Concern Expressed About Age Mix On Exchange
Enrollment through Connecticut’s health insurance exchange has increased over the past month, but Access Health CT board members were more interested in how many of those individuals were below the age of 34.
Enrollment numbers released Thursday showed that only 21 percent of those enrolling with one of the three private insurance carriers were between the ages of 18 and 34.
The average age of a person enrolling through the exchange with a private carrier is about 44 years old. About 35 percent of enrollees are between age 55 and 64, 23 percent fall between 45 and 54, and 41 percent are below the age of 44.
The number of people younger than 44 has increased about four points between December and January, Access Health CT’s Chief Operating Officer Peter Van Loon said. The 45 to 54 age group has gone up one point and the 55 to 64 age group has gone down five points.
“With reinsurance these concerns should be mitigated,” Van Loon said.
The concern he’s talking about is that people signing up for health insurance through the Affordable Care Act tend to be older and potentially less healthy. That’s the type of demographic mix that could threaten the calculations upon which the law is built.
Paul Philpott, an Access Health CT board member, said a recent New York Times article pointed out that the number needs to be closer to 25 percent to achieve actuarial viability.
“We’re actually tied with Florida at 21 percent. I don’t know if that’s a great place to be,” Philpott said.
Access Health CT CEO Kevin Counihan said there are three federal programs in place for three years to help insurance companies remain economically viable. One is a reinsurance program, one is a risk adjustment program, and another is a program to help address the issue of risk. All three programs are set up to “ameliorate adverse selection,” Counihan said.
He said if there is a claim that comes in for $200,000, the insurance company is only expected to pay $45,000. The rest is picked up by the federal reinsurance program.
“I totally appreciate your point about actuarial soundness,” Counihan told Philpott. “There has been a lot of attention paid to age mix. I personally think, and I would love to debate with you offline, that it’s a bit of a red herring at this point.”
Counihan said there are a lot of young people who tend to do a lot of things at the last minute. Enrollment in the exchange is open through the end of March.
He said he thinks the worry about the age mix is “just a little bit overstated.”
Philpot said he’s a little bit more concerned about it than Counihan because “all the reinsurance in the world does not change the underlying claims experience.”
He said the $200,000 claim still gets paid out by somebody.
Counihan said his point is that it doesn’t impact the actuarial soundness of the health plans, but there’s a debate to be had about whether the federal government should be doing that type of thing.
Robert Scalettar, another Access Health CT board member, urged caution about the age mix.
“We still don’t know what the health status is of the population,” he said. “We still understand what the age mix is, but we don’t know whether we are getting the 60-year-old gym rats, and there are plenty of sick young people as well.”
He said implicit in the conversation is whether the program is viable and whether it will increase premiums in the out years.
“They may have set rates pretty much in line with what they’re going to get,” Scalettar said.
He emphasized that it will take a year of medical claims experience in order to find out. Counihan added that there’s a marketing component and Access Health CT is focused on reaching 18- to 34-year-olds.
Meanwhile, between Oct. 1 and Jan. 15, some 86,001 individuals enrolled for plans through the exchange.
Of those, 43,840 individuals enrolled in plans with one of the three private insurance carriers: Anthem, ConnectiCare Benefits, and HealthyCT. Anthem has 64 percent of the enrollees, ConnectiCare has 33 percent, and HealthyCT, the new nonprofit, has 3 percent. The other 42,161 individuals are Medicaid recipients.