PPACA enrollment likely to exceed target

Although the Dec. 15 enrollment deadline for health coverage through the public exchange system has barely passed, tea leaf readers are releasing forecasts about how many Americans will purchase coverage in 2015 based on the activity.

Among them: consulting firm Avalere Health, which has been crunching data related to the Patient Protection and Affordable Care Act and spitting out forecasts and analyses for some time now.

Avalere predicted Tuesday that, by the end of 2015, some 10.5 million Americans will have purchased coverage via the exchanges. That’s good news for the Obama administration; it had estimated that slightly more than 9 million would opt for coverage. However, it’s less than the 13 million projected by the Congressional Budget Office. In 2014, 6.7 million got coverage via the exchanges.

The Avalere estimate assumes that between 4.5 million and 6 million Americans will become new health insurance customers thanks to PPACA. If that doesn’t quite add up, that’s because up to 16 percent of those who had coverage this year will likely drop it for various reasons next year, Avalere said.

“Altogether, total 2015 enrollment is tracking between 9.5 and 11.5 million, including people renewing their plans,” said Caroline Pearson, vice president at Avalere. “While 2015 enrollment may fall short of CBO estimates, it is still likely to exceed the Administration’s projections.”

Avalere said the challenge for 2015 enrollment will be to convince hard-to-reach segments of society to apply for insurance. Among the factors cited by Avalere’s forecast:

  • Health status: Convincing healthier individuals, especially young people, to enroll. Many people without major health issues didn’t sign up in 2014.
  • Age: Again, targeting younger people will be a challenge, since they tended to avoid application for coverage via the exchanges despite its low (or no) cost. “In 2014, 48 percent of exchange enrollees were over 45 years old. Over time, the percentage of enrollees in the elusive 18-34 age bracket must grow to meet enrollment targets,” Avalere said.
  • Income: Subsidies drew low-income Americans to the exchanges, but didn’t apply to higher earners. In some cases, those with higher incomes would have paid more for exchange insurance than the coverage they already had. “Subsidies provide clear value to many low-income enrollees; however, attracting higher income individuals to the market will be more challenging,” Avalere said.
  • Race and ethnicity: The government must continue to pursue Hispanics, who comprise almost a third of the uninsured but just 11 percent of 2014 enrollees.

December 16, 2014

Leave a Reply

Your email address will not be published. Required fields are marked *