Another 1.1 million Americans selected health plans through healthcare.gov and state-based marketplaces in January, according to new numbers released by the White House, for a total of 3.3 million enrolled under the Affordable Care Act since October. Here’s a snapshot of what we learned from today’s report and what we still don’t know, using data from the Department of Health and Human Services.
New sign-ups in January didn’t keep pace with the month before. That’s not shocking. The administration rebooted the flailing website on Dec. 1 with technical fixes, so December’s numbers include some pent-up demand from consumers who couldn’t get on the site. The White House surely would have loved to beat the December sign-up number in January, but the fact that it didn’t is more a reflection of earlier failures than an indication of slowing demand.
This is the news that White House officials want to shout from the mountaintops: Young people made up a slightly bigger share of new enrollees in January than they did in earlier months. “We’re seeing a growing population of Americans who are young, healthy, and well-covered,” Health and Human Services Secretary Kathleen Sebelius told reporters on a conference call today.
Getting young people into the insurance risk pools is important to balance the cost of covering older people and those with costly health conditions. While it’s too soon to tell how the age mix might affect premiums in future years, there’s some outside evidence that more young people are getting coverage. A Gallup poll released today shows substantial declines in the number of uninsured between the ages of 26 and 34—too old to be on their parents’ health plans and perhaps the most likely to risk going without coverage.
More news the Obama administration is happy to spread: Most people signing up on the exchanges are buying mid-tier “silver” plans, which on average pay for about 80 percent of medical costs. “The covered population is getting younger, and most younger Americans are choosing high-quality silver, gold, or platinum plans,” Sebelius said.
But today’s update left some important questions unanswered:
How many people turning to the health insurance exchanges had been uninsured before? Officials say they don’t yet have data on how many people signing up were previously uninsured, or how many had insurance that they lost when plans were canceled. We also don’t know how many previously uninsured people bought health plans off the exchanges. The Gallup data do suggest that the overall portion of Americans going without health insurance is declining as Obamacare kicks in, but we don’t have official numbers or much insight into the actual increase in insurance coverage.
How many people have paid their premiums? The White House is reporting numbers on how many people have enrolled in coverage on the exchanges, but not how many have paid for it. People won’t have coverage if they don’t pay their bills. The lack of data on this question also reflects the technical hurdles still ahead for healthcare.gov, including building a system to send subsidy payments to insurance companies. “As soon as we have our automated payment systems complete and tested, we believe we’ll be able to provide you additional data in terms of those consumers who have paid their premiums,” HHS spokeswoman Julie Bataille told reporters.
The Congressional Budget Office now projects that about 6 million people will enroll in health-exchange coverage this year, a figure revised down from an earlier estimate of 7 million. Now the White House is more than halfway to that benchmark. Enrollment continues through the end of March, and Bataille said there’s no talk of moving that deadline back. Millions of people will still have to sign up and pay for coverage to meet that target. But the odds of it happening look a lot better than they did in October and November.