Healthcare gained only 18,000 jobs in January, the slowest monthly increase since January 2014, which marked the onset of the expanded coverage provisions of the Affordable Care Act, according to the Health Sector Economic Indicators briefs released by the Altarum Institute’s Center for Sustainable Health Spending.

By comparison, the 12-month and 24-month averages are both 31,000 jobs per month. Benchmark revisions lowered the 24-month growth rate by nearly 15%, from 37,000 to 31,000.

Health jobs grew 2.5% year over year, faster than the pace of non-health job growth at 1.5, and the health share of total employment is at an all-time high of 10.73%, according to the report.

“With all of the uncertainty surrounding the future of the Affordable Care Act, it is not surprising to see the slowdown in health sector hiring in January, though we will await February and March data before deciding if this is a blip or the start of a trend,” said Charles Roehrig, founding director of the Center. “Despite the large downward revision in data on health job growth over the past two years, the data still show faster growth following expanded coverage. We showed previously that faster growth was concentrated in states with higher levels of expanded coverage and will be updating this analysis in March when benchmark revisions in state-level data become available.”

Altarum Institute is a nonprofit health systems research and consulting organization. The research analyzed data from the US Bureau of Labor Statistics Employment Situation report.