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Income Taxes
6 Months Ended
Jun. 30, 2019
Income Tax Disclosure [Abstract]  
Income Taxes
Income Taxes
During the three months ended June 30, 2019 and 2018, we recognized income tax expense of $314 and $450, respectively, which represent effective tax rates of 21.6% and 29.9%, respectively. The decrease in income tax expense and effective tax rate was primarily due to the suspension of the non-tax deductible Health Insurance Provider Fee, or HIP Fee, for 2019. For the three months ended June 30, 2018, we recognized additional income tax expense of $84 related to the HIP Fee.
During the six months ended June 30, 2019 and 2018, we recognized income tax expense of $708 and $918, respectively, which represent effective tax rates of 20.8% and 28.0%, respectively. The decrease in income tax expense and effective tax rate was primarily due to the suspension of the non-tax deductible HIP Fee for 2019. For the six months ended June 30, 2018, we recognized additional income tax expense of $167 related to the HIP Fee.