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Healthcare.gov Finished Strong Despite Rocky Start, Enrollment Data Show

By Phil Galewitz

May 1st, 2014, 2:42 PM

Obama administration officials on Thursday predicted health insurance premiums would be stable next year despite concerns that not enough young and healthy people signed up through the online insurance exchanges.

“The risk pool is fundamentally large and varied to support that kind of pricing…in every state,” said Mike Hash, director of the office of health reform for the Health and Human Services Department. “We believe … premiums will be stable.”

The upbeat assessment came as the administration offered the broadest glimpse yet of the demographics of the 8 million Americans who enrolled in health insurance through the health law’s online marketplaces through mid-April. Open enrollment for this year has ended in nearly all states and will re-open in November.

About 28 percent of enrollees nationwide were the coveted 18- to 34-year-olds, the group least likely to need health services. Analysts have debated whether enough young and healthy people have enrolled to ensure that premiums don’t spike in 2015 because of the significant number of older enrollees, many of them with expensive health issues. Insurance premiums for next year won’t be known until fall.

The report details the scope of the last-minute surge –about 900,000 people, or 12 percent of the more than 8 million enrollees, signed up after March 31.

Florida enrolled nearly 1 million people, far more than any federal exchange state – and about 250,000 more people than Texas, which has a larger population and more uninsured residents. Both Florida and Texas were among a handful of states whose enrollment doubled since March 1.

More than 4.8 million additional individuals enrolled in Medicaid and the Children’s Health Insurance Program through the end of March, compared to enrollment before the marketplace opened last October. About half the states expanded Medicaid under the law to cover everyone with incomes under 138 percent of the federal poverty level, or $15,800 for an individual.  Some of those new Medicaid enrollees were previously eligible but not enrolled in the program.

The report found that 63 percent of enrollees who answered questions about their racial or ethnic background through the federal exchange identified themselves as white, 11 percent as Latino and 17 percent as black. Almost one third of enrollees did not provide that information, according to the report released the Obama administration.

The largest number of Latinos enrolled in border states, including Texas at 33.6 percent, New Mexico at 31.1 percent, Arizona at 24 .2 percent and Florida at 19.2 percent.

The states participating in the federal exchange with the largest share of African-American enrollees were Mississippi at 59.5 percent, Georgia at 38.6 percent and Louisiana at 37.9 percent.

The highest enrollment of Asians among federal exchange states occurred in Virginia at 17.7 percent, New Jersey at 16.3 percent and Georgia at 14.8 percent.

Among the 8 million enrollees, 54 percent are women and 46 percent are men. Federal officials said they expected that gender gap because women are generally more likely to buy insurance than men.

About two-thirds of enrollees chose a mid-level, or silver plan—largely because that was the best deal for consumers getting a government subsidy. Overall, about 85 percent of people buying plans received subsidies.

Just 20 percent chose bronze plans, which had lower monthly premiums but higher deductibles and co-payments.

Nationally, about 60 percent of  13.5 million people who started to apply for coverage on the marketplaces–and were deemed eligible for the exchange plans based on their income and insurance states — completed the enrollment process.  About 63 percent of people completed the enrollment process on the state exchanges and 57 percent completed it on the federal exchange used by 36 states.

The 8 million-plus enrollees exceeded the projection made by the Congressional Budget Office, which had originally forecast 7 million would sign up in 2014, then downgraded that to 6 million after the rocky rollout of the federal exchange made it almost impossible for people to sign up in October and November.

 

 

15 Responses to “Healthcare.gov Finished Strong Despite Rocky Start, Enrollment Data Show”

  1. Greg S. says:

    28 % is not enough… Your title is very misleading . this is all according to the federal gov.

  2. Larry says:

    Too bad Greg! It appears that the marketplaces are popular with all ages. when you add in Medicaid expansion it is even more popular. and that number would be even higher if all states had participated – probably would’ve cut the number of unemployed by half. I want to see the republicans come back and take health insurance away from 15-20 million people.

  3. Sheldon Weisgrau says:

    @ Greg S: Whether or not 28% is “enough” depends entirely on the assumptions made by the insurers in setting rates. If they assumed a higher proportion of 18-34 years olds would enroll, their rates may be too low. If they assumed a lower proportion, their rates may be too high. Without knowing the assumptions used by the actuaries, it’s impossible to draw any conclusions.

    The likely outcome: some got it right, some didn’t. Just like every other year . . .

