Insurers: Early Pool of ACA Exchange Applicants Older Than Expected

TOPIC ALERT:

A little more than one month after the Affordable Care Act's insurance exchanges opened for enrollment, insurers are reporting that the pool of applicants for coverage in the marketplaces is older than expected, raising concerns about the potential effect on premiums, the Wall Street Journal reports (Weaver/Martin, Wall Street Journal, 11/4).

HHS has said it hopes that at least 2.7 million young adults -- or about 39% of the seven million target for total enrollment -- sign up for coverage in order to help offset higher costs incurred by older, sicker individuals (California Healthline, 10/16).

However, insurance executives and agents, as well as state officials and actuaries, said the majority of successful early applicants are older than they had expected. Some insurance officials said the typical target age for coverage in the marketplaces was about 40, on average, but several companies have found that the majority of its new enrollees are over age 50.

More specifically, officials with:

  • Kentucky's state-run exchange reported that nearly 40% of the estimated 4,631 enrollees in private health plans are older than 55, while 24% of the remaining enrollees are younger than 34;
  • Michigan-based Priority Health said the average age of new enrollees is 51, up from about 41 for plans offered for the current year;
  • WellPoint said most of its enrollees in Connecticut were between the ages of 55 and 64; and
  • Wisconsin-based Arise Health Plan said more than 50% its 150 enrollees are over age 50 (Wall Street Journal, 11/4).

The Obama administration has said that it expects the majority of young, healthy enrollees to wait until the last minute to enroll in coverage, citing past data from Massachusetts' exchange that launched in 2006. The open enrollment period for the ACA's exchanges ends in March (Novack, National Journal, 11/5).

Observers also say younger individuals are more likely to be deterred by the problem-plagued federal exchange website and likely will seek to enroll in coverage after the problems have been resolved (Wall Street Journal, 11/4).

Frank Apgar
Insurers having an older population than expected isn't really surprising. Why would one who is young and who thinks of themselves as healthy, who rarely if ever see a doctor pay premiums as opposed to a $95 penalty. Now if I am sick, use medications and have a chronic health condition where I access the health care system, it is to my advantage to sign up. Not surprising at all but quite predictable

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