Boomers dominate health sign-ups

By Katie Kerwin McCrimmon

Baby boomers are signing up for Colorados health exchange at much higher numbers than the so-called young invincibles who are critical to the success of health reform.

Colorados health exchange, Connect for Health Colorado, this week released basic demographic data for the first time since the exchange opened on Oct. 1.

Of the 9,980 people who signed up for health insurance in the first two months, 6 percent are ages 18 to 25. Another 11 percent are 26 to 34 years old. Most health analysts define young invincibles as people younger than 30. But even including young people through age 34, only 17 percent of sign-ups so far are coming from people ages 18 to 34. Meanwhile, older adults ages 55 to 64 accounted for 43 percent of people who bought plans in October and November.

Exchange spokeswoman Myung Oak Kim said Connect for Health is pleased with the diversity of ages among those who have signed up so far and anticipates young people will need some prodding.

We expect that many young adults will wait until the last minute to sign up and will need encouragement to recognize the importance of having and paying for health insurance, Kim said in a written statement.

Demographic data based on 9,980 sign-ups for private health insurance in October and November. (Source: Connect for Health Colorado)

Exchange Board Chair Gretchen Hammer said the early metrics dont mean much.

I dont think the data at this point in time is safe to interpret, said Hammer, who is also executive director for the Colorado Coalition for the Medically Underserved.

She said its far too early to make assumptions when only 9,980 people have signed up in Colorado. Altogether, exchange managers set a mid-level goal of enrolling about 135,000 people by the end of March. And counting all the people who are uninsured or buy private insurance through the individual market or through a small business, the exchange could tap as many as 1.9 million potential customers in Colorado, Hammer said. Furthermore, Hammer pointed out that there are fewer young people in Colorado ages 19 to 34 about 1 million than those who are 35 to 64 and number about 2.1 million.

The overall pace of sign-ups for private health insurance increased somewhat in the second half of November to 3,979 for the last two weeks compared with 2,593 during the first weeks, according to the new data. Still, with a total of 9,980 people signed up so far, the exchange is well below its lowest projections, which called for about 15,000 people signing up in October and November. At the same time, sign-ups for the public Medicaid program continue to far outnumber private sign-ups with 64,290 new Medicaid enrollees in October and November.

Hammer said the numbers for private sign-ups are moving in the right direction and exchange managers anticipate a burst of activity this month. Customers wanting coverage to start on Jan. 1 have until Dec. 23 to buy insurance after the federal government extended the deadline from Dec. 15 to buy on both federal and state exchanges. To buy coverage for next year, customers must sign up by the end of March. Those who dont will face penalties.

Board member and small business owner, Ellen Daehnick, is concerned that low enrollment numbers could threaten the financial viability of the exchange in the long run.

All of the financial projections for the exchange being able to pay its bills after the federal grants run out depend on meeting those projections, Daehnick said. If we underachieve, what does that mean for 2015? It could snowball and thats relevant for the financial health and sustainability of the exchange.

Kim, the exchange spokeswoman, said that Connect for Healths financial status is not impacted because of our funding structure through 2014 and we are focused on meeting our long-term sustainability goals.

The exchange conducted an outreach effort on Sunday with Denver area churches and an advocacy group called Boomers Leading Change in Health. Kim said Connect for Health is also planning a holiday Connect to Coverage Statewide Tour.

Board member Eric Grossman, who is a health IT expert, is also concerned about the financial viability of the exchange. Thats why he pressed managers to have a singular focus on sales when he spoke at last weeks exchange meeting.

Were in the red zone. If you look at the metrics and just do some basic math, weve got to get 12,000 enrollees a week.

Grossman said those goals are not insurmountable, but exchange board members must focus intently on boosting sales.

Its the fourth quarter. Theres one minute left. How are we gong to get there? he said.

Adam Fox of the Colorado Consumer Health Initiative cautioned that change will take time.
When Massachusetts launched its reforms, most people waited until the last minute to sign up.
We know that people are taking their time to select a plan and enroll. Almost 4,000 of 10,000 enrollments have taken place in the past two weeks (in Colorado), so were starting to see the enrollment numbers increase. Its not necessarily surprising that the first enrollees have been from an older demographic that may have more health problems and have been anxiously waiting health coverage options. Theres still time to get Coloradans enrolled through C4HCO (the exchange) and we anticipate the rate of enrollment to increase in the coming months, said Fox, director of strategic engagement for the consumer advocacy group.

Exchange board member Ellen Daehnick thinks the problem is more urgent.

Overall these numbers are way too low and its crunch time. Wait and see wont work. We have a problem that could pretty quickly become a significant problem. Connect needs to get out ahead of that. What actions are we taking to drive sales?

We need an immediate plan, she said. We dont have very much time.Weve got 10,000 sign-ups (so far) and a goal of 135,000. That math doesnt work.