During President Donald Trump’s first year in office, the number of uninsured Americans increased by an estimated 3.2 million.
That’s the conclusion of a new Gallup-Sharecare poll, which noted that the uninsured rate in the fourth quarter of 2017—12.2%—is 1.3 percentage points higher than the record low of 10.9% in the final quarter of 2016.
That’s the largest single-year increase since Gallup and Sharecare started tracking the uninsured rate in 2008. However, it’s still a lot lower than the 18% high seen in 2013—before the Affordable Care Act’s main insurance market reforms went into effect.
Gallup said media coverage of Republicans’ efforts to repeal the ACA may have contributed to the rising uninsured rate, as individuals might have been unsure whether they’d actually face a penalty for not having insurance.
Ultimately, that assumption will prove true, as Congress’ recently passed tax bill repeals the ACA’s individual mandate starting in 2019. The Congressional Budget Office has estimated that the repeal of the mandate will increase the number of uninsured people by 13 million over the next decade.
Another factor driving up the uninsured rate could be insurance carrier exits from the ACA exchanges, which have dampened competition and thus contributed to rising premiums, according to Gallup. Those higher prices may have led some consumers who fail to qualify for subsidies to forgo insurance.
The poll’s findings contained some good news for insurers that remain on the ACA exchanges, however. It noted that the uninsured rate among adults ages 18-25 rose by 2 percentage points in 2017. Those young, generally healthier consumers are sorely needed to balance out the risk pool in the individual market, as they offset the higher costs associated with their older, sicker counterparts.
Republicans in Congress appear likely to shelve their efforts to repeal and replace the ACA in 2018, as it’s an election year and they have other legislative priorities on which to focus.
However, the Trump administration is not slowing down its efforts to unwind the law through nonlegislative means. A prime example is the president’s executive order, which directs federal agencies to expand the use of certain plans that don’t have to comply with the ACA’s rules. Only time will tell how that will affect the uninsured rate in the coming year.