More people are uninsured in the United States than at any point since 2014, with women, young adults and lower-income people reporting the biggest jump, according to the latest survey by Gallup.

The Gallup National Health and Well-Being Index shows 13.7 percent of U.S. adults were without health insurance in the fourth quarter of 2018. It is still below the high of 18 percent reached right before the Affordable Care Act (ACA) took effect. The results are based on a survey of about 28,000 randomly selected adults.

State-level data was not available for 2018. In 2017, New Jersey’s uninsured rate was between 8 and 10 percent, below the national rate of 12.2 percent for that year.

Gallup cites a number of factors for the increase, including:

  • increased insurance premiums in many states for some of the more popular ACA insurance plans;
  • decreased marketing for open enrollment and shortened enrollment periods;
  • uncertainty in the marketplace with President Donald Trump’s attempt to eliminate the ACA; and
  • Trump’s decision to end cost-sharing to offset some premiums costs for lower-income Americans.

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