The number of Americans without health insurance rose a year ago, marking the first time in almost a decade the uninsured rate increased, according to data the U.S. Census Bureau published Tuesday.
"What were seeing is that even in a tight labor market, where jobs are generally available, health insurance is out of reach for many people - whether they're working or not working", Rebecca Kolins Givan, a professor in Rutgers University's School of Management and Labor Relations, told Salon.
The exact cause for the decline in health coverage remains unclear, but some health policy experts have pointed to the Trump administration's efforts to undermine the ACA as a likely explanation. President Donald Trump and other Republicans contend the law is fatally flawed, while Democrats maintain it has been undermined by recent GOP policies.
The rate increased to 8.5% in 2018, up half a percentage point a year earlier.
Democrats are laying the blame Trump, long accusing his administration of deliberately undermining Obama's health care law.
The rate of Americans without insurance has not fallen since 2009, in the midst of the worst financial crisis since the Great Depression.
The increase in uninsured Americans is striking partly because of the economy's expansion and increased payrolls.
In 2018, the number of people in the United States without health coverage rose to 27.5 million, up from 25.6 million the year before. Most states did not see a statistically significant change.
Also, more children were uninsured previous year, mainly because the share of lower-income kids covered by Medicaid or the Children's Health Insurance Program (CHIP) declined.
Tuesday's data make clear that the contraction of insurance has been broad. For the first time, the Census Bureau broke out the proportion of Americans buying health plans through the health law's insurance marketplaces.
The Trump administration has also rolled out some regulatory changes of its own meant to expand coverage. Meanwhile, enrollment in Medicare, the program for elderly and disabled people, grew slightly - probably as a result of the nation's expanding population of older residents, Census officials said in releasing the data. Businesses have been hiring minority and low-skilled workers at unusually high rates lately, helping give jobs and opportunities to Americans who struggled for years to get a chance. And there were more uninsured adults ages 35-64.
The fall in the US poverty rate has been driven largely by people moving from part-time to full-time work, helping boost incomes.
Employers added almost 2.7 million jobs in 2018, compared to 2.2 million in 2017.
The report also found uninsured rates increase in eight states: Alabama, Arizona, Idaho, Michigan, Ohio, Tennessee, Texas and Washington.
The data suggest that two decades of economic expansion has failed to translate into significant gains for the typical family, as median household income has increased just 2.7% since 1999.