Young Adult Health Insurance Sign-Ups Disappoint

WASHINGTON—The Obama administration so far is making little progress in getting more young adults to sign up for health policies on the federal insurance exchange, according to figures released Thursday.

Twenty-six percent of people who signed up for coverage as of Dec. 26 in the 38 states that use the federal exchange were ages 18 to 34, according to a report from the Centers for Medicare and Medicaid Services, which administers the law. That figure is largely unchanged from a roughly comparable two-month period through Jan. 16, 2015.

The numbers are below goals set by actuaries when the exchanges were launched in 2013. They estimated then that adults 18 to 34 would ideally make up 40% of the exchanges’ enrollment because the age group is generally healthier—which means they hold down premium rates by balancing out the greater medical spending of older enrollees.

Still, the percentage of new signs-ups among young adults is trending upward, federal officials said, though they said there isn’t comparative data to back up the contention.

The officials said they typically see a surge of younger people in the final weeks of the enrollment period, which continues through Jan. 31. The number for 2016 also will rise once the state exchanges’ sign-ups are added.

“We’re encouraged that marketplace consumers are increasingly young, engaged and shopping for the best plan,” Health and Human Services Secretary Sylvia Mathews Burwell said in a statement Thursday.

In 2014, about 28% of people picking plans on the federal exchanges were 18 to 34 years old.

The number of young people overall who are signing up—both young adults and children—was unchanged. Thirty-five percent of people who signed up or renewed coverage on the federal exchange as of Dec. 26 were under age 35, similar to the roughly comparable time period through Jan. 16, 2015.

Still, overall enrollment of healthy people of all ages matters for maintaining affordable premiums on a state-by-state basis.

Among all enrollees, more than 11.3 million people are signed up for coverage through both federal and state exchanges, the administration said. That includes 8.6 million people, or 76%, on through Jan. 2, and 2.7 million, or 24%, in the remaining 13 states that operate their own exchanges, through Dec. 26.

While some people who enroll for coverage fail to pay their premiums, the Obama administration should exceed its goal of having about 10 million people with paid coverage by the end of this year.

As of Dec. 26, more than half of the 8.2 million customers on both state and federal exchanges had come back to actively select a plan. Among states that use, about 60% of enrollees had switched to a different plan for 2016. People who don’t switch are automatically re-enrolled and could see higher premiums if they don’t shop around.

There have been concerns that a dearth of young people would lead to a preponderance of older and sicker people that cause premiums to rise, forcing some younger and healthier customers to leave and premiums to further climb. That hasn’t occurred because the number of healthy people on the exchanges has been strong enough to prevent it.

“The insurance risk pools are generally stable at this point. The [Affordable Care Act] looks to be sustainable,” said Larry Levitt, a senior vice president at the Kaiser Family Foundation. “Enrollment growth is key to further success,” Mr. Levitt added, with more uninsured people covered and more young and healthy people signing up.

The Obama administration and advocacy groups involved with enrollment have put an emphasis on getting younger Americans to sign up to help balance the market.

UnitedHealth Group Inc., the biggest U.S. health insurer, said in November it was considering withdrawing plans sold under the insurance exchanges because it had suffered major losses on the policies.

Meantime, Republicans in Congress passed a bill this week to overturn key provisions of the health law, though Mr. Obama promised to veto it.

Premiums have risen for many insurance plans in 2016. But the federal tax penalty under the health law for not having coverage also has climbed, and starts at $695 per adult in 2016, providing an incentive for people to get insured.

The Obama administration said that, nationwide, about four million people under age 35 signed up on either the federal or state marketplaces through Dec. 26. Nearly three million were between the ages of 18 and 34.

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