Practice Economics

Eight million enroll in ACA plans; 28% are young adults


With the official figures in, the federal government reported that more than 8 million Americans enrolled in private health plans through either state- or federally run insurance marketplaces between Oct. 1 and April 19.

A month after the close of the Affordable Care Act’s first open enrollment period, the Health & Human Services department released a detailed accounting of enrollment through the marketplaces. The final number for private plans was 8,019,763, including individuals who enrolled during the special enrollment extension ending April 19.

Although 8,019,763 Americans enrolled in private health plans, there is no data on how many individuals had paid their premiums.

HHS officials still could not say how many of the individuals who signed up for coverage had paid their premiums. That information won’t be available until later this year, they said.

It’s also still unclear how many of those who signed up for health plans through the marketplaces gained coverage for the first time. Among the 5.18 million individuals who selected plans in the federal marketplaces and also applied for financial assistance, only 13% said they had coverage at the time of their application. But HHS officials said that number is probably not reliable because it only includes a subset of enrollees and they were asked a narrow question about coverage, which did not take into account whether individuals had recently lost their coverage.

According to federal officials, an additional 4.8 million people gained insurance coverage via Medicaid and the Children’s Health Insurance Program, an additional 3 million adults under age 26 gained coverage by staying on their parents’ health plans, and an estimated 5 million people gained coverage by buying ACA-compliant plans outside of the marketplaces.

The report also sheds some light on who the newly insured are.

The majority of those who signed up for coverage on the ACA marketplaces were women (54%). About a third were under age 35, with 28% between the ages of 18 and 34 years. The largest number of sign-ups were among individuals aged 45-54 years (23%) and 55-64 years (25%).

Most who signed up (85%) qualified for financial assistance. The most popular type of health plan was the "silver" plan, with 65% selecting that plan and another 20% opting for the "bronze" plans.

Race/ethnicity was reported by 69% of enrollees. Of those, nearly 63% reported their race/ethnicity as white, 17% were African American, 11% were Latino, 8% were Asian, 1% were multiracial, and less than 1% were American Indian/Alaska Native and Native Hawaiian/Pacific Islander.

Republican lawmakers on the House Energy and Commerce Committee contend that only 67% of those who have selected a health plan in the federal marketplaces had paid their first month’s premium as of April 15. The committee said their information came from asking the insurance companies participating in the marketplaces for their enrollment data.

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