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Young adults make up one-fourth of Obamacare enrollees

Politico

By: Kyle Cheney & Jason Millman

Just under a quarter of Obamacare sign-ups so far have been in the critical 18-to-35-year-old age range, the Obama administration revealed Monday, the first time officials have given demographic data about health plan enrollees.

The administration had set a goal of around 38 percent to 40 percent of the enrollees in that age bracket by the time the sign-up season ends March 31.

The administration’s monthly enrollment update showed 2.2 million people had picked health plans in the federal or state health exchanges from Oct. 1 through Dec. 28. It’s not yet clear how many have paid their first monthly premium, a requirement before coverage can begin. An additional 3.9 million people have been deemed eligible for Medicaid.

More than half of those who have signed up are between 45 and 64, an age range that tends to be sicker and costlier to cover, according to the enrollment figures released Monday by the Department of Health and Human Services.

Young adults have to sign up in sufficient numbers to keep premiums in check and the health insurance market stable. Administration officials say the trends are going in the right direction at the midway point in enrollment.

“We are confident, based on the results we have now that we’ll have an appropriate mix,” said Mike Hash, director of HHS’s Office of Health Reform.

The HHS data also showed that nearly four in five of the new sign-ups have been deemed eligible for premium subsidies.

Republican leaders in Congress quickly pounced on the data to suggest Obamacare had fallen short once again.

“No group has been hit as hard by the Obama economy and Obamacare as America’s young people. After seeing massive premium increases and failed bureaucracy in the Obama administration, it’s no wonder they are staying away,” said Don Stewart, a spokesman for Senate Minority Leader Mitch McConnell.

House Speaker John Boehner’s office said the figures prove the health law has been “a bust so far.” “When they see that Obamacare offers high costs for limited access to doctors — if the enrollment goes through at all — it’s no surprise that young people aren’t rushing to sign up,” said Boehner spokesman Brendan Buck.

Administration officials insisted the age disparity was expected at this midpoint. Younger people, they argued, tend to procrastinate or at least wait until the bugs get worked out of the sign-up system, while older and likely sicker people were more motivated to get covered, despite the flaws in HealthCare.gov and some state-run exchanges.

A senior administration official said that enough younger people already had enrolled to avoid an insurance “death spiral” — which would make insurance costs skyrocket. Citing a Dec. 17 report from the nonpartisan Kaiser Family Foundation on insurance markets and youth enrollment, which he said basically found “that even if you only have 25 percent of your marketplace, of your composition being 18 to 34, that essentially takes death spiral off the table, that essentially you have a sustainable marketplace and that premiums would only be affected by a couple of percentages per person.”

Advocates for youth enrollment agreed. Monday’s HHS report “suggests we’re on the right track,” said Aaron Smith, executive director of Young Invincibles, which backs the president’s heath care law.

But some health insurers are getting nervous. Humana on Thursday warned investors that its enrollment mix is “more adverse than previously expected.”

The figures are a snapshot of the first Obamacare beneficiaries, whose coverage went live on Jan. 1. In general, the administration was bullish about the new numbers, saying they tracked closely with Massachusetts’s experience with its 2006 health care law.

“It is a brand-new day for health care for millions of Americans,” HHS Secretary Kathleen Sebelius said in a conference call with reporters.

About 60 percent of people signing up for exchange coverage are picking “silver” plans, which typically cover 70 percent of a person’s health care costs. Cheaper bronze plans accounted for 20 percent of sign-ups, while 20 percent picked richer gold and platinum plans. As a rule, the higher-cost plans include broader networks of doctors and hospitals and lower co-pays and deductibles.

Just a little more than 20,000 people had signed up for catastrophic health plans, which until recently were available only to people under 30 or older people who couldn’t find coverage under an affordability threshold in the law. The administration last month said it would also allow people whose health plans had been canceled to purchase catastrophic coverage this year.

The data released by the administration does not specify how many of the enrollees were previously insured, how many people have sought exemptions from the coverage mandate and the number of people who have actually paid their first premium.

Some states running their own insurance exchanges are reporting the number of people who’ve paid their first monthly premium. For instance, Rhode Island on Monday said that 11,770 people had signed up, including about 2,000 people who hadn’t yet paid through the first week of January.

HHS also said that 54 percent of enrollees were women, with a sharper disparity in some Southern states that have been particularly resistant to the president’s health care law, including Mississippi, Louisiana and Alabama. There, about 60 percent of all new enrollees were women. Federal officials said they couldn’t explain the wide variation.

Likewise, some states featured a far older enrolling population. About two-thirds of sign-ups in Arkansas, West Virginia and Wisconsin are between 45 and 64 years old. Maine (64 percent) and Ohio (61 percent) weren’t far behind. Federal health officials suggested “underlying demographics” could be influencing the age mix in those states.

“West Virginia is a state that has an older population,” said Nancy Delew, HHS acting deputy assistant secretary for planning and evaluation. “We expect that they might have an older share of enrollees.”

The District of Columbia’s exchange has the highest proportion of younger enrollees — though just 3,043 had picked exchange plans by the end of December, according to HHS numbers. Thirty-seven percent are in the 26-34 age group, and 20 percent are in the 35-44 age group.