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Pro-Medicaid protesters on Capitol Hill. Photo: Bill Clark/CQ Roll Call via Getty Images

The Affordable Care Act’s insurance exchanges have been the law's headline feature over the past eight years, but the law’s Medicaid expansion has covered just as many people, and its rolls are more likely to grow under the Trump administration.

Driving the news: Roughly 8.8% of Americans were uninsured last year, according to new Census figures released yesterday — essentially unchanged from 2016. That means the Trump administration has not kept the ACA’s coverage gains going, nor has it successfully rolled them back — at least, not yet.

However you slice it, states that expanded Medicaid cover more people, with more stability.

  • The uninsured rate rose last year in non-expansion states, even as it held steady nationally.
  • It’s no big surprise that more low-income families would have insurance in expansion states than non-expansion states. But expansion states cover more people across the board, including people whose incomes would make them ineligible for Medicaid.

What’s next: The Trump administration has mostly muddied the waters for the ACA's exchanges, rather than blown them up. Its biggest threat to the Medicaid expansion is its willingness to approve work requirements for the program.

  • Those new rules are just getting started, and the impacts can be significant: Arkansas has booted more than 4,000 people off the program in just one month.

Yes, but: More states are also likely to opt into the expansion this year or next, and work requirements are facing a challenge in the courts.

  • The same judge who previously blocked Kentucky’s work requirements from taking effect will also decide the fate of Arkansas’ policy. Judge James Boasberg said yesterday that the two are related and he’ll keep them both.

Go deeper

Dion Rabouin, author of Markets
10 mins ago - Economy & Business

The fragile recovery

Data: Department of Labor; Chart: Axios Visuals

The number of people receiving unemployment benefits is falling but remains remarkably high three weeks before pandemic assistance programs are set to expire. More than 1 million people a week are still filing for initial jobless claims, including nearly 300,000 applying for pandemic assistance.

By the numbers: As of Nov. 14, 20.2 million Americans were receiving unemployment benefits of some kind, including more than 13.4 million on the Pandemic Unemployment Assistance (PUA) and Pandemic Emergency Unemployment Compensation (PEUC) programs that were created as part of the CARES Act and end on Dec. 26.

Ben Geman, author of Generate
30 mins ago - Politics & Policy

The top candidates Biden is considering for key energy and climate roles

Photo: Alex Wong/Getty Images

Senate Minority Leader Chuck Schumer (D-N.Y.) has urged President-elect Joe Biden to nominate Mary Nichols, chair of California's air pollution regulator, to lead the Environmental Protection Agency, Bloomberg reports.

Why it matters: The reported push by Schumer could boost Nichol's chances of leading an agency that will play a pivotal role in Biden's vow to enact aggressive new climate policies — especially because the plan is likely to rest heavily on executive actions.

U.S. economy adds 245,000 jobs in November as recovery slows

Data: BLS; Chart: Axios Visuals

The U.S. economy added 245,000 jobs in November, while the unemployment rate fell to 6.7% from 6.9%, the government said on Friday.

Why it matters: The labor market continues to recover even as coronavirus cases surge— though it's still millions of jobs short of the pre-pandemic level. The problem is that the rate of recovery is slowing significantly.