Two health insurers say that the Ohioans signing up for their coverage through the state's federally run marketplace are trending younger as the open-enrollment deadline nears.
Whether that infusion of youth can keep premiums affordable for the hundreds of thousands of residents expected to rely on marketplace coverage in future years remains to be seen.
A spokesman for Medical Mutual of Ohio, which has had 45,000 people sign up for its marketplace plans, said the average age of its enrollees has declined by 10 years since Ohio's federally run health-care marketplace opened in October.
CareSource, a Dayton-based carrier also selling marketplace plans to central Ohioans, is reporting a similar trend in the 22,100 people it has signed up so far for its coverage. Their average age has dropped under 40, down nearly five years from the average enrollee age at the end of 2013.
"This indicates younger Ohioans are signing up just in time for coverage," said Scott Streator, CareSource's vice president for the health-insurance marketplace.
While expected, the last-minute youth signups are a welcome sign for supporters of the federally run marketplace, whose rollout in October was marred by technical problems.
Young people tend to be healthier, and it's widely thought that getting them signed up in greater numbers will help offset the cost of care for those on the cusp of Medicare eligibility.
In other words, the more young people who get covered, the more likely premium costs will be kept lower in 2015 for potentially hundreds of thousands of Ohioans who don't get coverage through their employer or Medicaid and choose to enroll through the marketplace.
A state-commissioned report in 2011 estimated that the state's marketplace enrollment would be 524,000 in 2017.
The supply of 18- to 34-year-old enrollees did not meet initial expectations, said Trey Daly, state director of Enroll America, a national organization working to maximize the number of state residents with health insurance.
"Finally, people are starting to focus," Daly said. "People put it off until the last minute. I think we all have procrastinator tendencies, and that's particularly true of the 18-to-34 segment."
The deadline to sign up for coverage technically is Monday, but the Obama administration announced last night that all consumers who have begun to apply for coverage on HealthCare.gov, but who do not finish by Monday, will have until about mid-April to ask for an extension.
Under the new rules, people will be able to qualify for an extension by checking a blue box on HealthCare.gov to indicate that they tried to enroll before the deadline. This method will rely on an honor system; the government will not try to determine whether the person is telling the truth.
The rules, which will apply to the federal exchanges operating in three dozen states, will essentially create a large loophole even as White House officials have repeatedly said that the Monday deadline was firm. The extra time will not technically alter the deadline but will create a broad new category of people eligible for what's known as a special enrollment period.
Problems at the outset of the marketplace's six-month enrollment period overshadowed the Obama administration's positive messages: that tax credits and subsidies would make marketplace coverage more affordable to many middle-class uninsured, and that people no longer could be denied coverage because of their pre-existing conditions.
Coverage also will be more comprehensive.
Despite the fact that 85 percent of those who have picked a plan in Ohio qualified for financial assistance, the sign-ups have been sluggish across the state.
A Kaiser Health News report this month found that, of 10 high-population states considered key to enrolling 6 million people in marketplace plans by March 31, only Ohio and Texas had seen less than 10 percent of potential enrollees sign up for such a plan.
As of March 1, 78,925 Ohioans had signed up, 52 percent of the federal government's goal for the first five months.
And in Ohio, 36 percent of those who had signed up for a marketplace plan through March 1 were 55 to 64 years old, according to data released by the federal government this month. That's the fifth-highest rate in the nation.
"We're seeing almost double the number of members in the 50-to-60 age group than we forecasted and just shy of half of those we expected to see under age 21," a Medical Mutual spokesman said in an email.
Ohio's older population in general helps explain that statistic, said Kathleen Gmeiner, director of Ohio Consumers for Health Coverage. So does pent-up demand for affordable health care.
A Kaiser Family Foundation analysis found that before the exchange, health insurers in Ohio had been denying coverage 33 percent of the time, a rate tied with Kentucky's and North Carolina's for highest in the nation.
Locally, Enroll America brought a "Countdown to Get Covered" bus campaign through Ohio last week. It stopped at Columbus State Community College, which held three public enrollment events in the past eight days.
Steve Salmen, 57, of Columbus, was there to learn more.
After the event, he said he remains frustrated and angry that the premium for his family's existing health insurance increased from $774 to $1,673 per month. And he's upset that marketplace coverage, comparably priced to what he paid last year, means he will have to accept government assistance.
"In December, my policy was affordable, and in January, it was no longer affordable," said Salmen, who was planning on purchasing through the exchange.
Now, "I have to take government subsidies."
But Steve Guthrie, 59, of Columbus, said he appreciates the peace of mind that cannot be taken away based on a pre-existing health condition in his family.
The self-employed owner of a chimney service business, his wife and their 18-year-old son had been on COBRA coverage from Guthrie's former job as a private-school teacher, but that coverage was temporary.
"We've barely escaped a couple of uninsurable moments," Guthrie said.
The plan he purchased through the marketplace was made more affordable with a tax credit.
"I saved $1,000 a month for what I think is better coverage," he said.The softening of the enrollment deadline, which the Obama administration is scheduled to announce officially today, is supported by consumer advocates who want as many people as possible to gain insurance under the 2010 Affordable Care Act. But it's likely to be criticized by Republicans who oppose the law and have denounced the way the administration is implementing it.
Administration officials said the accommodation is an attempt to prepare for a possible surge of people trying to sign up in the final days before the deadline. Such a flood could leave some people unable to get through the system.
The extra time also is designed to help people whose applications have gotten held up because of the website's technical problems -- or who haven't been able to get the system to calculate subsidies to help them pay for coverage.
According to a Health and Human Services official, who spoke on the condition of anonymity, an exact time frame for this extension has not been set, and depends in part on how many people request it. Nor have officials decided precisely how long people will have to select a health plan after they get the extra time.
By Ben Sutherly - The Columbus Dispatch, Ohio (MCT)
Information from The Washington Post was included in this story.
©2014 The Columbus Dispatch (Columbus, Ohio)
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