Federal Policy
Commonwealth Fund: Working-Age Uninsured Rate Jumps to 11.2%
A new Commonwealth Fund biennial survey finds the uninsured rate for adults ages 19-64 climbed to 11.2% this year, up from 8.9% in 2024, driven largely by the expiration of enhanced Affordable Care Act subsidies at the end of last year. Marketplace coverage among working-age adults fell to 6% from 8%, while Medicaid enrollment dropped to 13% from 16% in 2022 amid post-pandemic unwinding. Nearly half of the 7,362 survey respondents reported being uninsured, underinsured, or experiencing a coverage gap, and half delayed or avoided care due to cost. The report warns the uninsured rate will likely rise further in January when new federal work-requirement and six-month eligibility redetermination provisions for Medicaid take effect.
Why it mattersState Medicaid agencies and health plans should expect continued enrollment declines and rising uncompensated care costs as subsidy expiration and new eligibility rules compound coverage losses heading into 2027.