A strong economy did not keep the uninsured rate from rising between 2017 and 2018, a new study shows.
Researchers at left-leaning think tank the Urban Institute found 500,000 non-elderly people became uninsured, increasing the uninsured rate from 10.2% in 2017 to 10.4% in 2018.
That's despite a prosperous economy in 2018 and 1 million additional people gaining employer-sponsored insurance over that window, an increase of 0.4%, according to the report.
Those gains, however, were not able to offset decreases in coverage in Medicaid and the Children's Health Insurance Program (CHIP), which declined by 0.3%, nor in the individual marketplaces, which decreased by 0.1%.
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The uninsured rate increases were especially concentrated in states that did not expand Medicaid under the Affordable Care Act, according to the report.
In expansion states, 24.7% of non-elderly people were covered by Medicaid or CHIP, compared to 18.2% of people living in non-expansion states.
Because states that did not expand Medicaid rely more heavily on the exchanges to provide coverage to people who are enrolled in employer plans, the researchers warn the uninsured rates could increase further in future studies in these states as a result of the expansion of short-term coverage and the elimination of the tax penalty associated with having insurance.
And, though the study is based on data from years before the COVID-19 pandemic, the researchers wrote that the employer coverage losses that occurred as the virus spread are likely to play a role in future analyses, too.