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The ACA Biweekly snapshot of weeks 10 and 11

As the Affordable Care Act open enrollment season wraps up for 2017, the Centers for Medicare and Medicaid Services (CMS) is reporting a significant boost in signups. Over 8.8 million Americans have enrolled in a qualifying healthcare plan via the federal marketplace at HealthCare.gov, representing an increase of nearly 100,000 people during the same timeframe last year. President Donald Trump, who has been particularly vocal in his stance against the ACA, was sworn into office at the end of last week. Since then, several executive orders indicate that he has big changes in mind for the future of American healthcare reform. Despite the shift in tone with a new administration, enrollment numbers for former President Obama’s signature healthcare law continue to climb.

The most recent biweekly snapshot is based on the period from January 1 through January 14 and includes only those states that use the federal exchange site. State marketplace enrollment, which applies to the 12 states that currently administer their own exchanges, has not been included in the total. Since open enrollment began in November, about 2.8 million people have signed up for coverage using state-based marketplaces. In total, over 12.6 million Americans have enrolled in Obamacare this season.

The CMS tracks enrollment on a biweekly basis, noting that there’s still high demand for the kind of health insurance available on federal and state exchanges. Under Obamacare, health insurance is guaranteed issue, which means that people with pre-existing conditions can’t be denied coverage or charged higher premiums. There are also subsidies available on and off the exchanges, making insurance more affordable for most consumers. According to the Department of Health and Human Services, approximately 85 percent of enrollees can get help paying their premiums using federal subsidies.

Cost-saving subsidies are just one feature of the current healthcare law that may be subject to change under a Trump administration. Key leaders within the Republican Party, such as House Speaker Paul Ryan, want to replace income-based tax credits with credits based on age. Exact dollar amounts for these subsidies have yet to be released. About 20 million people stand to lose their current health insurance if the ACA is repealed.

The end of January typically marks a surge in signups as people decide last minute to enroll in health insurance. This year may be different given strong opposition from the new administration. Promotional efforts, which typically amp up around this time of year, may be halted as Trump continues to undermine Obamacare. In any case, enrollment for this year indicates that there’s still significant demand for comprehensive and affordable health insurance.

In addition to higher enrollment figures, the CMS snapshot also shows that more people are concerned about the future of health insurance now that Republicans have taken the helm in Washington. Over 1.3 million people called in to the HealthCare.gov customer service center between January 1 and January 14, about a tenth of the total number of phone calls since open enrollment started. Nearly 4 million people used the federal marketplace during the most recent two-week stretch.

States with the highest enrollment totals so far include Florida (nearly 1.7 million), Texas (over 1.1 million) and North Carolina (over half a million). These states use the federal marketplace. States that run their own marketplaces have not been included in the CMS totals. In California, which does utilize its own exchange, more than 320,000 new customers have signed up for health insurance since November 1. New York has seen an even bigger surge in enrollment with over 3.5 million signups as of January 19.

Trump has indicated that he plans to dismantle the individual mandate, which requires eligible Americans to get covered for the calendar year. But for now, that mandate is still in place and still applicable to this year’s filing status. Consumers face a penalty of $695 or 2.5 percent of their household’s taxable income – whichever is higher – for failing to enroll. The deadline to sign up for health insurance in 2017 is January 31. Coverage will start on March 1.