Share of Americans With Health Insurance Declined in 2018

Fewer Americans are living in poverty but, for the first time in years, more of them lack health insurance.

About 27.5 million people, or 8.5 percent of the population, lacked health insurance for all of 2018, up from 7.9 percent the year before, the Census Bureau reported Tuesday. It was the first increase since the Affordable Care Act took full effect in 2014, and experts said it was at least partly the result of the Trump administration’s efforts to undermine that law.

The growth in the ranks of the uninsured was particularly striking because the economy was doing well. The same report showed the share of Americans living in poverty fell to 11.8 percent, the lowest level since 2001. Median household income was $63,200, essentially unchanged from a year earlier after adjusting for inflation, but significantly above where it was during the Great Recession.

“In a period of continued economic growth, continued job growth, you would certainly hope that you wouldn’t be going backwards when it comes to insurance coverage,” said Sharon Parrott, senior vice president at the liberal Center on Budget and Policy Priorities.

But there was good news in the Census Bureau report for the White House. The decade-long recovery is at last delivering income gains to middle-class and low-income families. After decades of rising inequality, recent wage gains have been strongest for people at the bottom of the earnings ladder, said Michael R. Strain, an economist at the conservative American Enterprise Institute.

“You’re seeing improvements in employment outcomes for people with disabilities. You’re seeing improvements in employment outcomes for the formerly incarcerated,” Mr. Strain said. “These workers who are potentially more vulnerable, you’re seeing the recovery reach them.”

Democrats, however, are likely to highlight evidence that income gains have slowed since President Barack Obama’s final years in office. Median income grew 5.1 percent in 2015 and 3.1 percent in 2016.

And while Tuesday’s report showed the benefits of what now ranks as the longest economic expansion on record, it also showed the limitations of that growth. Median household income is only modestly higher now than when the recession began in late 2007 and is essentially unchanged since the dot-com bubble burst in 2000.

Democrats and Republicans alike have tapped into the sense among many voters that the economy is not working for them.

“It’s two solid economic cycles of struggling to either stay in place or get back out of a hole,” said Arloc Sherman, a senior fellow at the Center on Budget and Policy Priorities. “You can see why people would be impatient for real progress.”

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