Health insurance is unlikely to be affordable for the 18.1 million uninsured, low-income adults who have difficulty putting food on the table or a roof over their heads. High health insurance costs likely make purchasing health insurance particularly difficult for the 6.5 million uninsured, low-income adults who need insurance the most because they are in fair or poor health, have a work disability, or are pregnant. While many low-income adults facing hardship are insured, the probability of being uninsured is significantly higher for low-income adults having difficulty paying for food or housing (39 percent) than for those not experiencing such hardship (33 percent). The brief combines data from the 1997 and 1999 rounds of the National Survey of America's Families.