The number of uninsured children in the U.S. increased for the second year in a row and now tops 4 million, the most since ObamaCare became law, according to a new report released Wednesday.

According to the Georgetown University Center for Children and Families, the number of uninsured children increased by more than 400,000 between 2016 and 2018.

The report found that the increase has wiped out a large share of the coverage gains made since the enactment of the health care law in 2014. The report specifically cited the confusion surrounding the Trump administration’s failed attempt to repeal ObamaCare, the successful elimination of the law’s individual mandate and a months-long delay in funding the Children’s Health Insurance Program (CHIP) as reasons for the lack of coverage.

Read more at The Hill.