Enrollment in health insurance plans through state and federal exchanges are rising rapidly, especially among young adults, making it likely that the Affordable Care Act will achieve a large and stabilizing mix of enrollees by the end of the open enrollment period on March 31. Some 2.2 million people signed up in the first three months, from Oct. 1 through Dec. 28.
The U.S. Department of Health and Human Services reported last week that nearly a quarter of the enrollees were between the ages of 18 and 34 — a group considered critical to the success of the exchanges because, on average, they are healthier and cheaper to insure than older Americans.
Some commentators think that 40 percent of enrollees in the health exchange plans need to be in the younger group to keep premiums from spiking. That is a misconception. An analysis last month by the Kaiser Family Foundation estimated that even if that group accounted for roughly 25 percent of enrollment, it would keep premium increases relatively modest (perhaps 2.4 percent in 2015).
Exactly how the mix of age groups will affect premiums is hard to gauge, because it depends on what insurance companies expected. If enrollees in a plan are sicker than an insurer anticipated, that might lead the company to raise premiums for 2015. But competition among insurers to attract customers could also keep premiums down.
Because people no longer have to give their medical histories when they apply for insurance, nothing is yet known about the health status of those signing up. A survey in December found that 77 percent of those who had visited the exchanges were in good, very good, or excellent health. That bodes well for the balance of risks in the markets.
Young adults were expected to register at the last minute. In December, there was an eightfold increase in young adults signing up, compared with October and November. A similar surge is expected in March, before penalties are imposed.
The new numbers show that young and healthy people are beginning to realize that they too need good insurance.
— New York Times