Issues surrounding health care and health insurance coverage are not new for Americans. However, a new study from the Commonwealth Fund shows that gaps in coverage are growing and those who suffer the most are low-income families and people with chronic illnesses.
The study reveals that in 2023, 49 million Americans – 16% of the population – were underinsured, meaning while they had health insurance, their coverage had gaps that left them without the care they needed. This number doesn't include the 26 million Americans (8% of the population) without health insurance coverage.
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In 2024, those numbers have grown, with 35% of Americans being underinsured or facing a coverage gap and 9% not being insured at all. Of the underinsured adults, two-thirds are covered through an employer plan, while others have Medicare, Medicaid or individual and marketplace plans.
The study also indicated that health care costs prevent many Americans from seeking the care they need in a timely manner. Among the underinsured, 57% reported that they avoided necessary health care due to the costs and 41% said their health worsened.
the Commonwealth Fund is not the only organization that has revealed concerns about health insurance. KFF also shared a report earlier this year in which they polled Americans and found that the high cost of health care plays a major role in health-related decisions, like whether or not to have health insurance and when to get care.
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According to KFF, about half U.S. adults say it is difficult to afford health care costs and 61% of uninsured adults said they went without care altogether because of the cost. The cost of prescription drugs also prevents people from taking the medications they need – about 21% of adults didn't fill prescriptions due to the cost.
These systemic challenges are not just numbers on a report – they have profound human impacts, often with devastating consequences. A recent high-profile tragedy has brought renewed attention to the personal toll of denied insurance claims and the emotional strain experienced by individuals navigating the U.S. health care system.
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Following the murder of United Healthcare CEO Brian Thompson on Dec. 4, Americans stormed social media with their stories of frustration with United Healthcare and other insurance companies.
One user on X, @ProfYolonda, stated that United Healthcare "denied my surgery two days before it was scheduled. I was in the hospital finance office in tears (when I was supposed to be at the hospital doing pre-op stuff). My mother was flying out to see me. My surgeon spent a day and a half pleading my case to United when she probably should have been taking care of her other patients." The post has over 86,000 likes and almost seven million views.
Another X user, @Belinda_McBride, shared that her insurance "slow-walked" her treatment for over 11 years, prolonging her chronic pain until she was eventually able to get the life-changing surgery she needed. "Chronic pain will drive you nuts," she wrote. "It’s the worst, most dark place you can descend into. I’m now picking up the pieces of my years in hell."
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Many Americans must jump through multiple hoops before getting the treatment they need. Sara Collins, senior scholar at the Commonwealth Fund, told CNN that getting any kind of denial or delay of care – that a doctor recommended – is scary. "To have a decision all of a sudden be being made on the basis of financing is terribly upsetting for families."
the Commonwealth Fund's findings, paired with personal accounts of denied care, highlight a critical issue in the U.S. As the country grapples with rising health care costs and growing inequities in care, the Commonwealth Fund says that more work is needed to cover these gaps and ensure that health insurance does what it is supposed to do: get people the care they need without fear of going into debt.
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