24 Percent of Obamacare Enrollees Are Under 35, Data Show

24 Percent of Obamacare Enrollees Are Under 35, Data Show
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Size matters when it comes to measuring the public’s embrace of health insurance through the Affordable Care Act. So the first demographic dissection of enrollment through the federal and state insurance marketplaces offered a cautiously optimistic picture of how things are working, according to administration officials.

In a report released Monday, the Health and Human Services Department said 24 percent of those who selected health plans during the final three months of 2013 through state and federal exchanges were between 18 and 34 years old. That means more than three-quarters of those trying to obtain insurance -- either first-time insurance or replacement coverage -- were 35 and older, as the marketplaces geared up.

Because participating insurers are seeking pools of young and healthy people along with older, sicker individuals under the health law, the early snapshot of enrollees is considered important. The law’s coverage provisions and mandate that everyone have insurance or pay a fine went into effect Jan. 1, and consumers have until March 31 to enroll and purchase insurance for coverage mandated in 2014.

Officials said the overall trend lines comport with the Massachusetts experience, which became a model for the administration and Congress as the government made projections about how the Affordable Care Act would operate nationally.

Officials said it is not surprising that younger, healthier consumers are waiting longest to enroll and pay for coverage as they think about the law and visit HealthCare.gov and state exchanges. The administration believes enrollment of younger people will surge as the enrollment window begins to close in the spring.

“We think that the marketplace requires that we successfully, and state-by-state, enroll as many people as possible,” Mike Hash, director of the HHS Office of Health Reform, told reporters when asked if insurers are on track to realize the cost-effective mix of customers they sought.

“The trends so far are suggestive of an appropriate mix,” Hash added. “We expect an increase in the proportion of young adults as we go forward.”

HHS Secretary Kathleen Sebelius said there “is a very strong national demand for affordable health care,” which she quantified as more than 6 million Americans, if public and private sign-ups are added together. When 3 million people who are 26 and younger and covered by their parents’ insurance plans are added to the totals, Sebelius said the reform law was making coverage possible for more than 9 million people.

Missing in the newest HHS data was a reliable yardstick to quantify the overall population of enrollees who paid for insurance coverage after enrolling and selecting plans. Paying insurers after enrolling for new coverage is the final hurdle to gain insurance. Enrollment is not the same as being insured.

During a conference call Monday with reporters, officials also could not say how many (or what percent) of the nearly 2.2 million people who selected insurance plans through federal and state exchanges from Oct. 1 through Dec. 28 had no insurance at all before signing up for coverage. One of the prominent goals of the health law has been to move many of the nation’s 40 million uninsured into quality private coverage at costs they can afford (including through federal subsidies) and via Medicaid and the Children’s Health Insurance Program.

Thus far, more women (54 percent) selected health plans via the exchanges, compared with men (46 percent), HHS reported.

Although the administration understood before Jan. 1 that Hispanics were among the most enthusiastic supporters of the Affordable Care Act and its benefits, the government does not have a reliable profile of the race and ethnicity of enrollees to date, officials said. One reason is that some states do not require that information during the application or selection process.

The federal Spanish-language Web portal was delayed after Oct. 1, and has been criticized as riddled with errors since its launch. Spokesmen highlighted the face-to-face outreach in Spanish under way to enroll Hispanics, which is operating in many communities to augment Web-based enrollment explained to consumers in English or a blend of English and Spanish. 

Alexis Simendinger covers the White House for RealClearPolitics. She can be reached at asimendinger@realclearpolitics.com.  Follow her on Twitter @ASimendinger.

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