WASHINGTON - More than half of the almost 2.2 million people who bought health insurance on federal and state exchanges in the last three months are older than 45, records released Monday show.
Almost 1.2 million people have enrolled in private insurance through the federal health care exchange from Oct. 1 to Dec. 28., Health and Human Services Secretary Kathleen Sebelius said, and more than 1 million signed up in December alone.
Another 956,000 people have signed up for private insurance through state-based exchanges between Oct. 1 and Dec. 28, HHS records show.
About 55% of the early enrollees, Sebelius and other officials said, are between the ages of 45 and 64, an older group of people that often drive up health care costs.
Julie Bataille, spokeswoman for the Centers for Medicare and Medicaid Services, said 3.9 million people have signed up for Medicaid directly through the states, and that some of those enrollments are renewals. Combined with the young people still covered with their parents, that comes to 9 million people enrolled in private plans or Medicaid who may not have had the coverage before the 2010 passage of the Affordable Care Act.
Despite the large percentage of older Americans buying insurance, about 26% of those who enrolled are younger than 35, HHS officials said.
Nancy Delew, acting HHS deputy secretary for planning and evaluation, said the percentage of young people is similar to that seen in the early months of Massachusetts' enrollment in its health exchange under former Gov. Mitt Romney, the 2012 Republican nominee for president. The Massachusetts law, passed in 2006, was the model for much of the federal law.
Federal and state officials said they are continuing their efforts to advertise the need to buy health insurance to younger Americans, who are considered essential to the financial health of the health insurance market because they pay premiums but often do not use many health care services.
In essence, they help subsidize the health care costs of older people.
Delew said HHS expected older Americans would sign up for health insurance earlier, because they needed it, while younger people will wait until the deadlines.
Aaron Smith, co-founder of the Young Invincibles, a group that works to enroll young people in the exchanges, said the ultimate goal is that 37% to 40% of enrollees would be younger than 35.
"I think where we're at now shows that we're on track for that," he said. "We saw huge numbers in December, compared to the previous months."
Sebelius' announcement is another indication of the surge in enrollments since the troubled HealthCare.gov site was fixed on Nov. 30. But the early problems surrounding the site, plus controversy over insurance policies canceled because they didn't meet the requirements of the Affordable Care Act, have damaged the early months of the implementation of this key part of the law.
"We're seeing a very strong response through the marketplace," Sebelius said, adding that people have 11 more weeks to sign up for insurance through the exchanges. Those who do not have health insurance after March 31 will have to pay a penalty.
States showing gains
Along with the surge in federal enrollments in December, state exchanges said they are seeing rapid gains.
Peter Lee, executive director of California's health exchange, said younger Californians are "enrolling at rates similar to their population."
California is also stepping its advertising to younger people. On Thursday, it will start a YouTube campaign that uses comedians, celebrities and athletes to "speak to young people about why health reform is so relevant to them." Though it's led by California, the Tell A Friend, Get Covered campaign is nation-wide.
Lee said the state will also focus on students returning to school after winter break. "It's all part of building on the momentum that there has been already to enroll young people," he said.
Monday's news comes just after CMS announced it has replaced its lead contractor, CGI Federal, with Accenture. Accenture built California's site, which has been leading enrollment numbers in the state exchanges.
"Accenture's been a very good partner for us," Lee said. "We've had bumps in the road, but it's been a well-managed process."
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