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Patients visits a free medical clinic. Photo: John Moore/Getty Images

Roughly 27.5 million people, or 8.5% of the U.S. population, had no health insurance at some point in 2018, according to new figures from the Census Bureau.

Why it matters: Last year's uninsured rate increased from 7.9% in 2017 — the first time the uninsured rate has gone up since the Affordable Care Act has been in effect.

Between the lines: The uninsured population does not include the "underinsured," or people who have medical coverage but face prohibitively high deductibles and out-of-pocket costs.

  • The figure also does not include people who have short-term plans, association plans and religious-based sharing ministries — policies the Trump administration has promoted, but that have holes in coverage that could leave people on the hook for high costs.

The intrigue: The type of coverage that witnessed the largest decline in 2018 was Medicaid, which fell 0.7 percentage points.

  • 4 states where the uninsured rate had a statistically significant increase were Alabama, Idaho, Tennessee and Texas, all of which have not fully expanded Medicaid under the ACA.

The bottom line: The uninsured rate is still markedly lower before the ACA became law, but it's an odd paradox to see more people lose health coverage even though the economy created more jobs.

Go deeper

Caitlin Owens, author of Vitals
4 hours ago - Health

Biden taps ex-FDA chief to lead Operation Warp Speed amid rollout of COVID plan

Photo: Alex Wong/Getty Images

President-elect Joe Biden has picked former FDA chief David Kessler to lead Operation Warp Speed, a day after unveiling a nearly $2 trillion pandemic relief plan that includes $400 billion for directly combatting the virus.

Why it matters: Biden's transition team said Kessler has been advising the president-elect since the beginning of the pandemic, and hopes his involvement will help accelerate vaccination, the New York Times reports. Operation Warp Speed's current director, Moncef Slaoui, will stay on as a consultant.

The case of the missing relief money

Illustration: Sarah Grillo/Axios

A chunk of stimulus payments is missing in action, thanks to a mix up that put as many as 13 million checks into invalid bank accounts.

Why it matters: The IRS (by law) was supposed to get all payments out by Friday. Now the onus could shift to Americans to claim the money on their tax refund — further delaying relief to struggling, lower-income Americans.

The post-Trump GOP, gutted

McConnell (L), McCarthy (R) and Trump. Photo: Erin Schaff-Pool/Getty Images

Republicans will emerge from the Trump era gutted financially, institutionally and structurally.

The big picture: The losses are stark and substantial.