The number of Americans without health coverage, which declined for years after passage of the Affordable Care Act, shot up in President Trump’s first year in office, according to data from a new national survey.
At the end of 2017, 12.2% of U.S. adults lacked health insurance, up from 10.9% at the end of 2016, as President Obama was completing his final term.
The increase of 1.3 percentage points, although modest, marks the first time since at least 2008 that the share of adults without insurance increased from the previous year, according to the report from Gallup, which conducts a widely followed survey asking Americans about their health coverage.
The increase indicates that 3.2 million Americans lost health coverage in 2017, Gallup concluded.
The decline in coverage was most pronounced among slices of the population on which the Obama administration and its allies had focused enrollment efforts: young adults, blacks, Latinos and households making less than $36,000 a year, Gallup found.
By contrast, there has been significantly less improvement among such patients in Texas, which has not expanded coverage fully through the healthcare law.
But many Republicans, including leading Trump administration officials, have dismissed the coverage gains as meaningless. They have argued that the coverage provided under the healthcare law is unaffordable — because out-of-pocket costs are too high — or that patients face too many restrictions in their choice of doctors.
Trump came into office last January pledging to roll back the law, commonly called Obamacare. His administration undertook a sustained campaign throughout 2017 to discredit the law while congressional Republicans tried to repeal it.
The repeal campaign failed. But it helped weaken health insurance markets around the country, particularly in regions that already had few insurers and higher prices than the rest of the country.
At the same time, the Trump administration dramatically cut outreach and advertising efforts.
It is unclear how much each of those actions contributed to the erosion in health coverage, but the Gallup survey indicates a decline in the percentage of adults who bought insurance on their own rather than got it from an employer or a government program such as Medicare or Medicaid.
That is the part of the insurance market that has been affected most by political turmoil surrounding the health law.
“Further, media coverage of the policies to repeal and replace the healthcare law may have caused some consumers to question whether the government would enforce the penalty for not having insurance,” the Gallup report notes.
But the Republican tax bill that passed last month will eliminate the penalty on Americans who don’t get coverage in 2019. The elimination of that penalty, the so-called individual mandate, is widely expected to further reduce the number of Americans with coverage, although forecasts vary about how big a decline to expect.
The survey was based on a random sample of 25,072 adults living in all 50 states and the District of Columbia who were interviewed between Oct. 1 and Dec. 31. The margin of error is plus or minus 1 percentage point.