Maine’s Affordable Care Act enrollment ticked up for 2025, as uncertainty over the future of the health insurance law loomed after the Trump administration returned to office this week.

Enrollment increased 3%, from 62,586 for 2024 to 64,678 for 2025, which is far below the peak enrollment of 84,059 in 2016. Signups dropped in Maine after the state fully implemented voter-approved Medicaid expansion in 2019. Those who qualify for Medicaid are not eligible for ACA insurance.

Open enrollment ran from Nov. 1 to Jan. 15 at www.coverme.gov.

ACA enrollment rebounded to 66,095 enrollees in 2022, but had gone down slightly until this year. ACA insurance is for people who would otherwise not have access to private insurance through an employer — such as those who are self-employed or work for small businesses that don’t offer insurance — but do not qualify for Medicaid and have not yet turned 65, which would make them eligible for Medicare.

President Donald Trump has been hostile to the ACA, and during his first term — which ran from 2017-21 — attempted to repeal the law. The ACA was former President Barack Obama’s signature domestic policy achievement and went into effect in 2013. Repeal attempts failed in 2017 when Republican Sens. Susan Collins of Maine, Lisa Murkowski of Alaska and the late John McCain of Arizona joined Democrats in a dramatic vote to turn back repeal efforts by one vote in the Senate.

It is unknown whether Trump would try again to repeal the law or look for other ways to weaken the law. Additional subsidies that were approved during the Biden administration are set to expire this year unless Congress and Trump extend them. Called enhanced health care tax credits, they help reduce premiums, including for upper-middle class earners.

“The enhanced health care tax credits have been critical in keeping coverage affordable, especially for Mainers who are older and live in more rural locations,” Hilary Schneider, director of Maine’s Office of the Health Insurance Marketplace, said in a written statement. “Without these tax credits, many Mainers will likely make the tough decision to go without health coverage or will have to cut other necessary expenditures in order to afford health coverage.”

Gov. Janet Mills said in a written statement that having health insurance “saves lives.”

“There isn’t anyone who doesn’t get sick, and there isn’t anyone who doesn’t need to see a doctor at some point. From Day 1, my administration has worked to make health insurance available for more Maine people,” Mills said.