Some 3.3 million people signed up for health coverage through insurance exchanges as of January, but enrollment from young Americans remained tepid, new Obama administration figures showed on Wednesday.
The latest numbers signal that insurance enrollment progressed steadily as 2014 began. Roughly 2.2 million people had signed up for private plans nationwide by Dec. 28. The Affordable Care Act’s exchanges first opened in October.
The Obama administration heralded the figures as a sign that it had turned the corner on crippling problems with the insurance exchanges that prevented consumers from signing up for policies.
“We’re seeing a healthy growth in enrollment,” said Health and Human Services Secretary Kathleen Sebelius.
But Republican lawmakers said there was no reason for the Obama administration to cheer, given the continuing troubles with the 2010 federal health-care law. They noted independent reports indicating that many of the people using the exchanges already had been buying insurance on their own.
“Many of them [were] simply shifting from plans they liked to more-expensive plans the government thinks they should like,” said Senate Minority Leader Mitch McConnell of Kentucky.
Also worrisome is the fact that enrollment among young Americans—a closely watched demographic because their participation keeps premiums lower—barely ticked up in January.
In all, 25% of the people enrolling in private plans through the online portals since their launch in October were between the ages of 18 and 34, according to the data. Through the end of December, that proportion was 24%, according to a previous report from the federal government.
That is well short of the percentage of young people who might have registered in the exchanges. Insurers say they need strong enrollment from younger people. who are likely to be healthier, to balance out the likely higher costs racked up by older, sicker people.
Kaiser Family Foundation, a health-policy think tank, has said census data suggest that about 40% of people for whom the exchanges were intended are in the 18-34 age group.
Starting this year, insurers have been required to charge equal prices to people regardless of their medical history or gender, and are limited in how much they can vary rates by age.
The figures released Wednesday also indicate that more women are obtaining more coverage than men, as 55% of the enrollees are female.
The administration has said it cannot yet tell how many uninsured people have gained coverage through the exchanges, but it said some participants who previously had insurance would now be getting more generous plans than they had.
The Congressional Budget Office initially estimated that 7 million people would use exchanges in 2014; the nonpartisan agency has since revised that number downward to 6 million to take into account the technical problems that stopped many from signing up in the first weeks of the exchanges’ launch.
Actuaries have warned that if the participants in the exchange end up incurring bigger medical claims than they had anticipated, insurance premiums will jump in future years. Older people and women typically have higher costs, though not always, they say.
“The key question is how costs will compare to expectations,” said Ross Winkelman, a fellow of the Society of Actuaries. “Age is a useful, but imperfect predictor of costs. Enrollment at the oldest ages seems to be outpacing expectations, which will clearly raise some concerns.”
Administration officials declined Wednesday to discuss concerns about the balance of risk in the new insurance marketplaces.
“Every individual enrolled in a health plan is a success story,” said Julie Bataille, a spokeswoman for the Centers for Medicare and Medicaid Services.
Other supporters of the law have said they are banking on getting young people in as the deadline for getting coverage this year nears.
“We are doing everything we can in the next six weeks to make sure young people know they can get free or reduced-cost coverage,” said Aaron Smith, the executive director of the advocacy organization Young Invincibles.
The group has planned more than 100 events around the country for the coming Presidents Day weekend, including an enrollment event in Miami and a pub-crawl in Austin, Texas.
Date: Feb. 12, 2014