California's health insurance exchange is set to provide the first detailed information about the roughly 60,000 people who have signed up for coverage since open enrollment under the federal health care reforms began Oct. 1.
The figures, to be released during the Covered California board meeting Thursday, will test some of the agency's claims that the program is working effectively, including whether enough young and healthy people are signing up and how well its website is working. Insurers need to attract the healthier demographic to balance out the costs of those with pre-existing medical conditions who are most likely to seek the benefits of the online marketplaces.
Executive Director Peter Lee said last week that more than 59,000 people had signed up for private insurance health plans through the exchange from Oct. 1 to Nov. 12. That is a tentative number because Lee did not disclose the number of people who have actually paid premiums on their new policies. Those payments are due in December.
Nationwide, officials have acknowledged that early sign-ups have skewed toward older, sicker people who need health insurance. If that trend persists, it could lead insurance companies to increase premiums and deductibles in 2015 and beyond.
In California, Lee said, those who flocked to enroll first were “people that have been waiting a long time to get covered. They're weighted towards older, they're weighted toward people who have health conditions.”
He said people who are not as desperate for coverage might need to hear about Covered California seven or eight times before they sign up for health coverage.
Insurers have warned that they need a wide range of people signing up for coverage because premiums paid by adults in the younger and healthier group, between 18 and 35, are needed to offset the cost of carrying older and sicker customers who typically generate far more in medical bills than they contribute in premiums.
Covered California said it would release information about the age and income levels of enrollees, as well as ethnicity, language and which insurance plans they are choosing. The agency also said it would reveal the number of people who signed up using the website, www.coveredca.com, and the number who did so with paper applications.
Lee said last week that unlike the federal website, which has been beset with problems, Californians are “enrolling with ease” online.
Also Thursday, the board will announce California's responses to President Barack Obama's changes to the Affordable Care Act this week. Obama said he was extending the expiration deadline for existing individual policies to the end of 2015, and state Insurance Commissioner Dave Jones called on California to also extend its deadline. But insurance companies said that could lead to further problems with the exchange.
Covered California had already brokered a deal with insurance companies to end all those policies by Dec. 31, and Jones estimates that 1.1 million termination notices have gone out. Two companies already agreed to extend the deadlines for some policyholders because they failed to send the notices out in time.
So far, the Affordable Care Act has fallen far short of expectations in overall enrollment. The first set of data revealed that 106,000 people signed up for coverage nationwide during the first month, fewer than the roughly 500,000 initial sign-ups the Obama administration had expected.
Just a handful of states has released more detailed enrollment figures, all of which show older, sicker people signing up first. In Connecticut, six in 10 of those who have enrolled in private insurance are between 45 and 64 years of age. In Kentucky, nearly 3 of 4 enrollees were over 35. And in Washington state, less than a quarter of enrollees were between 18 and 34.