Share of uninsured Americans increases for the first time since ACA went into effect, Census data shows

The number of uninsured Americans increased by 1.8 million between 2017 to 2018, increasing the percentage of Americans without health insurance by 0.6 percentage points.

The uptick represents the first increase in the percentage of uninsured Americans since 2014, when the bulk of the provisions of the Affordable Care Act went into effect.

The data was released by the Census Bureau in its annual Health Insurance Coverage in the United States report.

The individual mandate, a provision of the Affordable Care Act, was still in effect in 2018 requiring health insurance in lieu of paying a tax penalty. For 2019, the tax penalty was lowered to $0, effectively ending the individual mandate.

At the state level, 25 states had a higher share of uninsured in 2018 compared with 2017, with Hawaii and Idaho experiencing increases by more than 1 percentage point.

The share of those uninsured increased across age groups, excluding slight decreases for those 26 to 34 years old and those 65 and older.

How does the census compile health insurance data

The US Census Bureau releases data on health insurance rates using two different measures. Its Current Population Survey Annual Social and Economic Supplement (CPS ASEC) is conducted between every February and April, asking respondents if they had health insurance at any point during the previous calendar year. Data used in this report from prior to 2016 had a different data processing approach to the post-2017 statistics.

The agency also asks about health insurance coverage in its American Community Survey. Unlike the CPS ASEC, that survey asks respondents if they are covered at the time of questioning. This data is used to provide estimates at the state and local levels.

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