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Health care signups: More older Americans so far

Obama US Spain

WASHINGTON (AP) -- It's an older, costlier crowd that's signing up so far for health insurance under President Barack Obama's law, according to government figures released Monday. Enrollments are lower for the healthy, younger Americans who will be needed to keep premiums from rising.

Young adults from 18 to 34 are only 24 percent of total enrollment, the administration said in its first signup figures broken down for age, gender and other details. With the HealthCare.gov website now working, the figures cover the more than 2 million Americans who had signed up for government-subsidized private insurance through the end of December in new federal and state markets.

Enrolling young and healthy people is important because they generally pay more into the system than they take out, subsidizing older adults. While 24 percent is not a bad start, say independent experts, it should be closer to 40 percent to help keep premiums down.

Adults ages 55-64 were the most heavily represented in the signups, accounting for 33 percent of the total. Overall, the premiums paid by people in that demographic don't fully cover their medical expenses. Some are in the waiting room for Medicare; that coverage starts at age 65.

Some questions remained unanswered.

For example, the administration is unable to say how of many of those enrolling for coverage had been previously uninsured. Some might have been among the more than 4.7 million insured people whose previous policies were canceled because they didn't meet the law's standards.

"The uninsured folks for whom the law was intended don't seem to have signed up in nearly as high numbers," said Richard Foster, a former statistics chief for the Health and Human Services department. "There is still a huge unknown aspect to this."

But even if the age mix remains tilted toward older adults, "it's nothing of the sort that would trigger instability in the system," said Larry Levitt, an insurance expert with the nonpartisan Kaiser Family Foundation. Premiums would go up next year for the overhaul, along with taxpayer costs per enrollee, but not enough to push the system into a "death spiral" in which rising premiums discourage healthy people from signing up.

Levitt and other experts expected older, sicker people to be more heavily represented in the early numbers. They would have had strong motivation to persevere in the face of website dysfunction.

Still, he said "it underscores a need to heighten outreach efforts to young people." Adults ages 18-34 represent 40 percent of the target group for the health care law, according to a recent Kaiser study. Open enrollment ends March 31.

Considering that the federal health care website was down most of the time in October, administration officials said they were pleased that the percentage of young adults was as high as it was.

"We think that more and more young people are going to sign up as time goes by," said Gary Cohen, head of the HHS office in charge of Obama's push to cover the uninsured. And there's a hammer, too: Those who fail to sign up face a tax penalty in 2015 for being uninsured.

With Monday's numbers, a fuller picture has started to emerge of who's signing up.

Some of the highlights:

- The administration continues to play catch-up. Originally, officials hoped to sign up more than 3.3 million people through the end of 2013, nearly halfway to the goal of 7 million enrollments by the end of March. Instead, enrollment as of Dec. 31 was not quite 2.2 million.

- Fifty-four percent of those who signed up were women, a slightly higher proportion of females than in the population.

- Nearly four out of five who signed up got financial help with their premiums.

- The most popular coverage option was a so-called silver plan, which covers about 70 percent of expected medical costs. Three out of five people picked silver. One in five picked a lower-cost bronze plan. Only 13 percent picked gold, which most closely compares to the typical employer plan. Another 7 percent went for top-tier platinum plans, and about 1 percent picked skimpy "catastrophic" plans available only to certain groups of people, including those under 30.

- A few states accounted for a huge share of the enrollment. California alone had 23 percent of the signups. California, New York, Florida, Texas and North Carolina accounted for nearly half the total.

Officials remain confident they'll be able to get young adults interested. Insurers, nonprofit groups, and advocates are moving ahead with marketing campaigns that were put on hold when the federal website that serves 36 states was struggling.

Administration officials said that in the coming weeks they plan to increase outreach to young people in 25 communities located in states served by the federal website. That effort includes a national youth enrollment day on Feb. 15 and targeted outreach by sororities and fraternities, as well as Voto Latino, which focuses on Hispanic youth.

In Miami, 19-year-old college student Stacy Sylvain was one of the last-minute online signups as 2013 drew to a close. In about an hour, the part-time waitress signed up for a plan with a $158 monthly premium, with the feds kicking in $48. She has a $2,500 deductible. Sylvain said she had no trouble navigating the website.

"Many people have a preconceived notion that young people are healthy and don't need to go to the doctor," said Sylvain, who suffered a minor injury when she fell and hit her head during an indoor soccer class in 2012. "Not having to worry about being uninsured and the what-ifs has made an incredible impact on my life."

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Danny January 13 2014 at 6:59 PM

As a taxpayer, I would say "you're welcome" to those that get subsidies or free health insurance. That is if they ever said thank you.

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1 reply
DaveK Danny January 13 2014 at 7:07 PM

No, it it the freeloaders who used the ER as their healthcare and then stiffed us with the bill and the health insurance CEOs who got $700 million bonuses who are paying. By making the freeloaders pay and making the insurers pay 80% of premiums to health care, instead of 70% or less as it used to be, those who could not afford health insurance before can get it. No tax payers involved.

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3 replies
Danny January 13 2014 at 7:02 PM

If you like your free welfare, food stamps, health care, cell phones, etc., thank a tax payer. Taxpayers are where the money comes from, not the government.

