Obamacare Sign-Ups -- 3.3 Million -- Skew Older, Female

Obamacare Sign-Ups -- 3.3 Million -- Skew Older, Female
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The Obama administration said Wednesday it doesn’t know how many Americans who previously had no health insurance have enrolled under the Affordable Care Act, but newly released government data indicates that 82 percent of nearly 3.3 million enrollees have qualified for tax subsidies or other assistance to gain coverage.

The administration is making an intense push to enroll women and younger Americans before a March 31 deadline. A chance to meet President Obama in Washington is a raffle prize offered this month through Organizing for Action, the pro-administration mobilization group that used to be his campaign machine. OFA is seeking volunteers to sign people up for insurance plans.

Health and Human Services Department officials said the outreach has helped entice women, in particular, to choose private coverage through the federal and state marketplaces. Younger Americans -- who tend to be the least expensive to insure, and therefore an attractive population for insurance companies -- make up a quarter of the enrollment mix to date (with roughly six weeks to go before the sign-up window closes for the year).

HHS Secretary Kathleen Sebelius reported Wednesday that a total of 3,299,432 people enrolled for private health insurance through the federal and state marketplaces from October through the end of January. Of that tally, 25 percent are between 18 and 34, while 53 percent are 45 and older. The majority -- 55 percent -- are women.

“It's very, very encouraging news,” Sebelius said during a conference call with reporters.

Studies show that women continue to be the primary customer base for medical care, either as direct consumers or coordinators for their families’ care. But women cost insurance companies more than do men, on average. In some states, the gender differential in enrollments has been pronounced. For instance, in Oregon and Louisiana, 60 percent of those who enrolled as of last month were female, according to the report

Julie Bataille, communications director for the Center for Medicare and Medicaid Services, said there would be no extension of the open enrollment period for individuals beyond the March deadline. The question of a longer grace period continues to come up because the administration has repeatedly used executive discretion to ease deadlines for employers, and for individuals who had their own insurance plans last year and hoped they could keep what they had.

Individuals who are not privately insured through employers, are not carried on their parents’ plans, and are not covered by Medicaid (or by the government health program for children) will be expected to get insured this year or else pay a federal fine.

The administration expressed confidence there will be a workable mix of healthy and sick people who sign up for private coverage before April 1 -- sufficient to support what HHS calls “market stability.” The government believes many younger enrollees are procrastinating until the last minute before signing up.

“What we are confident about is that [the total enrollment base] will be a large number, and it will be a population that is diverse enough to allow the marketplaces to function effectively,” White House Press Secretary Jay Carney said Wednesday.

HHS used its new data to suggest the trend each month has been toward surging enrollment, especially as problems are fixed on the government’s problem-plagued website, HealthCare.gov. Improving numbers could signal viability for “affordable” health care, officials argue, and Democrats hope they will be able to sell voters on the idea that enrollments mean the law is here to stay.

(HHS data do not show the number of people who actually paid their initial premiums, which is the technical definition of “insured.”)

Officials boasted that the population of those who “selected” plans through the federal and state marketplaces in January climbed 53 percent (1.1 million additional sign-ups) compared with the tally from October through December (nearly 2.2 million selections). The Democrats’ talking point Wednesday, published and emailed in an echo chamber, was “ACA Enrollment Picks Up Steam.”

But the government’s month-over-month data showed that January’s enrollment total shrank in comparison with December’s numbers -- when Americans were motivated to act before a Jan. 1 implementation date. Last month, HHS said 1.8 million people enrolled in December, indicating a decline of 700,000 sign-ups from Jan. 1 to Feb. 1. (Between Oct. 1 and the end of November, only 364,682 Americans selected coverage.)

When reporters asked HHS to compare the January marketplace totals reported Wednesday with those reported for December, Nancy Delew, the deputy assistant secretary for planning and evaluation, paused before answering.

“I don’t have that right in front of me,” she said.

If a surge in insurance shopping occurs before the March 31 deadline, total enrollments for 2014 could arc toward 6 million, given the trend line through January. That’s fewer than some outside economists originally said would be necessary to achieve “market stability,” but the administration -- given the website problems and withering GOP opposition -- would hail any number near 6 million as a significant achievement for those who purchased coverage, and for policymakers who helped enact reforms.

On top of an eventual total for enrollment in private plans, the government will also count the millions of Americans who qualified for new and continuing benefits under Medicaid in the states.

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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