By KAREN MATTHEWS and JENNIFER PELTZ

NEW YORK (AP) — Americans commemorated 9/11 with solemn ceremonies and vows Wednesday to “never forget” 18 years after the deadliest terror attacks on American soil.

A crowd of victims’ relatives assembled at ground zero, where the observance began Wednesday with a moment of silence and tolling bells at 8:46 a.m. — the moment when a hijacked plane slammed into the World Trade Center’s north tower.

“As long as the city will gift us this moment, I will be here,” Margie Miller said at the ground zero ceremony, which she attends every year. She lost her husband, Joel.

“Because I feel like if we don’t come, they don’t need to do it. And I want people to remember,” said Miller, of Baldwin, on Long Island. After so many years of anniversaries, she has come to know other victims’ relatives, and to appreciate being with them.

“There’s smiles in between the tears that say we didn’t do this journey on our own. That we were here for each other. And that’s the piece that I think we get from being here,” she said.

President Donald Trump was expected to join an observance at the Pentagon. Vice President Mike Pence was scheduled to speak at the third attack site, near Shanksville, Pennsylvania.

Former President George W. Bush, the commander-in-chief at the time of the 2001 attacks, was due at an afternoon wreath-laying at the Pentagon.

The nation is still grappling with the aftermath of 9/11 at ground zero, in Congress and beyond. The attacks’ aftermath is visible from airport security checkpoints to Afghanistan. A rocket exploded at the U.S. embassy as the anniversary began in Afghanistan, where a post-9/11 invasion has become America’s longest war.

The anniversary ceremonies center on remembering the nearly 3,000 people killed when hijacked planes rammed into the trade center, the Pentagon and a field near Shanksville on Sept. 11, 2001. All those victims’ names are read aloud at the ground zero ceremony.

But there has been growing awareness in recent years of the suffering of another group of people tied to the tragedy: firefighters, police and others who died or fell ill after exposure to the wreckage and the toxins unleashed in it.

While research continues into whether those illnesses are tied to 9/11 toxins, a victims compensation fund for people with potentially Sept. 11-related health problems has awarded more than $5.5 billion so far. Over 51,000 people have applied.

After years of legislative gridlock, dwindling money in the fund and fervent activism by ailing first responders and their advocates, Congress this summer made sure the fund won’t run dry . Trump, a Republican and a New Yorker who was in the city on 9/11, signed the measure in July.

The sick gained new recognition this year at the memorial plaza at ground zero, where the new 9/11 Memorial Glade was dedicated this spring.

Some 9/11 memorials elsewhere already included sickened rescue, recovery and cleanup workers, and there is a remembrance wall entirely focused on them in Nesconset, on Long Island. But those who fell ill or were injured, and their families, say having a tribute at ground zero carries special significance.

Meanwhile, the Pentagon announced Monday that its 9/11 memorial will close next week for electrical and lighting work. The project, expected to take until late May, includes repairs to lighting glitches in the shallow reflecting pools under the memorial benches.

Sept. 11 is known not only as a day for remembrance and patriotism, but also as a day of service. People around the country continue to volunteer at food banks, schools, home-building projects, park cleanups and other charitable endeavors on and near the anniversary.

By CHRISTOPHER RUGABER and RICARDO ALONSO-ZALDIVAR

WASHINGTON (AP) — The number of Americans without health insurance edged up in 2018 — the first evidence from the government that coverage gains from President Barack Obama’s health care plan might be eroding under President Donald Trump.

The Census Bureau also said in an annual report Tuesday that household income rose last year at its slowest pace in four years and finally matched its previous peak set in 1999. Median household income rose 0.9% in 2018 to an inflation-adjusted $63,179, from $62,626 in 2017.

The data suggest that the economic expansion, now the longest on record at more than 10 years, is still struggling to provide widespread benefits to the U.S. population. Solid gains in household incomes in the past four years have returned the median only to where it was two decades ago. And despite strong growth last year in the number of Americans working full time and year-round, the number of people with private health insurance remained flat.

“While any reduction in poverty or increase in income is a step in the right direction, most families have just barely made up the ground lost over the past decade,” said Elise Gould, senior economist at the liberal Economic Policy Institute.

Though income inequality narrowed last year, it remains near record levels reached in 2017. Last year, the richest 5% of the U.S. population captured 23% of household income.

An estimated 27.5 million people, 8.5% of the population, went without health insurance in 2018. That was an increase of 1.9 million uninsured people, or 0.5 percentage point.

More people were covered by Medicare, reflecting the aging of the baby boomers. But Medicaid coverage declined. The number of uninsured children also rose, and there were more uninsured adults ages 35-64.

Though the increase in the number of uninsured Americans last year was modest, it could be a turning point, the first real sign that coverage gains under Obama could be at least partly reversed. This year, the number of uninsured could rise again because a previous Republican-led Congress repealed fines under the Affordable Care Act for people who remain uninsured if they can afford coverage.

The Census report is sure to play into 2020 presidential politics. Health care is the leading issue for Democrats, with proposals including Sen. Bernie Sanders’ call for a government-run system to cover everyone and former Vice President Joe Biden’s idea for expanding Obama’s law and adding a government plan open to virtually anyone.

Trump spent most of his first year in office unsuccessfully trying to get a Republican Congress to repeal the Affordable Care Act. He is now asking a federal appeals court to overturn it as unconstitutional. The president also slashed the program’s sign-up season ad budget and scaled back funding to help people navigate the enrollment process. Trump also removed a subsidy for insurers, thereby triggering a jump in premiums.

Yet ACA enrollment has held fairly steady, with about 20 million people covered by its mix of subsidized private plans and a Medicaid expansion for low-income individuals. The Census report found that Medicaid coverage declined by 0.7 percent from 2017.