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After Trump attacks, Americans hold on to health insurance

The uninsured rate is almost exactly the same as at the end of the Obama administration.
by Ben Popken /
Image: A patient receives care at El Nuevo San Juan Health Center
A patient receives care at El Nuevo San Juan Health Center, one of 10 clinics operated in New York City by Urban Health Plan. UHP and other federally qualified health centers (FQHCs) provide health care to uninsured and underinsured patients across the United States.John Brecher / NBC News

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More than a year after President Donald Trump took office, the percentage of Americans without health insurance is almost exactly the same as it was at the end of the Obama administration, according to a new, authoritative CDC report.

In 2017, 29.3 million people were uninsured, only a slight increase from the 2016 levels of 28.6 million, the study from the Centers for Disease Control and Prevention found. That’s an uninsured rate of 9.1 percent versus 9 percent.

Trump has made multiple promises to undo the Affordable Care Act (ACA), also known as Obamacare. Critics warned that repealing the act, one of President Barack Obama's signature pieces of legislation, would lead to hikes in the number of uninsured.

"When we win on Nov. 8 and elect a Republican Congress, we will be able to immediately repeal and replace Obamacare," Trump told a campaign rally in Valley Forge, Pennsylvania, on Nov. 1, 2016. "Have to do it."

But it was not to be. After several efforts, the legislative attempt to undo Obamacare fell apart in the Senate. Republicans, however, were able to take a few chunks out of it, including repealing the so-called individual mandate, which requires Americans to keep coverage or be fined.

That change doesn’t go into effect until 2019, so we haven't yet seen the impact of people being able to opt out of coverage without tax penalties on the rates of the uninsured and on premiums covering potentially smaller pools.

In November, the Congressional Budget Office revised earlier estimates, predicting that repealing the individual mandate would lead to 13 million more Americans losing their coverage over the following 10 years, and premiums going up 10 percent. At the same time, the federal government would save $338 billion.

The new CDC report also contained a few warning signs.

The uninsured rate rose among middle-class adults, who don’t qualify for subsidized coverage under the ACA, to 8.2 percent.

The rate also rose significantly in states that didn’t use the ACA’s Medicaid expansion, averaging at 19 percent compared to the 9 percent uninsured in states that did expand low-income coverage.

Theresa Granger, a clinical assistant nursing professor at USC's Suzanne Dworak-Peck School of Social Work, said that even if Republicans try again and get more rollbacks, she doesn’t expect the health insurance market “will fail per se.”

“Obamacare has opened the market so that more insurance companies have the opportunity to compete," Granger told NBC News. “What we have now is more of an open market. Americans have more choices about their insurance. If Obamacare is dismantled, Americans will still have insurance available to them, but their options may be more limited and the cost to purchase insurance might change.”

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