The number of uninsured Americans increased in 2018, marking the first increase in the uninsured rate since the Affordable Care Act passed in 2010, with experts laying at least part of the blame at the doorstep of the Trump administration and their efforts to undermine the healthcare law.

Roughly 27.5 million people, or 8.5% of the population, lacked healthcare for all of 2018, up from 7.9% in 2017, according to data released by the U.S. Census Bureau on Tuesday.

Virginia did not experience a change in its uninsured rate, however, as the percentage of Virginia residents without healthcare stayed at 8 percent. This number does not take into account the state’s Medicaid expansion, which took effect in January 2019.

Prior to the Affordable Care Act, more than 15% of Americans lacked insurance, but President Obama’s signature legislation allowed millions of Americans to obtain coverage for the first time. 

Since taking office in 2017, President Trump and his fellow Republicans have attempted to gut the law at every turn. The Trump administration cut back on advertising and enrollment assistance for the healthcare marketplace, repealed the law’s individual mandate, and continues to actively support lawsuits seeking to repeal the law in its entirety.

If the ACA were repealed, the uninsured rate in Virginia would increase dramatically, as 642,000 Virginians could lose their health care coverage, including the more than 300,000 who benefited from the state’s expansion of Medicaid. 

While Virginia voted to expand its Medicaid program in 2018, many other states gave into pressure from the Trump administration and began to more frequently require families to prove their eligibility for Medicaid, the New York Times reports. As a result, 1.6 million fewer Americans were covered by Medicaid and the Children’s Health Insurance Program in 2018. 

“If you increase red tape you are going to lose people, many of whom are actually eligible for the coverage,” Joan Alker, a research professor at Georgetown University, told the Times.

The increase in uninsured Americans was especially noteworthy because the same report showed that the share of Americans living in poverty fell to 11.8%, the lowest level since 2001. 

Eliot Fishman, a senior director at the consumer group Families USA and a former Medicaid official in the Obama administration, emphasized the alarming nature of this fact when speaking to the Times. 

“It’s very frightening in that if this is happening now with unemployment at 3.7 percent, then what’s going to happen when the employer coverage situation gets worse?”