Health care plans attracting more older, less healthy people

New York TimesJanuary 13, 2014 

  • What North Carolinians are doing

    More than 107,000 North Carolina residents have selected a health insurance policy under the Affordable Care Act. Only about 10 percent of the 1 million-plus residents thought eligible for coverage have signed up during the first three months of enrollment.

    Blue Cross and Blue Shield, the state’s biggest insurer, has not disclosed how many have signed up with the company, but officials say they are still validating and processing applications that contain errors or have other problems associated with the troubled federal enrollment website. Blue Cross extended its payment deadline to Jan. 24, one of many insurers to move back the due date for January’s insurance bill.

    The federal data also show that 23 percent of North Carolina’s enrollments have been by people aged 18 to 34, the age group essential to the program’s success.

    In North Carolina, 89 percent of applicants have qualified for subsidies, among the highest subsidization rates in the nation. Only Oregon has a higher rate of subsidized insurance enrollments, at 100 percent. Staff writer John Murawski

— People signing up for health insurance through the Affordable Care Act’s federal and state marketplaces tend to be older and potentially less healthy, officials said Monday, a demographic mix that could cause premiums to rise if the pattern persists.

But officials expressed optimism that more young people will sign up in the months ahead, calling it “solid, solid news” for the health care law. They said that demand for insurance through the marketplaces was increasing across all age groups and that youth outreach will become more aggressive in the months ahead.

“We’re pleased to see such a strong response and heavy demand,” said Kathleen Sebelius, the secretary of health and human services. “Among young adults, the momentum was particularly strong.”

Officials for the first time released basic demographic information about the people signing up for insurance. Of those who signed up in the first three months, 55 percent are age 45 to 64, officials said.

Only 24 percent of those choosing a health insurance plan are 18 to 34, a group that is usually healthier and needs fewer costly medical services. People 55 to 64 – just younger than the age at which people qualify for Medicare – represented the largest group, at 33 percent.

Overall, officials said that 2.2 million people had signed up by Dec. 28 for health insurance through HealthCare.gov and the state-based websites. Administration officials have previously said they hope to see 7 million people enrolled in private health plans through the federal and state exchanges by March 31.

The age breakdown was the most highly anticipated data being released because of what it could say about the health of those who will be insured. White House and health policy experts have repeatedly said that insurers need to sign up large numbers of younger people to balance the financial risks of covering older Americans who require more medical care.

Officials Monday said they were basically pleased with the percentage of young people.

Larry Levitt, a senior vice president of the Kaiser Family Foundation, has said that “the mix of enrollment is much more important than the total number.”

“If you assume that sicker individuals are likely to come in first, then a smaller pool is likely to be a sicker pool,” Levitt said. “The best guarantee of a diverse pool is a big pool, because that means you are probably reaching younger and healthier people.”

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