The 2018 Commonwealth Fund Biennial Survey, taking a big-picture look at health insurance coverage in America eight years after passage of the Affordable Care Act, finds that the uninsured rate among adults ages 19 to 64 for 2018 was 12.4 percent, statistically unchanged from 2016 — despite actions taken by the Trump administration and Congress to weaken the Affordable Care Act. Since 2010, more people have health insurance, the survey finds, but a higher share of U.S. adults are “underinsured,” meaning they have high health plan deductibles and out-of-pocket medical expenses relative to their income.