Health insurance in the United States is a complex and evolving landscape, influenced by policy changes, economic factors, and demographic shifts. Understanding how Americans obtain and use health insurance is crucial for grasping the broader picture of healthcare access and equity.
How many Americans are uninsured? How much does the average American pay for health insurance? Stick with us at CMI while we uncover answers to those questions and more in this statistical snapshot of American health insurance.
Key Health Insurance Highlights
The United States Census Bureau provides data on health insurance coverage in the United States. The data are drawn from information that’s garnered by the Current Population Survey Annual Social and Economic Supplement (CPS ASEC). The infographic below highlights some of the key findings from 2024:
Marketplace Plans and The Affordable Care Act
Since the establishment of the Affordable Care Act (ACA) in 2010 and its subsequent implementation in 2014, Health Insurance Marketplace plans have seen significant uptake. The U.S. Department of Treasury says that over 49 million Americans have enrolled in ACA marketplace plans over the years, with a peak of 20.8 million enrollees in 2024 alone.
During the Biden administration, the average annual premium cost for enrollment in a marketplace health plan decreased to $800. This effectively supported American families in managing their monthly expenses and assisted entrepreneurs seeking coverage while launching new businesses.
HealthCare.gov analyzed trends in plan selections across various racial and ethnic groups from 2015 to 2023. The study found that although plan selections have risen for all groups over time, recent years have seen particularly strong growth among non-White consumers, with selections among Latino and Black individuals nearly doubling between 2020 and 2023.
The future of ACA marketplace plans faces uncertainty as enhanced premium tax credits are set to expire at the end of 2025. Without an extension, premiums could rise by an average of 75%, potentially leaving millions uninsured and pushing the total uninsured toward pre-ACA levels. Insurers are already proposing median premium hikes of 18% for 2026 due to rising healthcare costs and the loss of subsidies, which could drive healthier individuals out of the market and further increase premiums.
Key Highlights: Health Insurance Marketplace Premiums
In the United States, health insurance premiums vary significantly based on factors such as age, location, and plan type. Understanding the average costs associated with health insurance can help individuals make informed decisions when selecting a plan that best fits their needs and budget.
- The average monthly premium for a 40-year-old with a silver plan purchased from the Health Insurance Marketplace is $539.
- Virginia has the lowest average premium at $390, while West Virginia has the highest at $864.
- The average monthly premium varies by age:
- $396 for an 18-year-old
- $781 for a 50-year-old
- $1,187 for a 60-year-old.
Public Insurance: Medicaid and Medicare
As of July 2024, approximately 79.6 million individuals were enrolled in Medicaid and the Children’s Health Insurance Program (CHIP). This total marked a 13.7% decrease from the previous year. The decline is primarily attributed to the end of the continuous enrollment provision, which had been in place during the COVID-19 pandemic
As of April 2025, the Centers for Medicare & Medicaid Services (CMS) reports that 68.8 million people are enrolled in Medicare. Of these, 51.2% were enrolled in Medicare Advantage or other health plans. Over 90% of these enrollees were age 65 or over.
The Uninsured: Who Are They?
Despite high coverage rates, various sources approximate that around eight percent of the American population remains uninsured. In 2024, this equated to about 27 million uninsured individuals. The following infographic illustrates five key takeaways about the uninsured population in the United States:
Part-time or gig workers who lack employer-sponsored plans, and individuals living in states that haven’t fully expanded Medicaid, are included in the uninsured. Many face significant financial barriers, citing cost as the primary reason for going without insurance. For these households, even subsidized marketplace plans can feel out of reach when weighed against rent, food, and other essentials
Race, Ethnicity, and Age of The Uninsured
Uninsured rates in the U.S. vary sharply by race, ethnicity, and age. Hispanic and Latino communities have the highest uninsured levels, followed by American Indian/Alaska Native and Black populations. Barriers like language, immigration concerns, and limited access to employer-based coverage all play a significant role.
Age matters, too: young adults (19-25) often skip insurance to save money, while adults nearing retirement may struggle to afford coverage before becoming eligible for Medicare. These intersecting factors and many others highlight ongoing gaps in access and affordability across the healthcare system.
