Health & Spirit

Number of Americans without health insurance grows in Trump's first year, new figures show

Noam N. Levey, Tribune Washington Bureau on

Published in Health & Fitness

But many Republicans, including leading Trump administration officials, have dismissed the coverage gains as meaningless. They have argued that the coverage provided under the health care law is unaffordable -- because out-of-pocket costs are too high -- or that patients face too many restrictions in their choice of doctors.

Trump came into office last January pledging to roll back the law, commonly called Obamacare. His administration undertook a sustained campaign throughout 2017 to discredit the law while congressional Republicans tried to repeal it.

The repeal campaign failed. But it helped weaken health insurance markets around the country, particularly in regions that already had few insurers and higher prices than the rest of the country.

At the same time, the Trump administration dramatically cut outreach and advertising efforts.

It is unclear how much each of those actions contributed to the erosion in health coverage, but the Gallup survey indicates a decline in the percentage of adults who bought insurance on their own rather than got it from an employer or a government program such as Medicare or Medicaid.

That is the part of the insurance market that has been affected most by political turmoil surrounding the health law.

"Further, media coverage of the policies to repeal and replace the health care law may have caused some consumers to question whether the government would enforce the penalty for not having insurance," the Gallup report notes.

Enrollment for coverage in 2018 has been roughly on pace with last year, despite the Trump administration's continued hostility to the law.

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But the Republican tax bill that passed last month will eliminate the penalty on Americans who don't get coverage in 2019. The elimination of that penalty, the so-called individual mandate, is widely expected to further reduce the number of Americans with coverage, although forecasts vary about how big a decline to expect.

And recent moves by the Trump administration to weaken insurance rules are expected to further destabilize insurance markets.

"It seems likely that the uninsured rate will rise further in the years ahead," the Gallup report notes.

The survey was based on a random sample of 25,072 adults living in all 50 states and the District of Columbia who were interviewed between Oct. 1 and Dec. 31. The margin of error is plus or minus 1 percentage point.

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