The great healthcare jobs creation machine kept cranking in January despite industry uncertainty over plans to repeal and possibly replace the Affordable Care Act.

The industry produced 18,300 new jobs in January, raising overall employment in the sector to 15,617,200, according to the January jobs report from the Bureau of Labor Statistics.

That’s up 374,300 jobs from a year ago and 58,500 from Nov. 2016 when President Donald Trump won the presidency in an upset.

Trump is making repeal of ACA one of his first orders of business. The program has helped up to 30 million people gain insurance.

Overall, non-farm jobs grew a solid 227,000 in January to 145.8 million.

Healthcare, the industry that led the charge in jobs growth throughout 2016, saw construction and retail trade shoulder more of the lifting in January.

Construction produced 36,000 new jobs in January, while clothing and clothing accessory stores matched healthcare with 18,300 jobs. Construction, though, is responsible for 6.8 million total jobs, less than half that of healthcare.

Breaking down the healthcare sector, ambulatory healthcare services led the way with 11,000 new jobs in January. The segment employed 7.2 million people.

Hospitals also hired 4,000 more people in January, bringing its overall employment to 5.1 million.

Healthcare was the top job-producing sector over the past two years. It added 406,600 jobs in 2016 and 474,700 jobs in 2015.

While the 18,300 new jobs in January was about half of the average monthly gain made by healthcare in 2016, the sector more than continued to hold its own compared with other sectors.

Announcements made by Trump and Republican leaders to slash the ACA have been met with dire job-loss predictions.

Last month, the Commonwealth Fund and the Milken Institute School of Public Health at the George Washington University found that repealing key provisions of the ACA, including the insurance premium tax credits and Medicaid expansion, could lead to 2.6 million people losing their jobs in 2019. By 2021, nearly 3 million jobs in healthcare and other sectors could be lost.

That healthcare continued to add jobs in January illustrates that hospitals, physicians and other providers aren’t panicking over the likely ACA repeal, said Megan Neuburger, managing director at Fitch Ratings.

Even if ACA went away, federal law requires hospitals to staff facilities to take care of people who lost their insurance. Those hospitals just wouldn’t get paid for it, Neuburger said.

Basic healthcare volumes are still solid and the ACA debate has done little to change that so far, she said. “It’s business as usual,” she said.

What has changed dramatically is the shift of employment to ambulatory services from the hospitals as private insurers and the government have tried to reduce costs by moving volumes to less-costly settings, said Candace Hunter, chief economist at KPMG.

Since November, 2015, year-over-year growth rate for hospital employment has slowed to 2.2% from 2.8% at that time, she said.

The ambulatory sector today employs about 43% of healthcare workers vs. 35% in hospitals, which is almost the reverse of what it was in 1990, Hunter said.