After reaching a historic low late last year, the U.S. uninsured rate has been on the rise amid uncertainty over the future of the Affordable Care Act.
The uninsured rate was 12.3% in the third quarter of 2017, according to the newly released Gallup-Sharecare Well-Being Index survey. That's an increase of 1.4 percentage points—representing nearly 3.5 million adults—since the uninsured rate reached an all-time low of 10.9% in the third and fourth quarters of 2016.
The uninsured rate is now the highest recorded by Gallup since the last quarter of 2014, when it was measured at 12.9%. Even so, the current rate is still much lower than 18%, the rate measured in the third quarter of 2013 before the ACA's major provisions were implemented.
Lower-income and middle-income adults have seen comparatively larger increases in their uninsured rates since 2016 than their higher-income counterparts, and black and Hispanic adults have since seen higher increases than non-Hispanic whites.
The Gallup article said one of the factors that may be driving the increase is uncertainty about the ACA.
“Congressional Republicans' attempts to replace the healthcare law may be causing consumers to question whether the government will enforce the penalty for not having insurance,” it noted.
Some insurers’ decision to exit the ACA exchanges may also be playing a role, as the resulting lack of competition in some marketplaces may be driving premiums upward and driving some consumers to forgo insurance, the article said.
Indeed, while there are no U.S. counties without an ACA exchange carrier for 2018, many areas are served by just one insurer. Premiums are also expected to rise next year—in part to account for the Trump administration's decision to end cost-sharing reduction payments—which will hit consumers who don’t qualify for subsidies especially hard.
Insurers also have reason to worry that they will see lower sign-up figures than they’ve had in years past during the upcoming open enrollment period for ACA marketplace plans. The open enrollment period will be half as long this year, and the Trump administration has significantly scaled back advertising and outreach efforts.