The number of Americans without health insurance increased by almost 2 million people in 2018, according to new data released by the U.S. Census Bureau Tuesday.

The increase in the rate of uninsured, from 7.9% in 2017 to 8.5% last year, is particularly remarkable given the falling unemployment rate during that period, since most Americans get coverage through work. It's the first meaningful uptick in the number of people without health coverage since the main provisions of the Affordable Care Act took effect in 2014.

While the economy grew in 2018, individual health insurance premiums continued to increase, states tightened eligibility requirements for public safety-net coverage, and President Donald Trump carried on in his attempt to undo many of the health reforms passed by his predecessor.

The Census report indicates that the biggest decrease in coverage in 2018 came among those covered by Medicaid, the state-federal health program for low-income Americans. Almost two million fewer people were covered by Medicaid in 2018 than in the prior year.

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