TUPELO (TNS) — Mississippi is bucking the national trend, with about 16,000 fewer people signing up for the Affordable Care Act through the end of December as compared to last year.

Nationally, 11.5 million people have signed up for plans through Dec. 31, 286,000 more than for the same time period last year.

“Mississippi just isn’t consistent with national trends,” said Roy Mitchell of the Mississippi Health Advocacy Program.

The national increases come despite the push to repeal and replace the Affordable Care Act.

“The market is not just stable, it’s on track for growth,” said Aviva Aron-Dine, a senior official with the U.S. Department of Health and Human Services during a press conference call earlier this week.

Both the U.S. Senate and House took the first steps to roll back parts of the Affordable Care Act this week, setting the stage to use the budget reconciliation process. Republican Congressional leaders, including Mississippi Sen. Roger Wicker, have spoken about the need to create a process that provides a soft landing for those who access health insurance through the exchange or benefit from other provisions of the law.

Insurance and subsidies secured through the healthcare.gov exchange by Jan. 31 would be in force for the remainder of 2017.

In Mississippi

The 16 percent drop in Mississippi’s enrollment likely reflects the difficulty Mississippians have had maintaining health insurance coverage. Citing an Enroll America analysis, Get Covered MS project director Lottie Minor says the decline in Mississippi’s enrollment rate is a market correction of a sort.

Last year, more than 108,000 Mississippians signed up at Healthcare.gov by the end of January 2016. However, only 77,000 people put the coverage into effect by paying their first month premium by March 31.

Mississippi’s attrition rate is twice the national average. Health insurance is complex and can be bewildering to people signing up and using it for the first time. At the heart, it remains an education problem, Mitchell said.

“The main cause of attrition is people don’t understand health insurance and get very frustrated with it,” Mitchell said.

During sign up this year, there were 9,000 fewer people who reenrolled in plans in Mississippi compared to last year. However, 5,000 more Mississippians actively reenrolled compared to last year instead of being automatically reenrolled.

The consumers who have put the insurance into action generally like the insurance and want to continue, Minor said.

“Our renewals are outpacing new people who come in to sign up for the first time. Most people see the value in it,” Minor said, even though the future is uncertain. “Nothing is changing right away.”

The debate swirling over repeal and replace is making an impact. Both organizations said they have received a lot of calls.

“There is a lot of concern among Mississippians about what is going on in Congress,” Mitchell said. “Despite the confusion, consumers can and should get coverage.”

People who need assistance beyond healthcare.gov can use Health Help Mississippi at 877-314-3843 or Get Covered Mississippi at 855-699-2300.