A recent editorial, “Our View: GOP attacks on ACA mean more uninsured” (Sept. 12), claims that an increase of nearly 2 million individuals without health insurance, about 0.5 percent, “is the direct result of actions by the Trump administration and Republicans in Congress to dismantle the Affordable Care Act.”

No, it wasn’t. For one thing, there is no evidence for the editorial’s assertion that “one of the biggest factors was the repeal of the tax penalty for people who don’t buy insurance.” A report by the Census Bureau details the actual reasons for the increase. One was a decline in Medicaid enrollments, which the Centers for Medicare and Medicaid Services attributes to the economic recovery and an increase in incomes, which has raised more families above the Medicaid qualifying level.

The other significant increase in the uninsured group occurred in households with incomes between 300 and 399 percent of the poverty level, or between $73,800 and $102,742 for a family of four. These families aren’t wealthy, but they don’t qualify for subsidies to help with insurance premiums, which have risen sharply since the passage of the ACA, and many have been priced out of the private insurance market.

Most Americans understand that the ACA needs to be fixed. Republicans have good ideas, but are too dysfunctional to agree on a comprehensive alternative. Progressives think the fix is to throw more money at Obamacare, or to double down with a hugely expensive single-payer system. This makes the outlook for constructive reform bleak.