Trouble ahead? Early ACA enrollees are older than expected

Technical issues dissuade many Americans hoping to buy coverage

Surveys and initial reports from insurers suggest that technical issues dissuaded many Americans from purchasing health insurance during the exchange's first month, and that those who did enroll where older than expected.  

  • Who has enrolled in the 15 state-based exchanges? Our tracker.

Insurers: Enrollees are older than expected

A little more than one month after the Affordable Care Act's (ACA) insurance exchanges opened for enrollment, insurers are reporting that the pool of applicants for coverage in the marketplaces is older than expected, raising concerns about the potential effect on premiums, according to the Wall Street Journal.

HHS has said it hopes that at least 2.7 million young adults—or about 39% of the seven million target for total enrollment—sign up for coverage in order to help offset higher costs incurred by older, sicker individuals.

However, insurance executives and agents, as well as state officials and actuaries, said the majority of successful early applicants are older than they had expected. Some insurance officials said the typical target age for coverage in the marketplaces was about 40, on average, but several companies have found that the majority of its new enrollees are over age 50.

More specifically, officials with:

  • Kentucky's state-run exchange reported that nearly 40% of the estimated 4,631 enrollees in private health plans are older than 55, while 24% of the remaining enrollees are younger than 34;
  • Michigan-based Priority Health said the average age of new enrollees is 51, up from about 41 for plans offered for the current year;
  • WellPoint said most of its enrollees in Connecticut were between the ages of 55 and 64; and
  • Wisconsin-based Arise Health Plan said more than 50% its 150 enrollees are over age 50.

The Obama administration has said that it expects the majority of young, healthy enrollees to wait until the last minute to enroll in coverage, citing past data from Massachusetts' exchange that launched in 2006. The open enrollment period for the ACA's exchanges ends in March.

Observers also say younger individuals are more likely to be deterred by the problem-plagued federal exchange website and likely will seek to enroll in coverage after the problems have been resolved.

  • Five groups of exchange enrollees to target. Who will the new exchange enrollees be? A recent report, conducted by Enroll America, has identified five consumer profiles.

Poll: About 20% of exchange visitors enrolled

Twenty-one percent of adults who visited the insurance marketplace websites have enrolled in coverage, according to a new survey from the Commonwealth Fund.

The survey—which was conducted between Oct. 9 and Oct. 27 and included responses from 4,035 adults—also found that 17% of individuals who are eligible for coverage either visited the online exchanges or requested information about the exchange plans through the mail, phone, or in person. Of those individuals, 58% said were considering enrolling in or seeking out federal subsidies before the open enrollment period ends.

Of the individuals who visited the websites but did not enroll in coverage:

  • 48% said they were unsure if they could afford a plan;
  • 46% said they were still deciding on a plan; and
  • 37% reported experiencing technical difficulties with the portals.

Overall, the study showed that of those who visited the website:

  • 73% were in good health, compared with 25% who identified their health as fair or poor;
  • 52% were between ages 30 and 49, while 21% were between ages 19 and 29;
  • 70% rated their experience with the website as fair or poor;
  • 56% said it was impossible, somewhat difficult or very difficult to find a plan with the coverage they wanted; and
  • 61% said it was impossible, somewhat difficult or very difficult to find an affordable plan (Weaver/Martin, Wall Street Journal, 11/4; Novack, National Journal, 11/5; Easley, "Healthwatch," The Hill, 11/4).

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