Saturday, November 2, 2013

This is a BIG DEAL!

Most of these folks ended up in Medicare (about 85%), but my guess is the 41% figure will also be pretty close for the under 35s' share of health plan purchases. Here's the Healthier Kentucky site, so you can follow the progress over time.

38.6% signup from the under 35s' is the enrollment percentage for this critical group: 2.7 million target for under 35s' out of total Exchange target of 7.0 million. If we hit this "mix percent", we should have a balanced risk pool, thus avoiding premium spikes next year or any "death spiral". 

This is early evidence only. And it's not enough. But it's a good sign.

The only real argument Conservatives have ever had against the program is that the under 35s' won't sign up, leaving the risk pool unbalanced towards the less healthy, leading to a premium death spiral, and the possible collapse of the program. 

I have long predicted that they would sign up, because the vast majority of the uninsured have incomes less than 200% FPL (about $23,000); they cannot afford insurance (though they would like it); and at that income level, the subsidies are hefty, making buying insurance affordable. The uninsured under 35s' are not, for the most part, the young urban professional earning $30-35,000, and feeling immortal. These are the folks that Megan McCardle, George Will, Yuval Levin, and many others must have talked to, or been thinking of, in making their declarations of absolute certainty that the under 35s' will not sign up "against their interest." They will sign up. Because it is most definitely in their interests.

There's an interesting sleeper element emerging: what will the folks, with the bare bones plans that are being cancelled, decide to do - once they get over being mad? I think they'll buy insurance on the Exchanges, even at a higher price. Some will deal with insurance companies directly. Many will go to the Exchanges. Many are under 35 and healthy. Signups from this very large group should ensure pool stability.

The ACA is going to launch on solid footing, which will become evident by Christmas, or sooner. Enrollments may take time, like they did in Massachusetts. They may even have to delay the penalty schedule for a year, or issue a Policy Notice after March 31, saying that anyone certifying that he/she could not access the Marketplace will not be subject to the penalty. There is much Sound and Fury still to come, but...

Obamacare is here to stay, and its emerging success will be the reason the Dems retake the House in November.

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