The number of Americans without health insurance has risen significantly since 2016, reversing some of the strong gains made following the passage of the Affordable Care Act in 2010, according to the latest tracking survey from the Commonwealth Fund.
The uninsured rate among Americans between the ages of 19 and 64 is now 15.5 percent, up from 12.7 percent two years ago. That means about 4 million people lost coverage in that time, with the lowest-income Americans experiencing the biggest coverage losses. The survey of 2,403 adults was conducted from February 6 to March 30. It has a margin of error of 2.8 percentage points.
What’s behind the decline: The Commonwealth report cites two major factors: “1) lack of federal legislative actions to improve specific weaknesses in the ACA and 2) actions by the current administration that have exacerbated those weaknesses. These include the administration’s deep cuts in advertising and outreach during the marketplace open-enrollment periods, a shorter open enrollment period, and other actions that collectively may have left people with a general sense of confusion about the status of the law.”
However, 11.8 million Americans enrolled in ACA exchange plans during the 2018 open enrollment period, only about 1 million fewer than in 2016.
Where we go from here: Insurance coverage could decline further in 2019, the report says, given the 2017 tax law’s repeal of the individual mandate penalty and the Trump administration’s support for Medicaid work requirements imposed by states and for short-term insurance plans that don’t comply with the ACA’s standards for benefits. In the Commonwealth Fund’s survey, 5 percent of insured adults said they plan on dropping their insurance in 2019 since they will no longer have to pay a penalty for not being covered.