About 1.2 million uninsured adults fall into the Medicaid coverage gap: they earn too much to qualify for Medicaid in their state and too little for marketplace subsidies, which begin at 100% of the federal poverty level. KFF's analysis of 2024 American Community Survey data finds that Hispanic and Black adults together make up 56% of that group, over half.
Ten states have not adopted the Affordable Care Act's Medicaid expansion. Two of them, Georgia and Wisconsin, cover adults up to 100% of the poverty level through an 1115 waiver, so no coverage gap exists in either. The gap sits in the other eight.
KFF does not publish a figure for Black adults alone, and does not break the gap down by state and race. This page previously carried both. Neither existed.
What is actually published about the coverage gap
Every row is a figure KFF states directly. KFF does not publish a Black-alone count or a state-by-race breakdown, so neither appears here.
| Measure | Value |
|---|---|
Source: KFF analysis of 2024 American Community Survey data.
Methodology
American Community Survey 1-year and 5-year estimates used for population and income-stratified demographic profiles. Medicaid expansion status from CMS.gov state-by-state expansion tracker, current as of January 2024. Coverage gap estimates follow KFF methodology: non-elderly adults (19 to 64) with family income below 100% FPL in non-expansion states, excluding those with other coverage (employer, Medicare, other Medicaid). Black population share of gap estimated using ACS race-by-income microdata. Uninsured time series from NHIS and ACS.
Cite this page
APA
Black Health. (2026). Medicaid Coverage Gap: Black Americans Left Behind. Black Health Data Hub. https://blackhealth.org/data/medicaid-coverage-gap/
BibTeX
@misc{blackhealth_medicaidcoveragegap_2026,
title = {Medicaid Coverage Gap: Black Americans Left Behind},
author = {{Black Health}},
year = {2026},
url = {https://blackhealth.org/data/medicaid-coverage-gap/},
note = {Accessed July 30, 2026}
}
Direct link
https://blackhealth.org/data/medicaid-coverage-gap/
Embed this statistic
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License: KFF published analysis, quoted with attribution