Young adults are not signing up for Obamacare at a rate that could keep insurance premiums from going up, according to an Obama administration report that says nearly 2.2 million Americans have enrolled.
The latest report by the Department of Health and Human Services says only 24 percent of enrollees as of Dec. 28 were aged 18 to 34, short of the 40 percent goal among a demographic considered vital to making the law work.
Even so, the administration is optimistic that young Americans and uninsured person of all stripes would sign up in time for the March 31 deadline in the Affordable Care Act’s inaugural year.
“The numbers show that there is a very strong national demand for affordable health care made possible by the Affordable Care Act,” HHS Secretary Kathleen Sebelius said. “More than six million Americans have now either signed up for private health insurance plans or for Medicaid coverage through the marketplace.”
About 1.8 million of the enrollees signed up in December, a stark surge after officials fixed software glitches that spoiled the October rollout of HealthCare.gov, a web portal that serves 36 states.
Despite the administration’s optimism, GOP critics quickly lambasted the updated figures as too slanted toward older enrollees.
The number of sign-ups through the federal marketplace — nearly 1.2 million — outnumbered those signing up on the 15 state-run exchanges — roughly 957,000 — for the first time since HHS began to report data in mid-November.
Nearly 80 percent of people who signed up for private plans were deemed eligible for financial subsidies from the government to help them pay their premiums, Mrs. Sebelius said.
The new report is notable for two reasons — it comes halfway through the inaugural open enrollment period, which ends March 31, and it includes demographic data for the first time.
Among the 2 million-plus enrollees, 30 percent are described as aged 34 or younger, a figure that one HHS official described as “similar to our expectations.”
But only 24 percent were aged 18 to 34, according to the report.
“There’s no way to spin it: youth enrollment has been a bust so far,” said Brendan Buck, spokesman for House Speaker John A. Boehner, Ohio Republican. “When they see that Obamacare offers high costs for limited access to doctors — if the enrollment goes through at all — it’s no surprise that young people aren’t rushing to sign up.”
Young people tend to be healthier, and healthy enrollees are needed to keep premiums in check when sicker consumers with preexisting conditions enter state risk pools, because they can no longer be denied coverage.
Officials said the ratio is appropriate so far and reflects a trend they saw when Massachusetts rolled out its health reforms in 2006, when young people waited longer to sign up.
“We expect an increase in the proportion of young adults as we go forward,” said Michael Hash, director of HHS’s Office of Health Reform.
Overall, 54 percent of all enrollees were female and 46 percent male, according to the report.
The Congressional Budget Office projected that 7 million people would enroll in private plans by the end of March, so the pace of enrollment is lagging behind that goal.
On Capitol Hill, GOP critics of the law have shifted from repeated attempts to repeal the law to more nuanced attempts to point out its potential flaws. In particular, they’ve suggested that enrollees’ are putting their personal data at risk on the Obamacare portals.
Republican critics also say the law is disrupting doctor networks that patients enjoy and forcing young people to effectively subsidize sicker consumers’ care.
They’ve also criticized the rate of Medicaid enrollments compared to those selecting private health insurance.
Some of the Medicaid enrollment may be from the “woodwork” population that only recently discovered their eligibility, yet under Obamacare more than half the states expanded the entitlement program within their borders to those making up 138 percent of the federal poverty level.
Roughly 3.9 million people had been deemed eligible for Medicaid or the Children’s Health Insurance Program through the state-run exchanges as of the end of November, which includes people who renewed existing eligibility and people who were newly eligible. As of Dec. 28, more than 751,000 have been determined or assessed eligible for Medicaid of CHIP through the federal marketplace.
Monday’s report is the third monthly installment released by the Obama administration since the health exchanges opened on Oct. 1. The administration counted sign-ups through Dec. 28, and some states could only provide partial data sets.
California’s state-run exchange led the way with 498,794 enrollments, while New York’s chalked up 156,902. Among federal-exchange states, Florida brought in 158,030 enrollees, and Texas and North Carolina also recorded more than 100,000 sign-ups.
About 60 percent of enrollees in private coverage selected a silver plan, which offers mid-level coverage in the metal spectrum of plans available on the marketplace. Among the rest, 20 percent selected a lower-level bronze plan, 13 percent selected a higher-level gold plan and 7 percent selected a top-level platinum plan.
One percent enrolled in a catastrophic plan, a figure that is associated with people who lost plans that did not meet Obamacare’s coverage requirements in the new year.
Mr. Obama allowed these people to apply for a hardship exemption and purchase catastrophic plans, although health officials on Monday could not quantify how many people had taken this route.