  4. The state I live in did not expand Medicaid I really hope the Governor is not reelected.
    Its so unfortunate the state I love doesn’t care about its taxpayer’s enough to try to help the less fortunate. I live in PA.

  5. Nichelle Smith says:

    Expanding Medicaid is not the answer. Bringing jobs that offer better insurance THAN Medicaid is. It is still about the economy! More good jobs means better quality and access to insurance.

  6. JWan says:

    And – exactly how many of the 8 million people who enrolled actually paid for the insurance by the deadline?

  7. JWan says:

    And – exactly how many of the 8 million people who enrolled in Obamacare actually paid for their plans by the deadline?

  8. Melissa says:

    Well said, Nichelle. Well said.

  9. Sheldon Weisgrau says:

    @JWAN, insurers report that 85-90% of enrollees have paid premiums. This is a pretty typical figure for the individual insurance market, which is historically volatile. A harder figure to get at is how many were previously uninsured, but looking at all available surveys and data sources seem to put that figure at 50-60%.

    When we add in the number of Qualified Health Plans purchased off the exchange, the kids under age 26 added to their parents’ plans, and those covered by Medicaid expansion, we have about 20 million people insured under the ACA. All signs point to a reduction in the number of uninsured in the U.S. of 9-10 million. That seems pretty good to me.

  10. Karl Bunkelman says:

    For Michelle, Melissa and any other like minded folks: If you or your children had to go for even one day without coverage, it can be a very stressful experience. This historic program will assure that kids can succeed in school without the handicap of untreated illness and parents will be able to focus 100 percent on their jobs increasing productivity. Re jobs, the real tragedy is that we didn’t do this 50 years ago so that employers, needing to compete globally, would not have found it necessary to send jobs overseas due to the cost of insurance and that thousands of potential small business startups would have had the ability to attract qualified employees with a decent, affordable health plan.

  11. William says:

    NICHELLE SMITH SAYS: Expanding Medicaid is not the answer. Bringing jobs that offer better insurance THAN Medicaid is. It is still about the economy! More good jobs means better quality and access to insurance.

    So, who do your think will bring those jobs? Congress? Did you vote to elect the tea party? So, you think the tea party you supported will be moving a jobs bill through Congress any time soon? Don’t be such a stooge!

  12. William says:

    JWAN SAYS: And – exactly how many of the 8 million people who enrolled actually paid for the insurance by the deadline?

    All of them!

  13. Jeff says:

    “Re jobs, the real tragedy is that we didn’t do this 50 years ago so that employers, needing to compete globally, would not have found it necessary to send jobs overseas due to the cost of insurance and that thousands of potential small business startups would have had the ability to attract qualified employees with a decent, affordable health plan.”

    I am not anti ACA at all. I just am wonereing how you draw the conclusion that small businesses all of the sudden have affordable coverage. In the real world, the small business accounts I serve as a broker are seeing steep increases (25-40%) in premium cost.

  14. Penelope says:

    I always wonder why people get so excited at the idea of Medicaid expansion. I understand that tax-wise it’s great for the state, and that it can get insurance to those who need it but couldn’t qualify before, but there’s something I’m not understanding: it’s called the “Affordable Care Act,” correct? Implying that health insurance should now be more affordable than it was previously. If that’s the case, shouldn’t we (rather than having expanded medicaid) see an onslaught of previous Medicaid enrollees move off of Medicaid and onto affordable commercial plans? Where are those figures? Did that happen? Maybe I’m missing it, but I have yet to hear about the number of people who were previously on government-funded healthcare but can now say that they’ve found affordable plans on the exchanges. In my mind that’s the most important item that healthcare reform could have achieved, and as things stand it looks like that’s not happening.

  15. Sam says:

    WILLIAM SAYS:
    MAY 1, 2014 AT 7:14 PM
    JWAN SAYS: And – exactly how many of the 8 million people who enrolled actually paid for the insurance by the deadline?

    The “deadline” is not a specific day because people seeking insurance did not enroll on a specific day. Many had problems with the web site and were delayed. Hence, it’s a rolling deadline. Most first payments for people enrolled by the end of March 2014 were due in mid to late April 2014. Latest reports from the biggest private insurers on the exchanges suggest that, so far, at least 90 percent of those enrollees have already paid their first payment. The insurers are still receiving payments from people that had problems with their initial enrollment process. Better estimates are forthcoming very soon. Bottom line, it’s working very well.

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