Obamacare Late Surge May Signal Young, Healthy Sign-UpsAlex Wayne and Shannon Pettypiece
More than 1 million people waited until the last five days to sign up for 2014 health coverage under Obamacare, and early indications are that many were young minorities, insurance analysts and enrollment groups said.
That may be good news for health insurers who have been concerned that the customers enrolling in health plans through the new insurance exchanges are sicker and older than the average American.
About 7.1 million people signed up for private plans under the Patient Protection and Affordable Care Act by the close of the first enrollment period on March 31, President Barack Obama announced. The figure, a symbolic triumph for the president, met a year-old projection by the Congressional Budget Office that was thought out of reach after the exchanges were plagued by computer malfunctions last October.
“The enrollment surge is the best news possible for insurance companies,” Larry Levitt, senior vice president at the Kaiser Family Foundation, a Menlo Park, California-based nonprofit that tracks health programs, said yesterday in a phone interview.
Six million people had signed up by March 27. Enrollment events across the country were swarmed by late applicants last weekend, and the federal website, healthcare.gov, saw almost 8 million visits from March 29 to March 31. While computer errors again prevented many people from signing up on the deadline day, anyone who tried to enroll can complete the process this month, federal officials have said.
More than 5.4 million adults may have gained health insurance since the start of enrollment in Obamacare plans through early March, according to a survey released today by the Robert Wood Johnson Foundation. That would bring the percentage of uninsured Americans to 15.2 percent from 17.9 percent in September, the Princeton, New Jersey-based nonprofit group said. The survey of 7,500 adults younger than age 65 doesn’t include the late surge of people who selected plans close to the March 31 deadline, the group said.
It may be weeks before specific details are known about the impact of the Affordable Care Act or about the people who have signed up for coverage. The Department of Health and Human Services is expected to release a report later this month on enrollment through the end of March; previous reports have broken down enrollment by age and gender. They are silent on how many of the enrollees were previously uninsured, and how many have paid their first premium to health insurers, the final step required to finish signing up.
Through March 1, about 25 percent of exchange customers were from the ages of 18 to 34, according to the most recent report on enrollment. About 55 percent were women. Insurers, including the Blue Cross Blue Shield Association, which represents 37 large health plans, said from 80 percent to 85 percent of their customers have paid their first premium.
Insurance companies are hopeful the last-minute volume brought in younger and healthier customers, said Robert Zirkelbach, a spokesman for America’s Health Insurance Plans, the industry’s Washington lobby group.
“There has always been the assumption that those with urgent medical needs would sign up first and that the young and healthy would sign up at the end,” he said yesterday in an e-mail. “We’ll find out soon if that hypothesis was true.”
Beyond the total enrollment estimate, there is little data on insurers’ new customers. The last federal report on enrollment, which covered the period through March 1, included just 4.2 million people. Almost 3 million more have signed up since, with an unknown number to come this month.
“We are in a bit of a data-free zone,” Levitt said. “But it stands reasonable to believe the late enrollees are younger, healthier and previously uninsured. If you were sick and you needed insurance, you were the first in line.”
New official data from the government aren’t expected before the middle of the month.
“The people who signed up recently are different,” Doug Holtz-Eakin, a former CBO director and the president of the American Action Forum, a Washington advocacy group opposed to the health law, said yesterday in a phone interview.
“It could be they’re different just because they’re disorganized and procrastinators,” he said. “It could be they’re different because they’re young and healthy and don’t need the insurance. Or they could be different because they’re financially marginal, and they’re not able to sustain the payments. We have no idea.”
Groups working on enrollment provided anecdotal evidence that latecomers were younger than earlier sign-ups, and more were minorities. Adam Stalker, digital director at Enroll America, a group allied with the White House that organized local outreach efforts for the law, said the organization directed much of its paid advertising at African-American and Latino women.
“We saw a huge uptick in interest in the last couple of days,” he said. “For the small part of this we did help influence, it did seem it was younger folks and communities of color.”
Matt Saniie, director of data and analytics with the group, said the “vast majority” of the people it contacted had no insurance before enrolling. Another key unanswered question about the law is whether it has yet put a dent in the nation’s estimated population of 48 million uninsured.
In Alabama, Daniel Liss, the co-founder of Bama Covered, which coordinated student volunteers to promote enrollment, said that while initial applicants in his state leaned female, more men and young people came in late.
“You definitely had a younger demographic in the last week or two,” he said in a phone interview. “I was in Mobile last week and all of the employees of this one bar came in together, because the cook had gotten a plan for twenty bucks.”
There was a similar dynamic in Mississippi, said Roy Mitchell, executive director of the Mississippi Health Advocacy Program in Jackson. A combination of word-of-mouth and a television advertisement featuring an injured and previously uninsurable roofer, he said, began to draw men.
“We were seeing a lot of males come in during those final weeks, who were walking out and grinning and as happy as could be, because of the subsidies and how low the premiums were,” he said in a phone interview. “Some had never had insurance before.”
In Forth Worth, Texas, volunteers at the United Way of Tarrant County saw more Hispanics coming in as the deadline neared, said Tim McKinney, the organization’s president. The number of people seeking help enrolling got so heavy in the final weeks the group had to stop allowing walk-ins and required everyone to make an appointment, he said.
Unlike other organizations, though, McKinney said the United Way hasn’t seen a shift toward younger enrollees. Most of those signing up in the final days have been over 45, he said.
Holtz-Eakin, of the American Action Forum, said the Obama administration’s attempts to target younger customers, with promotions such as the president’s appearance on the Zach Galifianakis show “Between Two Ferns,” may have succeeded. Even so, much is uncertain, he said.
“What we know is: 7 million,” he said.