Observations on Obamacare from the marketplace

Observations on Obamacare from the marketplace

About half of the enrollments are coming from people who were previously insured and half are not. When I try to gauge this, I go to carriers who had high market share before Obamacare and have maintained that through the first open enrollment. Some carriers have said only a small percentage of their enrollments had coverage before but health plans only would know who they insured before.  By sticking to the high market share carriers who have maintained a stable market share and knowing how many of their customers are repeat buyers, it’s possible to get a better sense for the overall market. Other conventional polls have suggested the repeat buyers are closer to two-thirds of the exchange enrollees.

The number of those in the key 18-34 demographic group improved only slightly during the last month of open enrollment so the average age is still high. The actuaries I talk to think this issue of average age is made to be far more important than it should be. It is better to have a young group than an old group. But remember, the youngest people pay one-third of the premium that older people pay. The real issue is are we getting a large enough group to get the proper cross section of healthy and sick?


About 15% to 20% of new enrollees are not completing their first month’s enrollment by not paying their premium, according to my marketplace discussions.

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I note that the California exchange just reported their non-pay number was 13%. That makes sense to me because California did not have the information technology difficulties the feds did––many of the non-pays were caused by system related problems like duplicate enrollments and “834” transactions that weren’t able to be processed. California also appears to have a population more amenable to the new health law and therefore more likely to pay than the national average.


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