Maine’s Affordable Care Act sign-ups for 2019 are down by 5.5 percent, according to federal data released on Wednesday. The slight decline reflects a strong interest in purchasing ACA plans despite numerous efforts by the Trump administration to undermine the law, health experts said.

The numbers show plans selected from Nov. 1 through the end of open enrollment, Dec. 15.

Maine had 71,577 ACA enrollees in health plans that will start in January, down from the 75,809 who signed up for plans in 2018. Nationally, the year-over-year drop-off was 4.1 percent.

“With 8.5 million people signed up for health insurance for 2019 in the federal ACA marketplace, it is far from dead and remarkably resilient,” said Larry Levitt, senior vice president of the Kaiser Family Foundation, a health policy think tank, in a tweet.

The ACA marketplace is where individuals – often self-employed or part-time workers who traditionally have been priced out of health insurance – can purchase health benefits. Subsidies for those who earn up to 400 percent of the federal poverty limit, $100,400 for a family of four, help enrollees afford the insurance.

But the Trump administration has been hostile to the ACA, former President Obama’s signature domestic policy achievement. After a Trump-backed attempt by congressional Republicans to repeal the law failed in 2017, the Trump administration slashed advertising, in-person enrollment assistance, reduced the time period to enroll, eliminated the individual mandate penalty for not purchasing insurance, and supported a lawsuit that would dismantle the ACA. This year, a day before the last day of open enrollment – Dec. 15 – a federal judge in Texas ruled that the ACA was unconstitutional, but the law stands pending appeals, possibly to the U.S. Supreme Court.

The Supreme Court in 2012 ruled that the ACA was constitutional, but that was prior to approval of the 2017 tax cut law that gutted the individual mandate. Plaintiffs are arguing that eliminating the penalty for the mandate makes the law unconstitutional, an argument the Texas judge agreed with.

Mitchell Stein, a Maine-based health policy consultant, said that the “free plan factor” likely helped keep enrollments from plummeting more than 5.5 percent.

Since 2017, the ACA features zero-premium bronze plans for many lower-income enrollees. Stein said those who qualify for a zero-premium bronze plan – in Maine it’s roughly individuals who earn $25,000 or less – may have been more likely to use the automatic enrollment feature to maintain the same zero-premium plan. Heading into the final week of enrollment, 32,275 Mainers had selected a plan, so there was a surge over the final week.

“They may have checked to make sure they were still getting a zero premium plan and then used the auto-enrollment feature,” Stein said.

Stein said considering the Trump administration’s efforts to weaken the law, the slight decline was a “positive result.”

“I can’t help but think it could have been a lot worse. This goes to show that people value health insurance and continue to seek it out,” Stein said.

Joe Lawlor can be contacted at 791-6376 or at:

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