Commercial risk will be a critical catalyst of progress – it’s complicated, but is it possible? We think so.

Blog Post

Meet your new patients: Who is really signing up for Obamacare?

January 14, 2014

    Juliette Mullin, Editor

    The Obama administration yesterday released the first age breakdown of Americans who have obtained insurance coverage through the Affordable Care Act (ACA), and the results are not quite what insurers and providers were hoping for, with commercial plan purchasers skewing older than expected.

    • What changed on Jan. 1? Get primed on the ACA's coverage expansion provisions.

    New enrollees skew older than we had hoped

    According to the latest data, 2.2 million Americans—54% of whom were women—selected commercial insurance plans through an ACA insurance exchange from Oct. 1 to Dec. 28, 2013. Of those enrollees:

    • 6% were under age 18;
    • 9% were ages 18 to 25;
    • 15% were ages 26 to 34;
    • 15% were ages 35 to 44;
    • 22% were ages 45 to 54; and
    • 33% were ages 55 to 64.

    When outlining its expectations for the ACA last year, HHS said it hoped that seven million Americans would enroll in coverage by March, and that 40% of those Americans would be young adults. This was important for two reasons: (1) Young adults are critical to balance out the insurance risk pool; and (2) young adults account for about 40% of uninsured Americans. 

    • How will expansion affect the rates in each state?

      Using Harvard estimates and Advisory Board research, we've mapped out the expected uninsured rates in each state after the 2014.

      Check out this blog post explaining the method behind the map, and click here to expand the map.

    Some parts of the country are seeing high rates of young enrollees. (In the District of Columba, for example, 44% of enrollees are young adults.) But overall, the rate of young enrollees is significantly lower than the White House and health industry had hoped for, with fewer than 25% of enrollees being between the key ages of 18 and 34.

    But all hope is not lost. As Washington Post's Sarah Kliff points out, the current age breakdown is not so different from the age breakdown for early enrollment when Massachusetts expanded insurance coverage in 2006. The Northeastern state saw young adult enrollment increase later in the open enrollment period.

    Most new enrollees buy silver plans

    In addition to age breakdown, the latest data show that most customers (60%) in the exchanges bought a Silver Plan, the second tier of commercial coverage options. Meanwhile, only 20% selected a Bronze plan, the lowest level of coverage.

    The data also show that the vast majority of new enrollees—79% to be precise—obtained subsidies to purchase coverage. And 1.6 million Americans had a Medicaid determination or assessment through an exchange in 2013.

    Are you ready for your new patients?

    Being ready for health insurance exchanges will be the difference between 24 million challenges and 24 million opportunities.

    Watch this video now for three ways to prepare for the exchange tsunami.

    Have a Question?


    Ask our experts a question on any topic in health care by visiting our member portal, AskAdvisory.