Nearly 8.5 million Americans signed up for Affordable Care Act health plans for 2019 in the 39 states relying on HealthCare.gov — with a last-minute rush that suggests consumers were undeterred by a federal court ruling just before the deadline that deemed the law unconstitutional.

The tally as of midnight Saturday was a 4 percent drop from a year ago, according to federal figures released on Wednesday. The decrease from 8.8 million a year ago was significantly less precipitous because of a surge in Americans choosing ACA health plans during the final week.

After lagging by about 11 percent most of the six weeks of open enrollment — a shortened period adopted by the Trump administration a year ago — the more than 400,000 who selected coverage during the final week actually exceeded the year before.

The figures are not quite final, missing people who were awaiting help from federal call centers when the deadline arrived, as well as consumers in 11 states and the District of Columbia which run their own ACA insurance marketplaces and, in some cases, have later deadlines.

Nonethess, Seema Verma, administrator of the federal Centers for Medicare and Medicaid Services, which oversees much of the ACA, saidTuesday that the drop-off is a sign the Trump administration’s health-care policies are working.

In contrast to the initial chaotic year of the law’s enactment, when the website HealthCare.gov, was dysfunctional at times, this year’s enrollment was “seamless,” Verma said on a conference call with journalists.

She noted that enrollment for 2019 coverage lagged behind the nation in one state, New Jersey, that rejected two of the administration’s main strategies in the past year to weaken the ACA. President Trump signed a Republican tax law that eliminates a federal penalty for ignoring the ACA’s requirement for most Americans to have insurance, and Trump health officials have widened access to two types of skimpy health plans that are relatively inexpensive because they bypass the law’s required benefits and consumer protections. New Jersey overrode both and still ended up with a bigger enrollment drop than the national figure, Verma said.

On Friday night, with the enrollment deadline approaching in just over 24 hours, a conservative federal judge in Texas ruled in a lawsuit by Republican attorneys general that the entire ACA is invalid. Top health aides to Trump, who has been eager to dismantle the law, responded to the ruling by U.S. District Judge Reed O’Connor by trying to reassure consumers. For now, the law’s provisions remain in place, officials said, urging consumers to sign up on the final day, as usual.

Verma said Tuesday that the last day’s enrollment surge was milder than in previous years, but noted that the fact that the deadline fell on a Saturday could have played a role.


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