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Uninsured rate on the rise for the first time since passage of the Affordable Care Act

The findings come at a time when the fate of the ACA is in the hands of a federal appeals court.

Jeff Lagasse, Associate Editor

The number of Americans without health insurance has risen for the first time in almost 10 years, and while the increase is slight, it marks the first time since passage of the Affordable Care Act that the uninsured rate has climbed.

That's according to data from the U.S. Census Bureau, which found that 8.5%of the population didn't have health insurance at any point during 2018. In raw numbers, that translates to about 27.5 million people, up 2 million people from 2017.

The percentage of Americans with public coverage also fell slightly, by 0.4%, while the numbers of those with private coverage remained stable.

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The ACA had an almost immediate impact on the number of uninsured Americans, with the overall uninsured rate declining slowly but steadily over time. The data released this week indicates that trend may be reversing course for the first time since the law's passage in 2010.

In 2018, private health insurance coverage continued to be more prevalent than public coverage, covering 67.3% and 34.4% of the population, respectively. Of the subtypes of health insurance coverage, employer-based insurance remained the most common, covering 55.1 percent of the population for all or part of the calendar year.

Between 2017 and 2018, the percentage of people covered by Medicaid decreased to 17.9%, a 0.7% dip overall. The rate of Medicare coverage increased by 0.4 percentage points. The percentage of people with employment-based coverage, direct-purchase coverage, TRICARE, and VA or CHAMPVA healthcare didn't change in any statistically meaningful way.

The percentage of uninsured children under the age of 19 increased by 0.6% between 2017 and 2018, landing at 5.5%.


While the Census Bureau offered no conjecture on why the uninsured rate has climbed, under President Trump, Congressional Republicans had sought to repeal the ACA and replace it with a different system.

In December 2018, a federal judge in Texas ruled that the Affordable Care Act is unconstitutional, throwing coverage into question for millions of Americans at the deadline for 2019 open enrollment.

Soon thereafter, Democratic attorneys general, led by California Attorney General Xavier Becerra, filed a motion to allow for an immediate appeal of the ruling to the Fifth Circuit Court of Appeals in Texas, and asked that the decision be stayed. The matter is expected to eventually make its way to the Supreme Court.

Twitter: @JELagasse

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