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Affordable Care Act

In this file photo, Nurse Practitioner Sarah Jauron, right, examines Yolanda Ashley of Davenport at the Community Health Care Clinic. The U.S. Census Bureau says just 4.3 percent of Iowa's population is without health care coverage.

The number of Iowans who did not have health insurance dropped by 23,000 between 2015 and 2016, according to new government data released Tuesday, leaving just 4.3 percent of the state's population without coverage.

That's down from 5 percent in 2015.

Since 2013, the year before the major provisions of the Affordable Care Act kicked in, the percentage of Iowans without health insurance has been nearly cut in half.

Then, 248,000 people, or 8.1 percent of the population, did not have health insurance. The government said Tuesday that 132,000 Iowans were without insurance last year.

The new figures were provided Tuesday by the U.S. Census Bureau, which also released national figures for health insurance coverage, income and poverty.

Nationally, the uninsured rate fell from 9.1 percent to 8.8 percent, with the number of people without coverage declining from 29 million to 28.1 million.

In Illinois, 6.5 percent of the population was without insurance, down from 7.1 percent the year before and 12.7 percent in 2013. A total of 817,000 Illinoisans were without insurance last year, about half what it was in 2013.

How long those gains will continue to be maintained isn't clear.

Insurers have been fleeing marketplaces, citing financial losses and uncertainty. Attempts to repeal and replace the Affordable Care Act by President Donald Trump and Republicans in Congress have failed. In addition, the president has sent conflicting signals on what parts of the law will continue to be enforced.

Iowa's individual marketplace is in flux. Just one insurer, Minnesota-based Medica, has expressed an interest in continuing to participate in the Obamacare exchange next year, and then only by asking for a big premium rate increase.

The Iowa Insurance Division has asked the Trump administration to approve a waiver that would allow insurers in the market to offer a single, standardized plan of coverage, as well as put in place a redesigned set of premium tax credits and a reinsurance program that would help with high-cost beneficiaries.

The request is pending.