Share of Americans With Health Insurance Declined in 2018

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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, compared to less than 1 percent last year.

And while Tuesday’s report showed the benefits of what now ranks as the longest economic expansion on record, it also highlighted 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.

David Howell, a professor of economics and public policy at the New School in New York, said economic growth in recent years has helped families recover from recession, but done little to reverse the longer-run stagnation in middle-class incomes. Democrats and Republicans alike, he said, have tapped into the sense among many voters that the economy is not working for them.

“If you look at the long-run trajectory from 1979, it’s pretty disastrous,” Mr. Howell said.

The drop in insurance coverage in 2018 is relatively small compared to the long-term trend, but it suggests that policy changes under the Trump administration, which has been hostile to the health law, have made a difference.

The administration also cut back on advertising and enrollment assistance, programs that helped low-income people learn about the new insurance programs, among other changes that may have depressed the number of people signing up for health plans. The government also announced that it might begin counting Medicaid enrollment as a strike against immigrants who are seeking green cards or citizenship — a policy that was finalized this year. Insurance coverage for Americans of Hispanic origin fell last year, according to the report.

The administration’s decision in 2017 to eliminate a subsidy program contributed to large price increases for health insurance in the Obamacare marketplaces in many parts of the country the following year. Research from the Department of Health and Human Services shows that more than a million Americans who were previously buying their own insurance left the market in 2018.

But the Census Bureau figures show that the main change in the uninsured rate came from declines in Medicaid coverage. Urged by the administration, which expressed concerns about the program’s integrity, several states started asking families to prove their eligibility for Medicaid more often in 2018. The number of Americans covered by Medicaid and the Children’s Health Insurance Program fell by more than 1.6 million last year, according to administrative data.

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