Posted on Monday, 01.13.14

HEALTHCARE


Women and older Americans lead the way in Obamacare signups—in Florida and the nation

Young adults who can stabilize insurance markets have yet to sign up for Obamacare in expected numbers

BY DANIEL CHANG
DCHANG@MIAMIHERALD.COM

In Florida, as in the nation, women and older adults are signing up for health insurance in greater numbers than any other group using the Affordable Care Act’s insurance exchanges.

The state’s pace reflects a national trend among the more than two million Americans who have signed up through December.

The Obama administration on Monday unveiled for the first time age, gender and financial aid data for the insurance exchanges, revealing that in Florida and the nation, more than half of all those who signed up are women, and about one in three enrollees are between the ages of 55 and 64.

Women and older Americans have been expected to sign up in large numbers because traditionally they have paid higher prices for health insurance than men and younger people.

Young adults are key to creating stable insurance markets because they are expected to subsidize older and sicker adults. But fewer young adults than the Obama administration expected have signed up so far, according to enrollment numbers released by the U.S. Department of Health and Human Services.

Nationally, about one in four enrollees, or roughly 489,000 individuals, were in the 18 to 34 age group. That held true in Florida, too, where roughly 21 percent, or about 33,000 individuals, were 18 to 34.

About 36 percent of Floridians who selected a plan, or more than 56,000 people, were between 55 and 64. Florida also saw women participate in greater numbers, making up about 55 percent of enrollees who selected a plan, or 86,000 people.

Nationally, about 710,000 people are in the 55-to-64 age group, and women make up about 1.16 million individuals.

Speaking with reporters Monday, HHS Secretary Kathleen Sebelius said she was encouraged by the overall picture, saying, “There is a very strong demand for national healthcare made possible by the Affordable Care Act.”

In all, Sebelius said, nearly 6 million Americans have signed up for a health plan on the exchange or been funneled into Medicaid. An additional 3 million adults younger than 26, Sebelius said, gained coverage through their parents’ health plans.

Florida continued to enroll the most people among the 36 states using the federally-run exchange at healthcare.gov, with 158,000 residents selecting a plan — the second-highest rate in the nation behind California, which uses a state-run exchange.

Also Monday, the report said about 1.7 million people qualified for financial aid to help pay their monthly premiums. About 60 percent, or roughly 1.2 million people, selected a mid-range, “silver” plan that covers 70 percent of their healthcare costs.

In Florida, about 83 percent or 131,000 enrollees qualified for financial aid. About 57 percent of those who signed up — roughly 90,000 individuals — selected a silver-level plan.

Michael Hash, director of HHS’s Office of Health Reform, acknowledged that the proportion of young Americans signing up is behind the hoped-for pace.

But he expects a surge as the March 31st enrollment deadline nears, and as the Obama administration’s marketing efforts continue through the spring.

“We expect an increase in the proportion of the young adults as we go forward,’’ he said. “We’re confident, based on the results we have now, that we’ll have an appropriate mix of individuals enrolled in coverage.’’

The Congressional Budget Office has estimated that 7 million Americans will get their insurance through the new health insurance exchanges in 2014.

The Kaiser Family Foundation, a California-based nonprofit that studies the healthcare industry, has projected that 40 percent of those who sign up — 2.8 million people — need to be between 18 and 34 to keep insurance markets stable.

Steven Ullmann, a healthcare policy professor at the University of Miami School of Business, called the current rate of young enrollees “OK,’’ but said a higher proportion of them would bring down costs.

“That adjusts the risk pool,’’ he said, “so you bring down the risk level overall.’’

Ullmann gave two reasons why young Americans may not be signing up yet: Procrastination, and a relatively low penalty for not fulfilling the individual mandate — $95 or 1 percent of annual income, whichever is greater.

For all the new enrollment data released on Monday, however, much remains unknown.

Federal officials acknowledged that they could not yet determine how many of the Americans who have selected a plan or enrolled in Medicaid were uninsured before.

The data also failed to provide details about plan selection by county, or whether consumers were willing to pay higher premiums for a wider network and a lower deductible.

“It would be interesting to see how people are making decisions there as well,’’ Ullmann said. “How much choice are they willing to give up relative to price?’’.

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