Older people lured to insurance marketplace

With the enrollment deadline for the nation's health insurance marketplace six weeks away, federal officials say they remain confident the "young invincibles" will sign up in larger numbers.

Yet new monthly data released Wednesday show that just 25 percent of the nearly 3.3 million who signed up nationwide by Feb. 1 were in that 18-to-34 age group that has been considered key to keeping insurance costs down by balancing the financial risks of covering older people.

The majority, 69 percent, of enrollees were 35 to 64, the government reported.

"We will see more younger people enroll in the weeks ahead until the deadline. We believe we have work to do" on enrollments, administration spokeswoman Julie Bataille said.

Recently, officials and experts have backed off on the effect young people could have on the marketplace's success, saying it's more important to enroll healthy people, regardless of age.

Reports had indicated that to keep insurance rates competitive, the marketplace needed 40 percent participation from young invincibles, who got the nickname because they typically need little medical care and their premiums would help cover the costs of older Americans.

An estimated 16 million people in that age group are uninsured nationwide.

U.S. Health and Human Services Secretary Kathleen Sebelius found encouraging news in Wednesday's report.

"We're seeing a growing population of Americans who are young, healthy and well-covered, and these younger Americans are signing up in greater proportions," she said. "Nearly 1 in 3 Americans who have enrolled since Oct. 1 are now younger than 35."

Vivian Ho, the James A. Baker III Institute health economics chair at Rice University, agreed that enrolling healthy people matters. But she said it's important to enroll more young people because they account for such a large percentage of the nation's uninsured.

"It's just too early to tell what's going to happen," she said.

Ho said she's not convinced a mass of young people will sign up for coverage by the March 31 deadline. She believes many will choose to pay the penalty for not signing up - $95 or 1 percent of household income, whichever is larger.

"The only thing that will force them to sign up is the fine," Ho said. "The fine is going to increase to $695 in two years."

Neither Sen. John Cornyn nor Sen. Ted Cruz could be reached for comment about the enrollment data released Wednesday. Last month, Republicans jumped on the age-breakdown data as evidence the administration will fall short of its health care goals.

The new report, which covers sign-ups between Oct. 1 and Feb. 1, also indicated more women than men have continued to sign up for coverage.

Federal officials do not know how many of the people selecting the plans were previously un-insured, how many were Hispanic or how many have paid premiums.

In Texas, enrollment nearly doubled from more than 118,500 people selecting coverage by the end of December to about 207,500 by Feb. 1. Females continue to outpace males in enrollments, 56 percent to 45 percent. More than 66 percent who picked plans were 35 to 64 years old. Twenty-seven percent were 18 to 34.

The report says more than 586,000 Texans are eligible to enroll in marketplace plans, with about 302,000 applicants qualifying for financial assistance. More than 80,000 applicants qualified for Medicaid, but it's unclear whether they enrolled in that program.

Ho said it was encouraging that more Texans had selected coverage, but she said the number has little meaning without knowing how many of those are truly insured.

"That doesn't mean these people are actually going to pay premiums and become insured," she said, adding that the government should have an idea.

Until last week, federal officials projected that 7 million people nationally would sign up for marketplace coverage in 2014, with almost 3 million of them between the ages of 18 and 34.

The Congressional Budget Office dropped the projection to 6 million, citing the marketplace's disastrous rollout of its healthcare.gov website. Problems prevented people from using it more than a month after its Oct. 1 launch.

Rosa Velasquez is among the Texans who have applied for coverage but not yet bought a plan. The Houston massage therapist earns about $17,000 and has received medical care through Harris Health System's financial assistance program for low-income residents. She pays no premiums and is charged $3 to see a doctor.

Velasquez, who describes herself as a healthy person, said she's not sure she can afford to buy coverage.

"I'm trying to see what's best," the 60-year-old grandmother said. "It depends on the cost. That is the concern among all the people."