Share of Americans With Health Insurance Declined in 2018 – The New York Times

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.

“The way they are doing this seems clearly designed to throw people off this program,” said Eliot Fishman, a senior director at the consumer group Families USA, and a former top Medicaid official in the Obama administration. Mr. Fishman said he was particularly disheartened to see declines in the number of children with health insurance.

Brian Blase, a former special assistant to Mr. Trump for health care policy, said he’s not surprised to see enrollment in Medicaid fall. He pointed to a recent study suggesting that some Americans who had enrolled in the program in the early years of Obamacare were not in fact eligible for it. “My sense is in 2018 states probably started tightening eligibility,” said Mr. Blase, who is now president of the consulting and research firm Blase Policy Strategies.

Historically, health insurance coverage has tended to increase when the economy grows, since most Americans get health plans through employers. Indeed, before 2018, the uninsured rate had not risen in any year since 2008.

The 2018 trend may have reversed this year, as Obamacare premiums stabilized and more states expanded their Medicaid programs to cover the working poor.

There was robust growth in jobs and economic output last year, leading most experts to expect solid income gains as well. But median household income — the level at which half of households make more money and half make less — was $63,179 in 2018, little changed from 2017. The Census Bureau made significant changes to its methodology in 2013, making comparisons to earlier years difficult, but 2018’s household income is the highest recorded in the report. The record is too slim to be statistically important.

Some slowdown in income growth is to be expected. Much of the growth earlier in the recovery was driven by people returning to work. Now, with the unemployment rate near a five-decade low, most Americans are working, meaning income gains primarily reflect higher wages for people who were already employed, said Ernie Tedeschi, an economist at Evercore ISI. Among full-time, year-round workers, earnings rose more than 3 percent for both men and women.


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