The percentage of uninsured American adults increased 1.3 percentage points during 2017, which was the largest single-year increase since Gallup and Sharecare started measuring the rate in 2008.
That increase represents about 3.2 million Americans who became uninsured in 2017.
The percentage of adults without health insurance remained essentially the same at 12.2% in the fourth quarter of 2017. The third quarter uninsured rate was 12.3%.
After years of seeing the uninsured rate drop, the 2017 increase is likely the beginning of a trend of more uninsured Americans. Congress axed the individual mandate penalty in its tax bill late in 2017 and the Trump administration has implemented policies involving Medicaid likely result in fewer insured in the coming year.
However, the Trump administration is also promoting short-term catastrophic health plans and association health plans, which supporters say will allow more affordable options for currently uninsured Americans.
Nevertheless, Gallup is predicting more uninsured this year. “Having passed their tax bill, congressional Republicans' 2018 legislative goals include reforming funding mechanisms for Medicaid and Medicare — programs that subsidize healthcare coverage for low-income, disabled and elderly Americans. With less federal assistance from these programs to help offset the rising cost of health insurance, fewer Americans may be able to afford health insurance,” according to the report.
The report found the uninsured rate increased in all demographic groups last year except for senior citizens, who are eligible for Medicare. The rate increased most for young adults, blacks, Hispanics and low-income Americans. The uninsured rate of young adults dropped by 2 percentage points. The loss of this demographic group from the risk pool may be especially problematic. Not having younger, healthier people insured can result in an imbalanced risk pool, which leads to higher costs for consumers.
The uninsured rate for white adults increased by less than 1 percentage point in 2017, while black and Hispanic adults’ uninsured rates both went up by more than 2 percentage points. The rate of uninsured low-income Americans also increased 2 percentage points. Low-income Americans losing coverage could mean they will delay necessary care. That may cost the healthcare system more in the long run. Fewer insured low-income Americans could also mean more uncompensated care at hospitals. Uncompensated care was already on the rise in 2016.
Overall, the 12.2% overall rate is still well below the 18% uninsured rate in the third quarter of 2013. That percentage dropped after the Affordable Care Act’s individual mandate and Medicaid expansion took effect in January 2014.
The uninsured rate was at 10.9% in November 2016 when Donald Trump, who promised to repeal the ACA, was elected president. The repeal didn't happen despite Republican efforts, but Republicans took several measures to undermine the law, including the mandate repeal.
Gallup said the factors linked to the uninsured increase include payers leaving the ACA exchanges and the subsequent rising costs of plans. Also, Gallup pointed to media coverage of the “repeal and replace” effort, which may have resulted in some insured people dropping coverage because of the threats to repeal the individual mandate.
Sen. Patty Murray (D-Wash.), who is ranking member of the Senate HELP Committee, called the results "tragic" and blamed the president's "repeated sabotage."
“After a year of President Trump’s repeated sabotage — from putting up barriers to healthcare, cutting open enrollment and expanding loopholes, to trying to throw the entire system into chaos — it’s concerning but unsurprising to learn that fewer families have insurance and the ability to get the healthcare they so badly need. President Trump’s actions have put millions of lives at risk by putting healthcare farther out of reach. President Trump and Republicans must reverse course and stop this sabotage before it hurts more families," said Murray.