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More Than 3 Million Have Selected Health Insurance Plans in Exchanges, HHS Says

By Emily Ethridge, CQ Roll Call

February 12, 2014 -- More young people are signing up for coverage in the health insurance marketplaces, as well as more people who qualify for financial assistance for coverage, Health and Human Services (HHS) Secretary Kathleen Sebelius announced last week.

All told, nearly 3.3 million people selected plans in the state and federal marketplaces from Oct. 1 through Jan. 31, HHS said, with 1.1 million enrollments occurring in the month of January.

That January number is lower than the 1.8 million people HHS said enrolled in December, but administration officials emphasized that enrollment grew 53 percent in January over the first three months combined. Officials said they did not have data on how many of those who have selected plans have actually made a premium payment, or how many were previously uninsured or had their previous coverage cancelled because it did not meet the law's (PL 111-148, PL 111-152) requirements.

Officials also said that there is no internal discussion at HHS about extending the deadline to purchase insurance coverage past March 31.

Sebelius said 27 percent of the January enrollments came from young adults ages 18 to 34, which is up 3 percentage points from the previous three-month reporting period. That uptick offers hope to the administration that its outreach to young people is paying off.

Enrollment by healthy young adults is considered crucial for the stability of the new health insurance system, but administration officials rebuffed the idea that they had specific numbers they must reach.

"Every individual who is enrolled in a health plan is a success story," said Julie Bataille, a spokeswoman for the Centers for Medicare and Medicaid Services, on a recent call with reporters.

HHS officials said the numbers were consistent with the expectation that young people would wait until closer to the March 31 enrollment deadline to select a plan.

"We're encouraged by the enrollment numbers that we are releasing today and believe that we will see more enrollments in young people in the weeks to come," said Bataille.

The department said that young adult enrollment in January grew by 65 percent compared to the previous three-month reporting period, while enrollment for all other age groups combined increased by 55 percent.

Some observers say a lack of awareness about the young people is preventing young people from enrolling, even as the administration continues education efforts. A blog post in the journal Health Affairs noted that just 25 percent of young adults with incomes above 138 percent of the federal poverty level, and who are uninsured or have individual coverage, were aware of the marketplaces and subsidies. Just 41 percent were aware of the law's mandate.

The administration noted that 81 percent of young adults chose more pricey silver, gold or platinum plans. "The covered population is getting younger, and much younger Americans are choosing high-quality silver, gold or platinum plans," Sebelius said.

Only 1 percent of all enrollees selected catastrophic plans, but 97 percent of those who did so are young adults, according to the report.

The increased enrollment overall in January also indicates that people are having an easier time navigating the troubled website for the federally run exchange. "The site has supported the demand we've seen from consumers so far," said Bataille, who noted that work on the site continues "24/7."

HHS also found that 82 percent of people who selected a plan are eligible for financial assistance with their coverage, up from 79 percent during the period lasting from Oct. 1 through Dec. 28.

Of the 3.3 million who have selected a plan, 1.4 million did so in a state-based marketplace while 1.9 million did so in the federally facilitated marketplace. More than half—55 percent—of enrollees are women and 45 percent are men, HHS said.

Nearly one-third of the enrollees are age 34 and under, a statistic that includes children, while 25 percent are between the ages of 18 and 34.

In addition, about 3.2 million people have been assessed for their eligibility for Medicaid or the Children's Health Insurance Program through the marketplaces, HHS said.

House Minority Leader Nancy Pelosi, D-Calif, praised the enrollment numbers and called on Republicans to stop trying to repeal the law.

"Young adult enrollment is outpacing all other age groups, as more and more young people discover how the Affordable Care Act gives them coverage that meets their needs and their lifestyle," Pelosi said in a statement. "The Affordable Care Act is delivering on the historic promise of affordable, quality health coverage for all Americans."

But Republicans said the enrollment numbers were still below the administration's earlier goals.

"The Administration is a million short of its own goal for this month, and the young continue to reject ObamaCare," said House Ways and Means Committee Chairman Dave Camp, R-Mich., in a statement. His reference was to enrollment numbers that still fell short of being on pace to reach an earlier goal of enrolling 6 million people by March 31, or about 1 million people a month.

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