The share of U.S. adults without health insurance rose by 1.3 percentage points in 2017—making it the largest single year increase since 2008, according to a Gallup-Sharecare Well-Being Index poll released Tuesday.
The poll is based on telephone interviews with a random sample of 25,072 U.S. adults conducted from Oct. 1 to Dec. 31, 2017.
The poll found that the U.S. uninsured rate rose from a record low of 10.9% in the fourth quarter (Q4) of 2016 to 12.2% in Q4 of 2017, representing an increase of an estimated 3.2 million uninsured individuals. However, the poll found the uninsured rate is still well below a peak of 18% in Q3 of 2013—before several provisions of the Affordable Care Act (ACA) took effect, including the law's exchanges and individual mandate.
According to the poll, the U.S. uninsured rate from 2014 to 2016 had consistently declined, but that trend reversed in 2017.
The poll found that the uninsured rate from Q4 of 2016 to Q4 of 2017 increased across all demographic groups except for U.S. residents ages 65 and older, who qualify for Medicare. According to the poll, the uninsured rate rose the most among blacks, low-income U.S. residents, Hispanics, and young adults.
Specifically, the poll found that, from 2016 to 2017, the uninsured rate:
- Increased by two percentage points among U.S. residents ages 18 to 25;
- Increased by 1.8 percentage points among U.S. residents ages 35 to 64;
- Increased by 1.2 percentage points among U.S. residents ages 26 to 34; and
- Decreased by 0.2 percentages points among U.S. residents ages 65 and older.
In terms of race and ethnicity, the poll found the uninsured rate from Q4 2016 to Q4 2017 increased by:
- 2.3 percentage points among non-Hispanic black U.S. adults;
- 2.2 percentage points among Hispanic U.S. adults; and
- 0.7 percentage points among non-Hispanic white U.S. adults.
The poll attributed the recent uptick in the U.S. uninsured rate to a number of factors, including some insurers exiting or scaling back exchange plans in 2017 and media coverage of congressional GOP efforts to repeal the ACA.
Types of health coverage
The poll also found the percentage of U.S. adults who purchased their own health plans fell by one percentage point, from 21.3% in 2016 Q4 to 20.3% 2017 Q4, while other sources of health insurance—including Medicaid—remained largely the same.
According to the poll, that decline represents a reversal of a previous trend in which the percentage of U.S. residents with self-paid health plans had increased by 3.7 percentage points between Q3 of 2013, when the ACA's individual mandate took effect, and 2016.
According to the Gallup, the U.S. uninsured rate is likely to rise in the coming years in light a new tax reform law, which will eliminate the ACA's individual mandate penalty beginning in 2019. Further, the poll authors note that health insurance premiums are expected to continue rising, which could lead young adults—who help offset the health insurance costs of older and sicker adults—to not enroll in health coverage (Luhby, "Your Money, Your America," CNN Money, 1/16; Greenwood, The Hill, 1/16; Baker, "Vitals," Axios, 1/16; Levey, Los Angeles Times, 1/16; Gallup-Sharecare Well-Being Index survey, 1/16).
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