Geographical Influences on The Uninsured Rate
Uninsured rates vary across U.S. regions and states, driven in part by state policy choices, income levels, and demographic compositions. States that did not expand Medicaid under the ACA see the most substantial lack of coverage. Texas consistently has one of the highest uninsured rates in the country, followed by Florida, Georgia, Nevada, Oklahoma, and Wyoming.
These regional disparities highlight how policy decisions and local economics shape access to care. Expanding Medicaid, investing in outreach, and supporting affordable marketplace plans have all proven effective in lowering uninsured rates, yet progress remains uneven. Addressing these gaps will require state leaders to balance fiscal concerns with the long-term benefits of broader coverage, ensuring that where someone lives doesn’t determine whether they can see a doctor or afford treatment.
Insurance Coverage Gaps Across Occupations
In 2024, access to health coverage differed sharply by occupation. Uninsured rates ranged from just 2.5% among architecture and engineering workers to a striking 29.4% in farming, fishing, and forestry. This almost 27-point spread far outpaced the gap between full-time and part-time employees.
Even fields tied to technology or health care weren’t immune: computer and math professionals were far less likely to be uninsured than those in production or repair roles. Health care support staff were more than twice as likely to lack coverage as practitioners.
Several job categories outpaced the 14.7% uninsured rate for nonworking adults ages 19 to 64. Farming, fishing, and forestry led the list, followed by construction and extraction, food service, and building or grounds maintenance. Transportation and material moving workers, like truck drivers, had uninsured rates comparable to nonworkers (approx. 15%). Yet they faced the highest number of nonfatal work injuries and illnesses requiring time off.
Understanding the Average American's Health Insurance Costs
In 2024, the average annual premium for single coverage in employer-sponsored health plans was approximately $8,951, while family coverage averaged around $25,572. These figures represent a 6% and 7% increase, respectively, from the previous year. For workers with a standard health insurance plan, the typical annual deductible was $1,787 for an individual.
Beyond premiums, prescription drug spending reached $98 billion out-of-pocket in 2024, marking a 25% increase over the past five years. These combined expenses underscore the financial burden of healthcare in the U.S., highlighting the need for ongoing reforms to improve affordability and access to care.
Healthy Profits, Unhealthy Prices
It’s no secret that the American health insurance industry does well for itself. In 2023, the industry reported net earnings of nearly $25 billion, reflecting a “modest” increase from the previous year. This growth was primarily driven by an 8% rise in net earned premiums, totaling over $1.1 trillion, which helped offset a 9% increase in hospital and medical expenses.
Among the major insurers, UnitedHealth Group led with approximately $249 billion in premiums in 2023. The company anticipates generating between $450 billion and $455 billion in revenue for 2025. Other significant players included Elevance Health, Centene, and Humana, each generating over $100 billion in premium income.
While these figures indicate a profitable year for the industry, they also highlight ongoing concerns about the rising costs of healthcare and insurance premiums for consumers. The balance between insurer profitability and affordability for policyholders remains a critical issue in the national healthcare debate. The costs venture far beyond only finances.
Leading Health Insurers in the U.S.
- UnitedHealthcare
- Elevance Health (previously Anthem)
- Kaiser Permanente
- Centene Corporation
- Humana
- CVS Health (operating Aetna plans)
- Cigna Healthcare
- Health Care Service Corporation (HCSC – runs BCBS plans in five states)
- Blue Cross Blue Shield of Michigan
- Blue Shield of California
Decoding American Health Insurance Data
American health insurance is complicated, with millions gaining coverage through private plans, public programs, and the marketplace. The previous was only a statistical snapshot of health insurance in the United States. It’s imperative to remain informed, advocate for yourself and your loved ones, and understand the coverage complexities and gaps that remain. Check your insurance today.
High premiums, out-of-pocket expenses, and regional disparities continue to leave many underinsured or uninsured, particularly low-income adults and residents in states without Medicaid expansion. Addressing these challenges requires focusing on affordability, access, and equity. By tackling cost barriers and coverage shortfalls, policymakers can help ensure that insurance translates into meaningful, reliable healthcare.
