Uninsured rate under Trump surges to highest level since Obamacare began


The percentage of American adults without health insurance surged upward in 2018, reaching levels not recorded since before President Trump took office, according to a new national survey that revealed widespread coverage losses over the last two years.

At the end of 2018, 13.7% of U.S. adults were uninsured, up from 10.9% at the end of 2016, when President Obama was completing his second term.

The new number represents the highest uninsured rate since the beginning of 2014, when the Affordable Care Act began providing billions of dollars in aid to help low- and middle-income Americans get covered, according to the survey by Gallup.


The new report also indicates that some 7 million American adults have likely lost or dropped coverage since 2016.

“After years of progress it is deeply troubling to see more Americans becoming uninsured,” said Chris Hansen, president of the advocacy arm of the American Cancer Society.

“Research shows uninsured individuals are more apt to skip cancer screenings, delay getting necessary care and ultimately are more likely to have their cancer diagnosed at a later stage when survival is less likely and costs are higher. … We urge the administration and Congress to reverse this alarming trend and work together to enact bipartisan measures to protect access to quality health care for all Americans.”

The American Cancer Society is among scores of patient and consumer advocates, physician groups, hospital associations, and others working in healthcare who have issued increasingly dire warnings that Trump administration policies are jeopardizing Americans’ access to healthcare.

Between 2013 and 2017, more than 20 million previously uninsured Americans gained coverage, fueled largely by the healthcare law popularly known as Obamacare, according to national survey data from the federal government and other sources.

That brought the nation’s uninsured rate to the lowest levels ever recorded.

Since taking office, however, Trump has repeatedly attacked the healthcare law and enthusiastically backed a 2017 effort by congressional Republicans to roll it back.


The repeal effort failed, but the administration took a series of other steps to loosen insurance rules and dial back support for insurance markets created by the 2010 law, including dramatically cutting funding for advertising and outreach efforts.

Last year, Trump signed legislation eliminating the penalty on people who don’t have insurance, which was enacted to make insurance markets sustainable.

The marketplaces — a centerpiece of the Affordable Care Act — have primarily served low- and moderate-income Americans who don’t get health benefits through an employer or a government program such as Medicare or Medicaid.

Enrollment in the Affordable Care Act markets dipped slightly this year for the second year in a row, with some 8.4 million Americans signing up for coverage on federally run insurance marketplaces.

While cutting support for the markets, the Trump administration has also backed efforts by several conservative states to trim Medicaid, in part by imposing work requirements and making it more difficult for patients to get coverage through the government safety net program.

Administration health officials have portrayed these moves as an effort to make government programs more efficient and to make health insurance more affordable.


Yet an increasing body of evidence indicates the policies are taking a toll on coverage.

A recent study by the Georgetown University Center for Children and Families found the number of children in the United States without health insurance increased last year for the first time in more than a decade.

The new Gallup survey found the largest coverage losses in recent years have been among women, people living in households with annual incomes under $48,000, and young adults under age 35.

More than 21% of adults under 35 now lack health insurance, according to the Gallup survey, up nearly 5 percentage points in just the last two years.

The surging uninsured rate is now fueling growing calls from Democrats around the country for more aggressive steps to help people access coverage, including opening up the existing government Medicaid and Medicare programs to more Americans.

State leaders, including California’s new Democratic Gov. Gavin Newsom, are also pushing new initiatives to expand coverage, in part to counter the Trump administration’s ongoing attacks on the 2010 healthcare law.

Obamacare 101: A primer on key issues in the debate over repealing and replacing the Affordable Care Act. »


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