Health insurance is essential for getting timely care. In the United States, however, health coverage is fragmented, difficult to navigate, and unaffordable for many.
About half of Americans have employer coverage, 20 percent have Medicare, 20 percent have Medicaid, and 6 percent have plans through the Affordable Care Act marketplaces or individual insurance market. Eight percent have no coverage at all. Because each type of insurance comes with its own eligibility criteria, enrollment procedures, subsidies, and benefits, people transitioning from one coverage type to another are at risk for coverage gaps. Employers and policymakers, meanwhile, contend with growing health care costs that threaten the sustainability of public programs and the ability of people to afford their premiums and out-of-pocket costs.
The Commonwealth Fund’s Expanding Coverage and Access program seeks to ensure that everyone in the U.S. has access to affordable, comprehensive health coverage, whether through employers, Medicaid, Medicare, or the marketplaces.
2026 Program Funding Priorities
- Supporting and conducting research on approaches to universal coverage, including modeling the potential and actual effects of proposed policy changes on coverage programs and their enrollees.
- Helping to make coverage more affordable and comprehensive by analyzing the drivers of Medicare and Medicaid spending, underinsurance, medical debt, out-of-pocket spending, and coverage gaps and developing policy solutions. We also provide states with technical assistance.
- Ensuring consumers can make informed enrollment decisions. We conduct surveys, focus groups, and analyses to document the barriers to accessing accurate, understandable information about coverage options, how to obtain and maintain coverage, and how to use health benefits. We also develop policy options for reducing these barriers.
