 

middle-income families 

report being uninsured for 

at least part of the past 12 

months (2009 survey).*

1 in 4

New 2010 estimates show that the number of 

Americans without health insurance is growing, 

affecting middle-income Americans as well as 

those living in poverty. About 50 million adults 

18–64 years old had no health insurance for at 

least some of the past 12 months. People in all 

income brackets have been affected, not just adults 

living in poverty, according to a 2009 survey. 

In the past few years, the number of adults aged 

18–64 who went without health insurance for 

at least part of the past 12 months increased by 

an average of 1.1 million per year. About half of 

those additional adults were middle-income.* 

Adults without consistent health insurance are 

more likely to skip medical care because of cost 

concerns, which can lead to poorer health, higher 

long-term health care costs, and early death. 

*About $43,000–$65,000 household income for a household of four

Learn about your role in expanding access to 

health care See page 4

 Want to learn more? Visit

A record number of adults 

18–64 years old are uninsured

 www http://www.cdc.gov/vitalsigns

Centers for Disease Control and Prevention

Oce of Associate Director for Policy

November 2010
Problem

2

Adults 18–64 years old without 

health insurance, 2008–2010 (Jan-Mar)

Uninsured any time 

in past 12 months

Uninsured more 

than 12 months

2008 2009 Jan-Mar 2010

SOURCE: National Health Interview Survey, 2008, 2009,

and Jan-Mar 2010.

50M

0

10

20

30

40

50

Uninsured adults (in millions)

49M

46M

29M 28M

30M

Health Care

The number of adults 18–64 years old 

without health insurance is high and 

continues to rise. 

1. More adults 18–64 years old went 

without health insurance than ever 

before.

◊ About 1 in 4 adults this age (about 50 million) reported not having health insurance 

for at least part of the past 12 months.

◊ About 1 in 6 adults this age (about 30 million) went without health insurance for 

the past 12 months or longer.

◊ During each of the past few years, the number 

of adults this age who went without health 

insurance for at least part of the past 12 

months increased by an average of 1.1 million.

◊ More than half of adults this age without 

health insurance for more than the past 12 

months had no usual source of medical care.

2. Adults 18–64 years old who have a 

chronic illness and who do not have 

health insurance are more likely to skip 

or delay medical care because of cost.

◊ 40% of the entire US population has one or 

more chronic illnesses.

◊ Currently insured adults this age with a 

chronic illness who recently had even a short 

gap in health insurance coverage were 3 times 

as likely to skip medical care because of cost 

compared to those continuously insured.

◊ More than 40% of adults this age without 

health insurance in the past 12 months who 

had high blood pressure, asthma, or diabetes 

reported in 2009 that they had skipped care 

because of cost.

◊ Delays in health care can lead to poorer 

health and higher medical costs over time.

3. Adults 18–64 years old with a disability 

skipped or delayed some medical care 

in the past 12 months because of cost.

◊ Almost 1 in 4 (46 million) adults this age in 

the US have a disability.

◊ About 30% of adults this age with a disability 

reported in 2009 that they had no health 

insurance in the past 12 months.

◊ Overall, disabled persons were about twice 

as likely as those with no disability to skip 

or delay medical care. About 60% of adults 

this age with a disability who had recent 

gaps in the past 12 months in their insurance 

skipped or delayed medical care, compared 

with only 16% for those with continuous 

insurance coverage.
3

AL

AZ

AR

CA CO

CT

FL

GA

IL IN

IA

KS

KY

LA

ME

MI

MN

MS

MO

NE

NH

NY

NC

ND

OH

OK

OR

PA

SC

SD

TN

TX

UT

VT

VA

D.C.

WA

WV

WI ID

MT

NV

NM

WY

HI

AK

RI

MA

NJ

DE

MD

6.2%–13.8% 13.9%–21.4% 21.5–29.1%

Percentage of adults 18–64 years old who skipped or 

delayed medical care because of cost, by disability* and 

insurance coverage status

*Disability status is based on Basic Actions Difficulty, which involves movement, vision, hearing, 

emotional upset, and difficulty remembering or being confused, as defined by Altman and Bernstein 2008. 

See http://www.cdc.gov/nchs/data/misc/disability 2001- 2005.pdf, pp.75-77. 

SOURCE: National Health Interview Survey, 2009. Available at http://www.cdc.gov/nchs/nhis.htm. 

Reprinted from MMWR 2010;59(44). 

Insurance coverage

for the last 12 months

No insurance coverage

for all or part of past

12 months or more

With disability

No disability

61%

31%

16%

6%

US State Info

The percentage of currently 

uninsured adults, 18–64 years 

old, varies by state, ranging 

from 6% in Massachusetts, 

where there are strong state 

policies on coverage, to 29% in 

Texas.

Who’s at Risk

Percentage of adults 18–64 years old without

health insurance at the time of interview —

2009 Behavioral Risk Factor Surveillance System, US
4

For more information, please contact 

Telephone: 1-800-CDC-INFO (232-4636)

TTY: 1-888-232-6348

E-mail: cdcinfo@cdc.gov

Web: www.cdc.gov

Centers for Disease Control and Prevention

1600 Clifton Road NE, Atlanta, GA 30333

Publication date: 11/09/2010

What Can Be Done

The Affordable Care Act

◊ Is projected to extend health insurance for up to 

94% of people below 65 years old (an additional 

32 million people) by 2019. 

◊ Can reduce skipped or delayed care because 

people are less likely to have gaps in insurance.

◊ Requires insurance plans to cover and not 

charge co-payments for effective preventive 

services. Greater use of these services could 

save 100,000 lives each year. 

Everyone can

◊ Get healthy. Eat less sugar, salt and saturated 

fats and more fruits and vegetables. Walk 30 

minutes a day. Quit smoking, or don’t start.

◊ Stay healthy. Take any medicines your doctor 

has prescribed. Talk to your doctor about 

medication programs that help people with 

low incomes if you can’t afford your medicine.

◊ Sign up for health insurance. Even if you have 

a pre-existing condition, health insurance is 

now available in some states. For more information, go to http://www.healthcare.gov/

law/provisions/preexisting/index.html.

◊ Go see your main health care provider. Your 

primary care doctor, nurse practitioner, or 

physician assistant can make sure that you 

are up-to-date with preventive services such 

as immunizations, as well as cholesterol, mental 

health, and cancer screenings. Also, they can 

help prevent costly and disabling complications 

such as strokes and heart attacks.

◊ Find your options for health care you can 

receive right now. See http://www.hrsa.gov/

gethealthcare/index.html and http://www.

healthcare.gov.

Employers can

◊ Provide comprehensive wellness programs for 

employees that include physical activity and 

other wellness measures.

◊ Provide options that make health insurance 

and health care easier to afford for employees. 

These options should include basic primary 

care and prevention.

Health care providers can

◊ Include at least some preventive care at each 

patient visit. 

◊ Support the use of retail sites, schools, churches, 

and community centers to make it more convenient for people to get basic primary care and 

prevention, including vaccinations.

Health insurance plans can

◊ Promote healthy diet and physical activity for 

their enrollees. Adults who are overweight or 

have high blood pressure, high cholesterol, or 

diabetes are more likely to have higher health 

care costs.

◊ Provide basic primary care and prevention 

services in more convenient locations such as 

retail sites, schools, churches, and community 

centers. 

 www http://www.cdc.gov/vitalsigns

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