The key, both KFF and Chandler say, is to recruit enough healthy members no matter what their age.
“It is important to attract the ‘young invincibles,’ but maybe with a greater focus on the ‘invincible’ part,” the KFF study said.
Many worry that consumers with expensive illness will be the first to sign up and healthy folks, who don’t think they need immediate coverage, will be inclined to stay away — especially given the sign-up portals’ computer problems.
The KFF analysts expect young-adult enrollment to increase with the approach of the March 31 signup deadline to avoid penalties for lacking coverage. Even if some carriers experience sicker-than-average members and high medical claims, the ACA includes risk-sharing mechanisms to reduce carriers’ exposure and potential need to raise premiums, many have noted.
Chandler, whose blog is entitled “ACA Death Spiral,” is less confident it will all work out.
President Obama’s decision to let insurers renew 2013 plans for existing policyholders will tend to keep healthy people out of plans falling under the health law, which could drive up average costs, he said. He thinks risk-sharing mechanisms might need hundreds of millions of dollars more to do their job of stabilizing the market.
In any event, what’s most important is not enrollees’ birthdays but how sick they are. Nobody will know that for months.
“People have focused on age because that is the only data we have,” Chandler said. “But the real issue is the health status of the people we enroll.”
Kaiser Health News is an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communications organization not affiliated with Kaiser Permanente.
Tue, Dec 17 2013