In it, but not of it. TPM DC
Prior to HealthCare.gov's Oct. 1 launch, the Obama administration said it was aiming for close to 40 percent of enrollees to be between 18 and 34. So the law certainly isn't hitting its mark yet. But outside experts said there's reason to be optimistic that the ratio will improve during the last three months of open enrollment -- and even if it doesn't strike a perfect balance, the law should be fine.
First of all, most expected the early enrollees to be older and sicker because they need health insurance more urgently. But a number of factors -- including increased awareness and a desire to avoid the individual mandate penalty -- could encourage more young people to sign up in the next three months.
"It is critical to remember that we are still early in the open enrollment period," Caroline Pearson, vice president at Avalere Health, an independent consulting firm, told TPM. "We have always assumed that older and sicker individuals would be the first to enroll, and younger, healthier people would enroll closer to March. So, we shouldn’t panic about low young adult turn-out at this point because it is to be expected."
As TPM previously reported, the administration always expected young people to come in later. A senior administration official outlined the Massachusetts experience during that state's implementation of a similar health insurance overhaul. In the first three months of enrollment, young people composed 17, 17 and 24 percent of sign-ups, respectively. But in the last three months, that jumped to 34, 36 and 34 percent respectively.
The White House is hoping for a similar spike. But even if the law doesn't hit its target perfectly, Obamacare has protections in place to keep it afloat financially. A reinsurance program protects carriers against a bad risk pool. The Kaiser Family Foundation also released a report last month that concluded if 25 percent of the enrollment pool were young people, the resulting premium increase might be only 1 to 2 percent, not enough to fatally undermine the law's actuarial base.
"I see no signs at this point of a feared premium 'death spiral.' The insurance market will be stable with an enrollment mix like this," Larry Levitt, senior vice president at the Kaiser Family Foundation, told TPM after seeing the new numbers. "But heightened outreach to young people, and even more importantly healthy people, will help to keep premiums down."