The next big test for Obamacare, after clearing the 8 million enrollments threshold when nobody thought it could, will be what happens to premiums in 2015.
Given the timing of their public release, likely to be in the weeks before voters go to the ballot box this fall, the premiums could also be a factor in the final news cycles of the 2014 campaign.
With the final enrollment numbers released last week, we got the last word on how Obamacare did in signing up young and healthy people, probably the most telling public barometer for what will happen with premiums next year. Young and healthy enrollees help offset the costs of the older and sicker ones who insurers can no longer discriminate against.
In that aspect, the law didn’t do great as a whole: 28 percent of sign-ups were in the prized demographic, ages 18 to 34. Administration officials had said, long before the disastrous launch of HealthCare.gov, they were aiming for closer to 40 percent. But outside experts have said that Obamacare is doing well enough to avoid a widespread pandemic of outlandish premium increases.
But the national numbers don’t tell the whole story. Each state is its own marketplace, so each state needs its own palatable mix of healthy and sick enrollees. That’s why when there was (premature) speculation premiums would skyrocket next year, those sounding the warning had to specify the impact would be felt differently in different parts of the country. A state might fare very well if it had a good 2014 and vice versa.
What really matters is what insurers themselves expected, because that’s how they priced their products. Their expectations might not have been the same as the White House’s and certainly varied depending on the demographic make-up of individual states. Washington, D.C.’s numbers, for example, are likely skewed by congressional staffers required to purchase insurance through the insurance marketplace — and insurers likely accounted for that because D.C. is also its own market. The 2015 premiums will be the ultimate signal.
But based on last week’s enrollment report and its raw numbers on the young and healthy sign-ups, these are the states (plus D.C.) with the best and worst Obamacare outlooks going into 2014.
1. Washington, D.C: 45 percent of sign-ups were ages 18 to 34
2. Utah: 33 percent
3. (tie) Alabama: 31 percent
3. (tie) Georgia: 31 percent
3. (tie) Kansas: 31 percent:
3. (tie) Mississippi: 31 percent.
3. (tie) New York: 31 percent
3. (tie) Virginia: 31 percent
1. West Virginia: 19 percent of sign-ups were ages 18 to 34
2. Hawaii: 20 percent
3. Arizona: 21 percent
4. (tie) Oregon: 22 percent
4. (tie) Vermont: 22 percent
Data for all 50 states and TPM’s map tracking month-by-month enrollment are below.