Thursday, July 19, 2018
Health

Most Obamacare enrollees are over 35, new data show

TAMPA — About one-fifth of the 158,000 Floridians who signed up for health coverage through the Obamacare marketplace are young adults, a hard-to-reach population considered critical to stabilizing the individual insurance market.

Florida's enrollment numbers mirror national figures announced Monday, which show the 18-34 age group makes up a quarter of the 2.2 million Americans who signed up for coverage. Older adults, who tend to have higher health costs, dominated the sign-ups, with the 55-64 age group making up roughly one-third of the enrollees both statewide and nationwide.

The figures were announced by the Obama administration, which for the first time provided demographic information on enrollees buying private health plans through healthcare.gov.

Young and healthy adults are critical to the new system; their premium payments are expected to subsidize the health care costs of older and sicker enrollees. The Affordable Care Act limits how much insurers can charge older adults and also prohibits discriminating against people with pre-existing health conditions.

Obama officials say those figures suggest insurers appear on track to attract the desired mix of young people over the next 11 weeks of open enrollment, though insurance groups said it was still too early to tell. A study last month from Kaiser Family Foundation suggests young adults should make up about 40 percent of the individual market.

No data are available on the number of young adults who bought policies directly from insurers rather than through the government-run marketplaces. Those sign-ups would also strengthen the individual market.

Aaron Smith, executive director of advocacy group Young Invincibles, said there are about 19 million uninsured adults in the 18-34 age group. Cost has been their biggest hurdle, he said, but under the health care law, most of them have incomes that are low enough to qualify them for federal subsidies.

"We are confident that young adult enrollment rates will continue to surge," he said.

The Obama administration's top health official, HHS Secretary Kathleen Sebelius, appeared in Tampa as the enrollment figures were released. She was on hand to highlight an initiative by Mayor Bob Buckhorn to open nine of the city's recreation departments to residents seeking help signing up for health insurance.

Enrollment through healthcare.gov, the federal website plagued by numerous technical problems after going live Oct. 1, spiked in December as repairs were made. Nationwide, enrollment through the federal website was seven times greater that month than the combined total for October and November.

In an interview, Sebelius noted that 1 in 8 of the new sign-ups nationwide were from Florida. "That's not surprising because you have such a large number of uninsured," she said. "But the momentum seems to be continuing."

Other highlights of the report:

• Even though Florida legislators have so far refused to expand Medicaid eligibility, enrollment in the government health plan for the poor could be growing, anyway. Around 58,400 adults and children who applied through the marketplace were deemed eligible for Medicaid or the Children's Health Insurance Program. The federal website has had trouble transferring those potential sign-ups to the state (Medicaid is run jointly by the state and federal governments), so it's unclear how many new people are now on the rolls.

• Nearly 80 percent of those buying a private health plan qualify for a subsidy.

• About 60 percent of people chose a silver plan, 20 percent bought bronze, 13 percent gold and 7 percent platinum. The higher the metal tier, the higher the monthly premium but the lower the copays and deductibles.

In Tampa on Monday, Buckhorn announced the initiative to let federally funded "navigators" — people certified and trained to help consumers use the online health marketplaces — keep regular hours at nine city recreation departments. In addition, city firefighters and rescue workers will carry information about insurance options when they go out on 9-1-1 calls, many of which help ill patients who have no coverage.

Tampa's initiative stands in contrast to the state's decision not to allow enrollment at state-run health department offices.

Sebelius said she has seen similar mayor-led initiatives in other states, though none in Florida. She called Buckhorn's plan "a wonderfully creative approach. . . . It's a great leadership example."

Jodie Tillman can be reached at [email protected] or (813) 226-3374.

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