Affordable Care Act Lowered Number of U.S. Uninsured

Enrollment for coverage under the Affordable Care Act – also dubbed Obamacare – was down by at least one million people in 2026 after subsidies were cut as part of the Big Beautiful Bill Act at the end of last year. In 2024 and 2025 already, the number of Americans without health insurance had risen once again as the price of coverage went up in the inflation crisis, but also because pandemic-era rules for Medicaid eligibility were taken back. In the years of the pandemic, it had fallen slightly as more people were able to receive Medicaid coverage.

Looking back at the number of uninsured Americans since the 1990s, the introduction of ACA insurance marketplaces in 2014 stands out as a major change in the U.S. insurance landscape. Since then, the number of the uninsured has been significantly lower despite some ups and downs over the years.

Yet, as ACA subsidies as well as Medicaid funding were cut by the Trump administration and inflation keeps pushing health care cost up, a return to a higher number of uninsured is likely. KFF estimates that in 2026, closer to 5 million people will drop ACA coverage. The Congressional Budget Office last year said that it believes that between Medicaid and ACA cuts, 13.7 million more people could become uninsured, which could mean that over the next ten years or so, the number of uninsured Americans could exceed 40 million once again.

In 2010, a high of 48.6 million Americans were uninsured, amounting to 16 percent of the population. This was down to 33.2 million (10.3 percent) in 2019 and as of 2025, stood at 28 million or 8.3 percent of Americans.