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edmonstonrobert January 13 2014 at 7:03 PM

As a retired physician, I can recall the days when Medi-Cal (medicaid) paid me 13% of what I
billed. Most of Obama-Care is going to be like medicaid. I don't think todays health care
providers can survive on reimbursements that are lower than their overhead, anymore than
I could l5 years ago when I QUIT!

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cindyscintom January 13 2014 at 7:08 PM

What Obama Care is Really About
I'm a 54 year old consulting engineer and make between $60,000 and $125,000 per year, depending on how hard I work and whether or not there are work projects out there for me.

My girlfriend is 61 and makes about $18,000 per year, working as a part-time mail clerk.

For me, making $60,000 a year, under Obama Care, the cheapest, lowest grade policy I can buy, which also happens to impose a $5,000 deductible, costs $482 per month.

For my girlfriend, the same exact policy, same deductible, costs $1 per month. That's right, $1 per month. I'm not making this up.

Don't believe me? Just go to www.coveredca.gov

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cindyscintom January 13 2014 at 7:19 PM

If I want to upgrade my policy to a low-deductible premium policy, such as what I had with my last employer, my cost is $886 per month. My girlfriend can upgrade her policy to the very same level, for just $4 per month. That's right, $4 per month. $48 per year for a zero-deductible, premium healthcare policy.

I mean, it's bad enough that I will be forced to subsidize the Obama Care scheme in the first place. But even if I agreed with the basic scheme, which of course I do not, I would never agree to subsidize premium policies. If I have to pay $482 a month for a budget policy, I sure as hell do not want the guy I'm subsidizing to get a better policy, for less that 1% of what I have to fork out each month for a low-end policy.

Why should the other guy get to buy an $886 policy for $4 a month? Think about this: I have to pay $10,632 a year for the same thing that the other guy can get for $48.

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1 reply
Dave cindyscintom January 13 2014 at 7:23 PM

It's called "socialism", and "redistribution of wealth".

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1 reply
Tom Dave January 13 2014 at 7:41 PM

Apparently you don't know what "socialism" is. Look it up in the dictionary before you go babbling nonsense. As for "redistribution of wealth," Ronald Reagan started it and George Bush took it further. They redistributed the wealth from the middle class to those who were already wealthy.

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dwc1863 January 13 2014 at 7:19 PM

The ACA was NEVER meant to work. Either this year or next for sure the American people (most anyway) will see it for what it really is (maybe was) a scam to bring down 1/6th of the US economy. Don't worry the government will take "care" of you. All of us. Right!

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2 replies
Tom dwc1863 January 13 2014 at 7:38 PM

Apparently you aren't aware of the fact that there is a mandate which forces people to buy their own health insurance instead of freeloading at the emergency room. The ACA is forcing individuals to pay for their own insurance so that the rest of us don't wind up absorbing the costs. But don't let that stop you from mischaracterizing the ACA. I'm sure you have some other agenda you're pursuing.

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1 reply
Danny Tom January 13 2014 at 8:10 PM

You certainly are idealistic. If you believe what you are spewing, you must work for Obama. There are cheats and liars everywhere, and the democratic party is full of them. In fact, the only thing Obama is president of is the cheater and liar club.

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Joebudgie dwc1863 January 13 2014 at 7:40 PM

Is anyone watching to see if gas chambers are being built?

Flag Reply 0 rate up
dunnritepac January 13 2014 at 7:19 PM

He is a cheap liar

Flag Reply +6 rate up
comfy01 January 13 2014 at 7:22 PM

Okay lets all sing the Obama song. Don't worry be happy. I told a lie and all the old folks can die.

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1 reply
Tom comfy01 January 13 2014 at 7:34 PM

The people who lost their coverage had sub-standard policies. If Obama had added "unless you have crappy insurance" to his statement, he'd have been alright. Furthermore, we're only talking about 2% of those who have health insurance, so, what he said was correct for 98% of those with insurance. You must be a Fox News watcher.

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2 replies
tsm44 Tom January 13 2014 at 7:43 PM

I had one of those sub-standard policies a rod and it was good and i had preexisting condition prostate cancer so go bite the big one jerk off, all this was for power and money grab by the democratic party!

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Danny Tom January 13 2014 at 7:45 PM

Obama will never be alright. He is a fraud and deceit. Lies and deception has been his MO from the beginning. The only reason he got in twice is because of no-information voters like you.

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molecularmayhem91 January 13 2014 at 7:27 PM

As the saying goes, When Capitalists cant sell you a product, they'll work to make it better.
When socialists cant sell you a product they'll say "you have to buy it, its the law".

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1 reply
DaveK molecularmayhem91 January 13 2014 at 7:33 PM

You mean like the old health care system? You know, the one where the insurers only signed up healthy people and told those with preexisting conditions to go F themselves? Or maybe you think the old and sick people should be turned into Soylent Green? When insurers are more interested in profits than health care, the health care will suffer. That is why we pay twice as much as any other developed country for health care and yet we are on the bottom of the heap when it comes to things like longevity, infant mortality, etc. The reason why we need ACA is that pure capitalism failed.

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1 reply
scubaeqhp DaveK January 13 2014 at 8:03 PM

Yep, the strong survive and the weak perish. It is human. Deal with it. Darwin at his best.

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skooli January 13 2014 at 7:32 PM

Is there a spread sheet online where someone could plug in the variables to see how this whole thing will work under different scenarios?

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