Health care enrollment rises; more young adults sign up

Tony PughMcClatchy Washington Bureau

Nearly 3.3 million Americans have enrolled in health coverage on state and federal health insurance marketplaces as of Feb. 1 and sign-up rates for young adults continued to grow, according to new figures released Wednesday by the Obama administration.

The federal marketplace has logged 1.9 million enrollees since enrollment began in October, while another 1.4 million have signed up for insurance coverage through state-based exchanges. The new sign-ups keyed a 53 percent enrollment jump over the previous three-month reporting period.

The new January numbers come the same day that a new Gallup Poll found the nation’s uninsured rate had fallen to a five-year low of 16 percent from 17.1 percent in the fourth quarter of 2013.

“While more than a month remains in the first quarter, the preliminary data show the uninsured rate appears to be on track to drop to the lowest quarterly level measured since 2008,” Gallup reported.

The Gallup estimates, based on phone interviews with more than 19,000 adults, may vary over time, but “if the uninsured rate continues to fall over the next several months, it may suggest that the Affordable Care Act’s requirement for most Americans to have health insurance, which took effect on Jan. 1, is responsible for the decline,” according to the polling organization.

With just over six weeks remaining before the marketplace enrollment period ends on March 31, total U.S. enrollments are 2.7 million shy of reaching the estimated 6 million sign-ups that the Congressional Budget Office recently projected for the 2014 coverage year.

The CBO originally expected 7 million people to enroll before technical problems with the website caused them to reduce that estimate by one million.

Officials at the U.S. Department of Health and Human Services could not determine how many of the new enrollees were previously uninsured, how many have paid their premiums or how many enrollments were cancelled because of non-payment.

But Health and Human Services Secretary Kathleen Sebelius said most new enrollees are paying less for coverage.

“As they learn about their new coverage options, Americans are finding getting covered has never been more affordable,” she said in a telephone press call with reporters. “Eighty-two percent of those who have signed up for marketplace plans are receiving a lower-cost premium.”

On, more than 90 percent of people who select “silver” plans that cover at least 70 percent of medical costs, are also paying less for coverage, Sebelius said.

Young adults ages 18 to 34 accounted for 27 percent of January sign-ups, up from 24 percent from October through December.

In January alone, more than 318,000 young adults signed up for coverage, compared to more than 489,000 who enrolled between October and December.

That 65-percent increase – from 489, 000 to more than 807,000 total young adults enrolled – was the largest increase for any age group in January, Sebelius said. Between October and January, one in three marketplace enrollments were under age 35, she added.

A strong mix of young adults, who are generally healthier and cheaper to insure, are crucial to keeping premiums affordable under Obamacare. Administration officials have estimated that roughly 40 percent of new marketplace plan members need to be under age 35 to offset the coverage costs for older plan members who are typically less healthy and more expensive to cover.

Health law supporters were heartened by the new data.

“We are thrilled to see young adult enrollment rates continue to increase and expect this trend will continue as more learn that they can get help paying for their insurance,” said Aaron Smith executive director of Young Invincibles, a non-profit health care advocacy group for young adults.

Efforts to enroll young adults will increase this week as cities across the nation host more than 100 sign-up events as part of National Youth Enrollment Day on Saturday, Feb. 15.

The surge in young adult sign-ups matches similar trends in Massachusetts when the state’s universal health care initiative was launched in 2006, said Anne Filipic, president of Enroll America, a national support group for the Affordable Care Act.

“Based on past enrollment efforts, our research, and what we’re hearing in the field, we’ve always said that young people would wait until later in the open enrollment period to make their decision, and we’re now seeing that pattern begin to play out,” Filipic said.

While national exchange enrollment has reached 55 percent of projected sign-ups, individual state numbers vary dramatically. A new analysis by Avalere Health, a Washington health consulting firm, shows that 15 states have topped 60 percent of their expected enrollments for 2014, led by California at 118 percent of projected enrollment, Idaho at 98 percent and Washington at 94 percent.

Other high-performing states include North Carolina at 85 percent, Kentucky at 77 percent and Florida at 74 percent.

Lower-performing states include Alaska, 34 percent; Arkansas, 18 percent; and the District of Columbia, 22 percent.

"The latest data show that exchange enrollment continues to rebound following early technological problems although progress is uneven across states," said Caroline Pearson, vice president at Avalere. "The question remains if the final enrollment surge at the end of March will make up the ground lost in October and November."

Wednesday’s data also showed, for the first time, that most new enrollees – 62 percent – have selected “silver” health plans that cover at least 70 percent of medical costs. Nineteen percent have selected “bronze” plans that cover at least 60 percent, 12 percent picked “gold” plans that cover 80 percent and 7 percent chose “platinum” plans that cover 90 percent. Only one percent of marketplace enrollees have chosen catastrophic plans.

Other highlights from the new marketplace data: 55 percent of marketplace enrollees are females and 82 percent of enrollees have qualified for tax credits or other cost-sharing subsidies that offset the cost of coverage.

By Tony Pugh
McClatchy Washington Bureau