Young adults signing up at higher rates off Obamacare exchanges


(Photo by Mike Segar /Reuters)

A higher rate of young adults and uninsured people are signing up for coverage through a private insurance website as next week's enrollment deadline approaches, according to information released by the company Tuesday.

The enrollment data, issued by eHealthInsurance, provides a snapshot of how some customers are shopping for insurance away from Obamacare exchanges during the law’s first enrollment period. HHS has issued monthly enrollment reports on Obamacare exchanges, but it's been harder to capture data on enrollment outside of the public exchanges.

EHealth, a national online insurance broker predating the health care law, operates similar to the Obamacare exchanges, offering customers a selection of health plans from competing insurers. However, shoppers on eHealth's website can’t access federal subsidies to help purchase insurance, though the company says it has helped people enroll in subsidy-eligible plans by telephone.

Since Jan. 1, about 45 percent of those picking new health plans through eHealth were between 18 and 34 years old, the company says. By comparison, the all-important demographic accounted for 27 percent of signups on Obamacare exchanges the past couple of months. EHealth says its rate of youth enrollment has increased from 39 percent of signups between October and December.

EHealth said it couldn’t provide numbers on actual enrollments because it’s a publicly traded company and is still in the middle of an active quarter. It also didn’t an offer an explanation for why it’s enrolling young adults at a higher rate than Obamacare exchanges, but it could show that youth enrollment may be ticking up in public exchanges this month.

The rate of eHealth customers who identified themselves as previously uninsured has also increased since the first three months of the enrollment, the company says. Since January, 51 percent of the website’s shoppers say they were previously uninsured, up from 34 percent between October and December.

The online broker also reports a higher rate of people purchasing catastrophic and bronze-level plans, which feature cheaper premiums but higher out-of-pocket costs. While catastrophic plans account for about 1 percent of plan selection on Obamacare exchanges, about 14 percent of eHealth customers have purchased the skimpier plans. About 43 percent selected bronze plans through eHealth, while 18 percent picked bronze plans in the Obamacare exchanges.

The greater enrollment in plans with cheaper premiums could reflect customers’ price sensitivity, since eHealth customers largely aren’t getting federal subsidies for purchasing insurance. What’s not known from the eHealth data is how many people purchasing plans on their website were under 400 percent of the federal poverty level and therefore could have qualified for federal insurance subsidies.

Update (7:20p.m.): An administration official points out that insurers have to consider exchange and off-exchange enrollment in ACA-compliant plans as part of the same risk pool. So, if more young people are going off the exchanges to sign up in new plans, the administration is just fine with that.

"When insurance companies consider the 'mix' they are required to look at who enrolled in ACA-compliant plans both inside and outside the Marketplace," the administration official said. "In other words, evaluating the risk pool requires counting everyone in ACA-compliant plans, whether on or off-Marketplace."

Jason Millman covers all things health policy, with a focus on Obamacare implementation. He previously covered health policy for Politico.
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