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U.S. Department of Health and Human Services

Silver plans by far the most popular insurance option

Kelly Kennedy
USA TODAY
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WASHINGTON — Almost two-thirds of the 8 million Americans who enrolled in health insurance through the Affordable Care Act picked mid-range "silver" plans, according to new data on sign-ups released Thursday by the Department of Health and Human Services Department.

The type of plans selected by those choosing private insurance, as well as the new customers' demographics, were key parts of the latest HHS report, which covers the entire open-enrollment period for the law.

Silver plans cover 70% of health costs, leaving the consumer responsible for the rest. Consumers could choose from bronze, silver, gold or platinum plans, with platinum plans having the highest premium and the lowest out-of-pocket costs for the consumer. About 20% chose bronze, 9% chose gold, 5% chose platinum. Two percent a bare-bones catastrophic care plan. All plans include no out-of-pocket costs for preventive exams, such as yearly physicals or women's annual cancer screenings.

The new data showed that 54% of those enrolling in insurance were women, while 63% of all enrollees were white. Of the remaining enrollees, the HHS report showed, 17% were African American, 11% Hispanic, 8% Asian, 1% multiracial, 0.3% American Indian/Alaska native and 0.1% native Hawaiian/Pacific islander.

Administration officials said they believe they will enroll more Latinos and younger people over the years, as they continue to emphasize their recruiting efforts.

Latino enrollment is "slightly lower" than the number of people qualified to enroll, with about 11% of the 14% of people eligible to enroll actually purchasing a plan, said Myra Alvarez, associate director of the HHS Office of Minority Health. But she said that was to be expected.

The statistics also do not include states with their own exchanges, such as California and New York, where millions of people enrolled in private plans. U.S. Census figures show that about 29% of Hispanic people are uninsured. Often, educating people about the Affordable Care Act and the exchanges also involved educating people about what health insurance is in general, Alvarez said.

One million of the 20 million calls to the HHS call center were in Spanish, said Julie Bataille, communications director for the Centers for Medicare and Medicaid Services.

About 20.8 million people are now enrolled in insurance because of the law, said HHS Secretary Kathleen Sebelius. That includes those 8 million who enrolled in private insurance, 4.8 million now covered by Medicaid and the Children's Health Insurance Program, 5 million who bought coverage outside the state and federal exchanges and 3 million adults younger than 26 now covered through their parents' insurance.

Eighty-five percent of those who enrolled in private health insurance through the state and federal exchanges between Oct. 1 and April 15 received federal subsidies to help pay for it, the HHS report showed. That is similar to figures released earlier by HHS.

The statistics also show that 28% of the 8,019,763 people who selected private health insurance are between the ages of 18 and 34, the age group that insurance analysts believe will help balance out the market's finances.

Thirty-one percent of the 3.8 million who enrolled in March were in the 18-to-34 age group, the latest records show. In the first three months of open enrollment, only 25% of those who enrolled were in that age group.

Officials believe enough younger people have bought insurance to keep premiums stable, said Michael Hash, director of the HHS Office of Health Reform.

There are some who believe the numbers could still go up significantly, particularly from the young and healthy.

Although open enrollment ended March 31, anyone who experiences a major life event may qualify to buy insurance, said Jen Mishory, executive director of the Young Invincibles, a non-profit group urging young people to get coverage. That includes marriage, moving, job changes and aging off parents' plans.

"All of those events are more likely to happen to people younger than 35," Mishory said. "The numbers are high in terms of who could qualify."

For example, Mishory said, about 2.6 million people will turn 26 and no longer be eligible for coverage under their parents' plans.

Enrollment in exchanges not run by the federal or state governments was estimated by the Congressional Budget Office to be 5 million. On Thursday, eHealth, the nation's largest private health exchange, released quarterly results that showed a 34% increase in individual and family insurance plans.

Brian Mast, an eHealth spokesman, said shopping for insurance on private exchanges has increased significantly.

report

While the number of people ages 18 to 34 fell from just over 50% last year to 42% this year at eHealth, Mast said it was still "a pretty healthy number." Last year, about 9% of enrollees were ages 55 to 64; this year, it's 16%.

In the first month of open enrollment, Mast said people who were not eligible for federal subsidies rushed to eHealth to buy insurance they probably could not buy before. They also tended to choose bronze plans, unlike the government exchanges where people chose silver plans.

An eHealth survey, Mast said, showed that 44% of its customers were previously uninsured.

WHO PAID PREMIUMS?

Despite the extent of the statistics, HHS still does not know how many people have actually paid their insurance premiums or how many have bought insurance that complies with the law but is outside the federal and state marketplaces.

"We are interested in having reliable and accurate data as much as you are," Bataille said, adding that she doesn't expect to have it until the end of the year.

HHS, however, did cite numerous reports from media organizations and insurance companies that show between 80% and 90% of those who selected plans have paid their premiums.

House Republicans pre-empted the data Tuesday with a report from the Energy and Commerce Committee that says that 67% of enrollees had paid their first month's premium by April 15. Committee members sent letters to every insurer included in the plan and asked for the data. However, the insurers told the committee that people still have time to pay the premium, so committee members will ask for an update by May 20. Committee members nevertheless cited the incomplete data to criticize the law.

"These numbers stand in stark contrast to the White House's previous assertions," said House Majority Leader Eric Cantor, R-Va. "If President Obama disputes the information provided by the insurance companies, he should direct HHS to immediately release complete enrollment data, including how many people were previously insured."

The House report did not include data from state-run exchanges. California announced that 1,395,929 people had signed up by April 15, well above its initial goal of 580,000, and that about 85% had already paid their premiums.

Though the market officially closed March 31, the federal site and several state sites remained open until April 15 for people who said they had a hard time completing their application by the deadline.

Sebelius announced her resignation last month after the federal exchange reached 7.5 million enrollees, which outpaced estimates. She will remain in the job until her designated successor, Office of Management and Budget Director Sylvia Mathews Burwell, is confirmed by the Senate.

Follow @kellyskennedy on Twitter

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