Jan. 23 (UPI) -- Roughly 13.7 percent of U.S. adults went without medical insurance in the fourth quarter of 2018, the highest rate since before the Affordable Care Act made took effect in 2014, a new Gallup poll found.
An estimated 7 million more adults are without health insurance now versus 2016 when the rate of uninsured dropped to a new low of 10.9 percent. Gallup collected data as part of the National Health and Well-Being index, which surveyed 28,000 adults per quarter in 2018. Respondents were asked if they have health coverage.
There are a number of factors that could be contributing to the decline, Gallup said.
"One may be an increase in the rates of insurance premiums in many states for some of the more popular ACA Insurance plans in 2018," Gallup said. "For enrollees with incomes that do not qualify for government subsidies, the resulting hike in rates could have had the effect of driving them out of the marketplace."
Some insurers have dropped out of the ACA exchanges, too. The enrollment period has been shortened and there's not as much marketing and awareness of the exchanges, Gallup said.
Gallup also cited a statement President Donald Trump made shortly after he took office among the "political forces" possibly increasing uncertainty.
"I want people to know Obamacare is dead; it's a dead healthcare plan," Trump said at the time.
He's since cut funding for the ACA, commonly known as Obamacare, and effectively eliminated the mandate that required Americans to have health insurance.
ACA marketplace exchanges opened on Oct. 1, 2013, and most new insurance plans went into effect on Jan. 1, 2014.
The percentage of uninsured adults under 35 jumped from 16.8 percent at the end of 2016 to 21.6 percent at the end of 2018. Adults making less than $24,000 a year make up the highest percentage of uninsured, as 25.4 percent not having coverage. Adults making between $24,000 to $48,000 a year were next, with 19.1 percent uninsured.
The biggest concentration of uninsured adults is in the South, where 19.6 percent of adults don't have health coverage. The East is the lowest with 7.1 percent.