Even with a strong economy and robust job market, 700,000 people lost health insurance between 2016 and 2017, an Urban Institute study shows.

The uninsured rate national increased from 10% in 2016 to 10.2% in 2017, the first increase since 2013 and the advent of the Affordable Care Act. Under the ACA, the uninsured rate fell every year between 2013 and 2016 and 18.5 million people gained coverage, according to the study, which was commissioned by the Robert Wood Johnson Foundation.

The report found that population growth and increases in employer-sponsored insurance mitigated, but did not overcome, reductions in Medicaid and CHIP and ACA marketplace coverage.

The uninsured rate in Medicaid expansion states held at 7.6%, but grew from 13.7% to 14.3% in non-expansion states, which also lost marketplace coverage at twice the rate of expansion states.

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