While the Trump administration and Republicans in Congress spent the last year making repeated attacks on the nation’s healthcare system and the Affordable Care Act (ACA), 2017 saw the largest single-year jump in the uninsured rate since that law was implemented in 2010.

According to the Gallup-Sharecare Well-Being Index, released on Tuesday, more than three million Americans lost their health coverage in 2017, bringing the uninsured rate up to 12.2 percent. The end of 2016 saw a record low number of uninsured Americans, with 10.9 percent without coverage.

Households with incomes lower than $36,000 per year were among those that saw the biggest decline in coverage in 2017, a trend that analysts say is likely to worsen following President Donald Trump’s decision to end cost-sharing subsidies in October.

The subsidies allowed companies to provide insurance for low-income households, and even before Trump’s executive order in October, talk of their elimination caused some insurance companies to stop offering coverage through the state exchanges set up by the ACA. That in turn drove up the cost of insurance at companies that remained.

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