Younger, healthier Americans needed to make Obamacare financially viable are not signing up in sufficient numbers. Most enrollees have been people older than 50, many with pre-existing medical conditions.
The skew toward the older crowd raises concerns that there will not be enough payments from young people to offset the cost of providing coverage for the older, ailing population, the Wall Street Journal reported
The early numbers, while statistically too small to draw conclusions, raise concerns about the practicality of the insurance marketplaces.
"We need a broad range of people to make this work, and we're not seeing that right now," Heather Thiltgen of Medical Mutual, one of Ohio's largest insurers, told the Journal. "We're seeing the population skewing older."
The target enrollee is about 40 years old.
If the older drift continues, a more expensive base of customers, older and less healthy, would drive up costs for everyone. The federal government has committed to reimburse insurers if they underestimated costs.
This still may not be enough to keep the system afloat should the overall customer pool be appreciably older than forecast.
Widespread problems with the HealthCare.gov system — which serves 36 states that are not operating their own marketplaces — have dissuaded younger, healthier people from enrolling. Those who cannot chance being without coverage have persevered.
Testifying before the Senate Health, Education, Labor and Pensions Committee on Tuesday, Medicare chief Marilyn Tavenner said the administration is trying to fix the problems with youth enrollment as soon as the website is fully operational.
“Based on our analysis we will have it fully functioning by the end of November,” Tavenner told the committee.
Under questioning from Maryland Democratic Sen. Barbara Mikulski about how the administration would get more young people enrolled, Tavenner declined to details specifics, but said that it would be “a combination of media — both television, radio, and some print.”
The campaign would run through December, January, February and March, and would focus on specific markets. Tavenner would not identify those areas, either.
The young-to-old ratio is not much different in the states that run their own marketplaces and where the process is smoother, according to the Journal.
In Connecticut, where Access Health CT is the Health Insurance Marketplace, the largest insurer, WellPoint Inc., reported that most of its enrollees were between 55 and 64, according to the Journal.
Under the law, people who want their coverage to start on Jan. 1 must enroll by mid-December. Those who seek coverage sometime later in 2014 must enroll by March 31.
White House officials are optimistic that younger people will sign on in large numbers as the deadlines approach, the Journal said.
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