Driven by a drop-off in enrollment after
A total of 12.2 million Americans enrolled in a plan through one of the healthcare law's marketplaces during the 2017 open enrollment period, according to the report, which provides a final tally of this year's signups.
The 2017 final figure, which updates a preliminary report released last month, was down from 12.7 million in 2016.
Enrollment had been running slightly ahead of last year's pace until Trump took office Jan. 20.
The drop-off — which came after slow but steady increases in 2015 and 2016 — has fed criticism that the new administration has deliberately tried to undermine the marketplaces.
Within days of taking office in January, the administration pulled television ads urging Americans to sign up for health insurance.
Trump also issued an executive order in which he suggested his administration wouldn't implement rules crucial to sustaining markets, although the administration later issued other rules to help stabilize insurance markets.
Several major insurers have pulled out of the marketplace over the past year, citing losses from sicker-than-anticipated customers. Many insurers that remained increased premiums sharply this year.
Low- and moderate-income shoppers qualify for subsidies to offset the costs of their monthly premiums.
The House Republican bill to repeal and replace the Affordable Care Act would dramatically scale back financial assistance now available to many lower-income and older consumers. More than 80% of marketplace customers now get assistance.
GOP leaders say they also want to roll back rules that require insurers cover basic benefits, though those requirements are not eliminated in the current House legislation.
Overall, the marketplaces and the expansion of state
More than 20 million previously uninsured Americans have gained health insurance, data show, and the nation's uninsured rate dropped to the lowest level ever recorded.
9:50 a.m.: This article was updated with staff reporting.