America's uninsured rate held essentially steady from 2016 to 2017, according to U.S. Census Bureau figures published on Wednesday, the first year this decade that the nation did not make progress in reducing the ranks of those without health insurance.
The finding suggests America's recent success in lowering its uninsured population has plateaued, with potential implications for policymaking and the fate of the U.S. health care system.
"There has been a stall in the progress of reducing the number of uninsured Americans,” said Laura Skopec, a health care expert at the Urban Institute, a centrist think-tank.
In 2016, 8.8 percent of the American population — or 28.1 million people — did not have health insurance. In 2017, the number of those without health care rose by about 400,000 people to 28.5 million while the rate of the uninsured did not change, according to Census Bureau figures. The increase was not statistically significant.
The reversal comes after nearly a decade of progress in bolstering the number of Americans with health care. The number of uninsured Americans fell steadily from 2010 until 2016, decreasing by at least 0.3 percentage points every year over that period. From 2010 to 2016, the uninsured rate fell dramatically — nearly in half — as tens of millions of more people were signed up for health insurance under the Affordable Care Act signed by President Obama in 2010.
Fourteen states saw increases in their uninsured populations in 2017, compared to just three states — New York, California, and Louisiana, which recently expanded Medicaid — that saw the number of uninsured fall.
"It may be statistically insignificant, but the uptick [in uninsured Americans] represents hundreds of thousands of real people,” said Sara Rosenbaum, a health expert at George Washington University.
The data do not reflect the Trump administration’s most significant changes to the American health care system, which primarily came into effect in 2018.
The Trump administration has given states permission to impose new work requirements on their Medicaid enrollees, but none were implemented in 2017. The Republican tax law passed last fall also repealed the Affordable Care Act’s individual mandate to buy private health insurance, but that did not go into effect until this year. (Trump and Republicans in Congress tried unsuccessfully to repeal the ACA, President Obama’s signature health law, in 2017.)
Some health care experts blamed the Trump administration for eliminating the Affordable Care Act’s outreach budget. Others said the numbers reflect a leveling off the gains under the ACA, compared to the initial years of the law’s implementation when there was a boost in enrollment.
Additional analyses have also found progress on the number of insured either stalling or reversing. A survey from the Commonwealth Fund found the rate of uninsured adults jumped from to 14 percent in 2017 from 12.7 percent in 2016. The same survey again found the rates of all uninsured adults increased to 15.5 percent in 2018.
A smaller survey released by the Centers for Disease Control and Prevention in 2017 found the ranks of the uninsured holding essentially constant.