Tag Archives: Risk Pool

Obamacare enrollment of young adults about 50 percent below target

If you remember, Obamacare works by forcing young people (especially young men) to pay for care they don’t need and won’t use. This lowers the costs of health care for younger women and especially for older, sicker people. The target is 2.7 million enrollments of people from age 18-34.  But are young people signing up for this plan in numbers like that?

Investors Business Daily has the answer.

Excerpt:

Data through five months of the open-enrollment period show that slightly fewer than 10% of eligible 18- to 34-year-olds have signed up for coverage. Among young men, roughly 1 in 12 has signed up.

The Kaiser Family Foundation puts the ObamaCare-eligible population at 28.6 million, with 40%, or about 11.4 million, in the 18-to-34 age group.

Compared to the size of the potential market, the first-year target of 7 million enrollees, including about 2.8 million young adults, was relatively modest.

Yet it’s now clear that the initial target is well out of reach. The Avalere Health consultancy projected that sign-ups — paid and unpaid — will end March at around 5.4 million.

Through February, not quite 1.1 million young adults had selected an exchange plan. Among this group, the male-female breakdown was about 45% vs. 55%. That matters because women at child-rearing age are more likely to run up big medical bills.

In February, 268,000 18- to 34-year-olds signed up, so a decent upsurge in March could lift the total close to 1.4 million. But that’s before winnowing out the people who don’t pay.

Anecdotal reports from a handful of states and large insurers now point to a paid rate of about 85%, possibly lower.

While that could improve before the March 31 deadline, there’s reason to suspect that the paid percentage might lag among young adults, since they are showing more reticence about signing up in the first place.

Once the unpaid group is subtracted, it appears likely that young-adult enrollees will fall at least 50% below the first-year target The White House had initially set that target at 2.7 million.

[…]The age mix is important because the exchanges charge younger people higher premiums relative to pre-ObamaCare individual market insurance, so that older people can be charged less without negating insurer profits.

If young adults make up just 25% of the ObamaCare exchange population, it would wipe out much, but not all, of the 3% to 4% profit margin insurers typically allow for in setting premiums, Kaiser Family Foundation experts figure.

Yet that calculation assumes the health status of those who do sign up is about average. In general, an insured pool comprising a smaller share of the eligible group raises concern that the covered group will be costlier than average.

So they are expecting 2.7 million, but even with a late surge of enrollments, they are only going to get 1.4 million young people. That’s bad for Democrats, but I am happy that young men are not signing up for this law. They have nothing to gain from it. Maybe this whole mess will be worth it if young men understand that big government rides on the backs of young men. They are expected to pay the taxes, but without getting any of the benefits. Sex changes? IVF? Maternity? Well woman exam? Birth control pills? We don’t use that. We don’t mind paying for that for our wives, but we don’t want to pay for it for complete strangers.

Does the last-minute Obamacare exemption fix anything?

One of my favorite writers on health care policy is Michael F. Cannon of the libertarian Cato Institute. He has an article in Forbes magazine that I think is a good level-set for the Obamacare changes that are happening in 2014 and beyond.

He writes:

[…]President Obama announced, just days before the deadline for purchasing coverage with a January 1 effective date, that he would offer a categorical “hardship exemption” from the individual mandate to anyone who had their insurance cancelled due to ObamaCare.

[…]If these folks choose not to buy health insurance, they will not face a penalty. They will also have the option to buy, “if it is available in your area,” the lower-cost catastrophic coverage that ObamaCare otherwise offers only to people under age 30, or who receive the separate “unaffordability” exemption from the mandate.

The obvious purpose of this policy is to give political cover to Senate Democrats who must face the voters next year, and are no doubt afraid of attack ads like this one.

[…]Yet this exemption may not be of much value to those who qualify, and is likely to create more problems for ObamaCare supporters than it solves.

The people who qualify for this exemption don’t actually want it. They want health insurance. They had affordable coverage, until ObamaCare took it away from them, and that’s what they still want now. Sebelius boasts that ObamaCare’s catastrophic plans cost 20 percent less than other ObamaCare plans, but don’t confuse that with affordable coverage. The Manhattan Institute’s Avik Roy — who is now the opinion editor for the sprawling Forbes empire – notes that ObamaCare’s catastrophic plans can still cost twice as much as what was previously available on the individual market.

But even if they like their catastrophic plan, they can’t keep it. Sebelius has complete control over the duration of the exemptions, which she has described as a “temporary” step “to smooth [consumers’] transition” to enrollment in Exchange plans. So in a matter of months, Obama will violate his “if you like your health plan” pledge again by kicking these folks out of their catastrophic plans. They will get another cancellation letter tossing them into the Exchanges. Their premiums will surge again. They may lose their doctor again.

The exemption means insurers will suffer losses this year, and rates will be higher next year, for all ObamaCare plans.

The president argued before the Supreme Court that ObamaCare’s regulatory scheme cannot work with out the individual mandate. Yet he has now exempted millions of the very people he most needs to comply with it. This exemption siphons good risks out of the Exchanges and destabilizes the risk pools for both the standard ObamaCare plans and the catastrophic plans. Participating carriers set the rates for their Exchange plans with the expectation that these folks would be purchasing bronze, silver, gold, and platinum plans through the Exchanges. But the healthiest members of this now-exempt group are the most likely to go uninsured or purchase a catastrophic plan. So Obama’s blanket exemption makes those risk pools older and sicker.

This blanket exemption also destabilizes the risk pools for the catastrophic plans. It opens those pools to lots of people over age 30, who have higher health expenses than people under age 30, and whom the insurers were not expecting to buy catastrophic plans when they set those rates.

So the effect of this is going to be to raise rates temporarily, because the insurers companies are not getting the younger, healthy people they need to make the rates as low as they originally calculated. They are going to lose a ton of money because the Democrats are changing the rules at the last minute. They people who have coverage are going to be the ones who make all the claims, and the people who normally don’t make claims are now exempt, temporarily – until the 2014 elections. This is going to be a huge hit to the health insurance companies.

As I noted before, the Democrats are going to have to bail out the insurance companies in order to account for the losses. It’s actually in the Obamacare law already, as David Freddoso explained. But will the Democrats use money from their political party to pay for their mistakes? Hell no – they will borrow it from your children, which is what they are so good at doing. There is a cost for electing incompetent people, and it’s going to continue to rise until the fools are voted out.