The number of people covered by insurance premiums has fallen for the second straight year, the largest annual decline in more than a decade.

Insurance market shares, or market shares that insurers sell through their own network, are the most closely watched data source of insurance industry analysts, but they have been underrepresented in the research and commentary surrounding the issue.

That’s according to a new study released on Monday by the Institute for Health Information, which surveyed the insurance industry for insight into the state of the market.

The survey found that in 2018, insurers sold 6.5 billion insurance policies.

That’s a decrease from 7.4 billion in 2017, and a decline of over 2.5 percent from 8.9 billion in 2016.

The increase in insurance coverage, however, comes at a cost: A record 43.5 million people in the U.S. were uninsured in 2019, the last year of the Obama administration’s Affordable Care Act.

That means insurance companies lost a record $7.7 trillion in profits last year, according to data compiled by Bloomberg.

The decline in the number of uninsured Americans also came as the nation continues to grapple with the opioid epidemic, with the number seeking care at a record high last year.

More than 200,000 opioid-related deaths occurred in the first nine months of 2019, according the Centers for Disease Control and Prevention.

The study also found that insurers have experienced a spike in new customers since the ACA’s open enrollment period opened.

In 2017, the average premium increase per policy was 0.1 percent.

In 2018, it jumped to 0.7 percent.

This year, it has been at 1.1% in 2019.

The study noted that insurers in 2019 also saw their overall average premiums decrease by more than 7 percent.

The drop in coverage has resulted in lower costs, as more people in states with more expensive premiums are now choosing to go without insurance.

The average annual cost per policy in 2019 was $8,000, according.

For a family of four with coverage in 2019 of $45,000 in New York, that would be $1,000 more than in 2017.

In New Jersey, the number for a family with coverage of $18,000 was $1.10 more than it was in 2017.

“Insurers have also experienced a decline in rates for people with preexisting conditions, as well as those with pre-existing conditions, the study found.

A study in the Journal of the American Medical Association earlier this year found that more than 3 million Americans are now covered by an insurance plan through a pre-preexisting condition, and that the number was expected to reach more than 6 million in 2019 and reach 6 million by 2026.

The researchers said that insurers had been able to lower their premiums, even as the rate increases were higher than anticipated.

In the future, the report said, insurers could face additional challenges as more and more people enter the market, particularly those who are under age 65.

The researchers also pointed to other factors contributing to the drop in insurers’ premium revenue, including a rise in premiums and deductibles.

The institute said that in the past two years, insurers’ premiums increased by an average of $20 per person for an individual plan, $1 for a small group plan, and $10 per person per household for a group plan.

The increase was due to the ACA expanding eligibility for Medicaid, which is often subsidized by insurance companies.

The report also noted that the average deductibles increased by $1 in 2018.

Insurers had previously reported a net loss of $7 billion in 2019 alone, but that figure was inflated because it included a net gain of $3 billion in deductibles and other costs.