Health care coverage is supposed to make it possible and affordable for people to get the care they need. But what happens when coverage is too expensive, difficult to use, or missing altogether?
The Asclepius Initiative’s (TAI) 2026 Kentucky Health Care Coverage Survey shows the health care challenges in Kentucky. Some participants had no insurance. Many more had coverage, but still went without medical care because of cost. A majority expressed support for a different approach to health care coverage.
TAI’s survey of 1,080 Kentucky adults in May and June 2026 focused on experiences getting and using insurance, the effects of medical costs, views about covering everyone, and concerns about changes in health care policy. The 2026 survey is TAI’s third, following those in 2022 and 2024.
Coverage Remains Out of Reach for Some Kentuckians
In 2026, 7.5% of Kentuckians were uninsured, compared to 5% in 2024.
Cost was the most common reason given for being uninsured. Among participants without coverage, 44.9% said insurance was too expensive. Another 24.1% cited being unemployed, and 11.6% said their employer did not offer insurance.
Consistent with findings from KFF, TAI’s results reveal concerning differences among racial and ethnic groups. Black participants were more than twice as likely (13.7%) to be uninsured as white participants (6.5%). Hispanic participants also had a higher uninsured rate than white participants (15.2%).
Having Coverage Doesn’t Always Make Care Affordable
Health insurance is supposed to make medical care more affordable. But for many survey participants, costs still stood in the way of getting the care they needed. More than half of participants (51.6%) reported avoiding, skipping, or delaying care or medications because of cost. This included nearly half (48.1%) of those with insurance and 95.4% of those without it.
Medical bills competed with critical household needs and affected quality of life. Nearly one in four participants (24.5%) said they couldn’t buy essential goods such as food or clothing because of medical expenses. Nearly half (46.3%) worried about health care costs at least once a month.
These experiences show why affordable coverage does not end with paying a monthly premium. Out-of-pocket costs further impact the ability of people to visit a doctor, fill prescriptions, and receive treatment without sacrificing other necessities.
Kentuckians Want Coverage They Can Count On
The survey explored opinions on entitlement and consistency of coverage. The responses indicate a strong desire for more stable coverage.
Nearly eight in ten (79.2%) agreed that health care is a basic human right. More than seven in ten (71.6%) favored a national health care coverage program that would provide coverage for everyone.
Participants placed value on keeping coverage regardless of life circumstance. More than a third (34.6%) said they would make major life changes such as retiring or going back to school if they didn’t have to worry about health insurance. More than half (54.3%) agreed that insurance should not be tied to a job, and 68.3% believed people should be able to change jobs without losing their coverage.
Questions About the Future Add to the Pressure
The survey also asked about thoughts on health care financing and the effects of recent policy changes affecting cost and coverage.
Nearly half of participants (47.8%) reported paying higher insurance premiums than in 2025. A similar share (46.7%) expected their out-of-pocket medical expenses to increase in 2026.
Among participants with Medicaid, nearly one-third (31.8%) expected that they or someone in their household would lose coverage in 2026. Although the majority of changes expected to cause the largest drops in Medicaid coverage have not yet taken effect (intentionally delayed until after the 2026 midterm elections), Medicaid enrollment fell 6% nationally between June 2025 and June 2026 and 8% in Kentucky, the tenth-largest rate of decrease in the country.
What Comes Next
This is the first of five planned posts sharing findings from TAI’s 2026 survey. Future articles will look more closely at how people choose plans, the problems they face when trying to use them, the tradeoffs between paying for care and other household necessities, Kentuckians’ views regarding a national health care coverage program, and the impact of upcoming state and federal policy changes on cost and access to care.
Together, these survey results reinforce the critical importance of TAI’s mission to educate, inspire, and mobilize the public to advocate for a universally accessible, continuous, affordable, equitable, and high-quality health care coverage system.
The majority of both Kentuckians and Americans believe that health care is a right, not a luxury. It is time for the evidence to drive policy change, allowing the U.S. to join the rest of our high-income peer countries and make coverage for all a reality.