Iowa is one of 17 states that saw an increase in the share of its population go without health insurance last year, according to survey results published Wednesday by Gallup.
It was the first time since the major provisions of the Affordable Care Act were implemented in 2014 that states saw increases in their uninsured rates, Gallup said.
In Iowa, the uninsured rate jumped from 3.9 percent in 2016 to 7.2 percent in 2017, Gallup said, one of the largest increases in the country.
That's just short of what it was in 2013, when Gallup’s survey said 9.7 percent of the population was uninsured.
Gallup found no statistically significant change in the other states. It said it was the first time since 2013 no state experienced a decline in the share of its population without health insurance.
Critics of the Trump administration blame it for sabotaging the Affordable Care Act, also known as Obamacare. They've criticized the administration for revoking the requirement Americans have health insurance, shortening the opportunity to sign up for plans, as well as repeated attempts to repeal the law, which they say created uncertainty for insurers and individuals.
Critics of the ACA have complained rising premiums are driving people away.
In Iowa, the state saw more than 26,000 people flee the state's Affordable Care Act-compliant individual marketplace in 2017, according to the state's insurance division.
All but one insurer fled the state's ACA marketplace in 2017, and the remaining company, Medica, raised its premiums by an average of 56 percent for 2018 plans.
Doug Ommen, the state's insurance commissioner, said Wednesday premiums have risen in the marketplace ever since the rollout of the ACA, and he expects the uninsured rate to go even higher next year. "The deterioration is going to continue," he said.
Ommen proposed restructuring the state's marketplace last year by revamping the premium tax credits that subsidize coverage for people making up to four times the poverty level. His plan would have based the credits on age and income, as well as offering a reinsurance plan to help insurers cover higher cost people.
The state withdrew the proposal last fall, though, saying ACA rules wouldn't allow it to be accepted.
The Iowa Legislature did approve a law this session allowing the sale of a health benefits plan that skirts the coverage requirements and protections of the Affordable Care Act, but it is expected to cost less.
The insurance division last month also extended the ability of 38,000 Iowans with transitional insurance plans to keep them through 2019. Those plans were sold after the ACA was passed in 2010 but before the major provisions took effect in 2014.
In the Gallup survey, West Virginia, New Mexico, Iowa and Hawaii were the only states to see their uninsured rates go up by more than 3 percentage points in 2017.
The Gallup state-based data was gathered from January to December of 2017.
Nationally, it said, the uninsured rate rose from 10.9 percent in the last quarter of 2016 to 12.2 percent in final three months of 2017.