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More Good News For The ACA: Final Month Of Enrollment Sees Surge In Young Adult Sign-Ups

President Obama speaks to college students before the start of open enrollment last fall.

President Obama speaks to college students before the start of open enrollment last fall.

The Affordable Care Act saw a surge in enrollment last month, as nearly 3.8 million people selected a plan through the exchanges, including 1.2 million young people, administration officials announced on Thursday. The last-minute surge represented “an 89 precent increase in the cumulative number of individuals” who signed up for a health care plan through the marketplace between March 1 and April 19.

Cumulatively, more than 8 million people have enrolled in a plan though the Affordable Care Act’s state and federal marketplaces since the beginning of open enrollment in October. More than 2 million of those people — or 28 percent — are between the ages of 18 and 34.

According to federal officials, an additional 4.8 million people gained insurance coverage via Medicaid and the Children’s Health Insurance Program, an additional 3 million adults under age 26 gained coverage by staying on their parents’ health plans, and an estimated 5 million people gained coverage by buying ACA-compliant plans outside of the marketplaces. We also got the first official reports on the race and ethnicity of those signing up for health care. Of those who did, 62.9 percent are white, 16.7 percent are African American, and 10.7 percent are Latino. Just over half (54%) of those who signed up for coverage were women.

The administration had considered participation of younger, presumably healthier, people essential to make cost projections viable. Significantly, the proportion of young people who’ve signed up falls in line with the experiences of Massachusetts, which enacted similar reforms in 2006. There, the number of young enrollees increased over time so that almost 30% of enrollees were between the ages of 19 and 34 after the first six months of sign-ups.

The administration also provides encouraging data on effectuated enrollment, or the number of individuals who have gained coverage through payment of the first premium. According to the report, insurers have indicated that “80 percent to 90 percent of the people who have selected a Marketplace plan have made premium payments.”

Young adults have traditionally had the highest rate of uninsured of any age group, with about 30% lacking coverage prior to the ACA. While a lot of young people think they don’t health insurance, those without coverage face significant health and financial problems. Young people are at a critical stage in their lives, when long-term health risks, such as obesity, sexually transmitted disease, and tobacco use, often present themselves, and when early medical intervention can make a real difference. About 1 in 6 young adults has a chronic illness like cancer, diabetes, or asthma, and nearly half of uninsured young adults report problems paying medical bills. Lacking proper health insurance can also lead to long-term financial problems if substantial medical debt is incurred. Now, in addition to having new ways to access affordable insurance, young adults will find that those plans offer better coverage. For example, many preventive care visits–which young adults are likely to need more than treatment for illnesses–are covered entirely.

Experts have long predicted that enrollment among young people would start off slowly and then surge at the last-minute, as we saw in Massachusetts, and as we are now seeing play out in state and federal marketplaces. This is just the latest in a string of good news for the Affordable Care Act, and for Democrats up for reelection in November. As more Americans gain coverage and begin to use their new health insurance plans, Republicans’ fixation with repealing the health care law is becoming more politically toxic with each passing day.


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