Report: Health status, not age, most crucial aspect of ACA

Young people, once considered a fundamental part to the Affordable Care Act’s viability, may not be as integral to the health reform law’s ultimate success after all, according to the results of a recent report.

In the days leading up to the enrollment period for the ACA, as well as in the time afterward, a variety of reports were released about insurance benefits, particularly as they pertained to the health reform law. For example, a study from the Kaiser Family Foundation indicated that the practicality of the ACA largely hinged on young people – most of whom are healthy – signing up for coverage, as their premiums would help pay for those who require medical services more frequently.

Though still important, an analysis from nonpartisan public policy think tank the Commonwealth Fund noted it’s not the be-all, end-all for the health reform plan to continue on.

Appropriately titled, “Young Adult Participation in the Health Insurance Marketplaces: Just How Important?” it found that more indicative of how the ACA will function is if a substantial number of people who are sick enroll for coverage through the state- or federal-based exchanges, regardless of their age.

One of the tenets of the ACA is that insurers cannot deny someone coverage because of preexisting conditions. The report found that while insurers have prepared for taking on more people who may be unhealthy, a higher-than-anticipated percentage of enrollees with health issues could complicate matters.

“There has been a lot of discussion about the importance of young adults in the marketplaces but no consensus on how many young adults are needed to achieve the right balance and what happens if those numbers aren’t reached,” said Sara Collins, author of the report and vice president for the Commonwealth Fund’s health care coverage and access department. “What these conversations and analyses by researchers illuminate is that the role of young adults has likely been over-emphasized. Their participation is important, but lower-than-expected enrollment this year won’t trigger market failure.”

Sufficient number of healthy enrollees needed not known
As for how many enrollees would be needed in order to effectively offset the number of unhealthy enrollees, the report said that it’s still too early to come to this type of conclusion. What’s important, however, is that a wide variety of people participate in the insurance marketplaces, not necessarily mainly young people.

“The Affordable Care Act was designed to extend affordable, comprehensive health insurance to the millions of Americans our health insurance system was failing,” said David Blumenthal, president of the Commonwealth Fund.

He added that more reports like these will be needed as more people continue to sign up for coverage through the exchanges, as these provide a more clear picture of whether universal health care can be achieved.

The White House has set a target of enrolling 7 million people through the exchanges by March 31, according to numerous reports.

The U.S. Department of Health and Human Services recently released the latest numbers of how many people have selected or enrolled in a qualified health plan, breaking down the numbers into categories. For example, of the approximately 3.3 million who have chosen a plan between Oct. 1 and Feb. 1, roughly 55 percent have been female and 45 percent male. Additionally, approximately one-third are under the age of 34, one in four are between 18 and 34 years of age, and the vast majority – 62 percent – selected a silver plan of the four different “metal” options. The second-most popular was bronze at 19 percent.