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White House Effort to Draw Healthy People into Exchanges

By Emily Ethridge, CQ Roll Call

May 10, 2013 -- The Obama administration has identified specific groups of people it would like to focus on as it promotes enrollment in the state health insurance exchanges next year.

The administration plans a localized approach to reach 2.7 million healthy people who are 18 to 35 years old and without health insurance, according to information provided by senior administration officials.

Enrolling that population group is crucial to stabilizing the marketplace, because the healthier people will balance out the costs of covering enrollees who are older and sicker. The ratio of healthy people to sicker people who participate in the exchanges will affect the premium rates in the second year.

The Congressional Budget Office (CBO) expects 7 million people to enroll in the insurance exchanges in the first year, and the administration expects that nearly 5 million will be those with pre-existing conditions or those who already buy insurance on the individual marketplace.

Of the 2.7 million young people being pursued, 96 percent have no chronic conditions, 57 percent are female, and 52 percent are non-white, according to senior administration officials. In addition, one-third of the population lives in one of three states: California, Florida and Texas.

The administration's focus now is on consumer outreach and assistance, as nearly all of the guidances and rules for the health care law's (PL 111-148, PL 111-152) marketplaces are complete, the officials said.

Speaking at a recent White House event, President Barack Obama touted the law's benefits and tried to assure people who are anxious about the law.

"I am 110 percent committed to getting it done right," he said. "It's not an easy undertaking. If it were easy, it would have already been done a long time ago. Undoubtedly there will be some mistakes and hiccups as the thing gets started up, but we're learning already from them."

The administration's enrollment outreach will be tailored to each specific group, and the plan is to appeal to young people with a simple insurance application, providing new benefits, and tax credits to help buy insurance. For example, in California, 54 percent of the goal population is eligible for tax credits, and 50 percent is Hispanic.

Administration officials also said they planned on reaching out to mothers specifically, because they can encourage their children to buy insurance.

Assisting in the outreach efforts will be community health centers, which recently received $150 million from the law to help enroll the uninsured. Churches and other community organizations can also help with enrollment, the administration officials said. They noted that lessons learned from the 2012 presidential campaign have informed their outreach plan.

Open enrollment for the insurance exchanges begins Oct. 1 and lasts for six months, with coverage beginning Jan. 1, 2014. That gives the eligible population an extended period to sign up, so the outreach efforts can ramp up over time, the officials said.

The officials noted that they recently completed the paper application for insurance in the exchanges for single adults, which is three pages long. They are now translating that into an online application.

The administration said that once people enroll in the exchanges and begin receiving insurance benefits, the politics of the law could change. The GOP message of stopping the law will mean taking away real benefits, not something abstract, they said, noting that the House plans to vote on a bill (HR 45) to repeal the law next week.

Republican leaders criticized Obama's speech and promoted the upcoming repeal vote.

"The president's health care law is a train wreck for men and women alike, and that's why a majority of Americans support Republican efforts to repeal it to protect their health care—and their jobs," Speaker John A. Boehner, R-Ohio, said in a statement. "The entire law should be repealed so we can enact a step-by-step, common-sense approach to health care that starts with lowering costs and protecting American jobs."

Obama dismissed the "political bickering" over the law and told people to get informed about how the law would affect them personally.

"Precisely because there's been so much misinformation, sometimes people might not have a sense of what the law actually does. And that misinformation will continue at least through the next Election Day," he said. "This is too important for political games."

"You stand to benefit, if you're not already benefiting from this thing," Obama added. "Don't let people confuse you. Don't let 'em run the okey-doke on you. Don't be bamboozled."

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