Friday, June 20, 2014

Are the Obamacare Exchanges Attracting People in Poor Health?

The Kaiser Family Foundation released a survey Thursday of individuals who have purchased health insurance during the first open enrollment period under the Affordable Care Act. The poll included a question about self-reported health status, the responses to which suggest that 2014 purchasers through the health exchanges may be less healthy than the broader population.

According to the study, 20% of participants in exchange plans reported their health as being in “fair” or “poor” condition, whereas only 9% of those purchasing exchange-compliant coverage outside of the exchanges report being in fair or poor health.

These findings tend to bolster an April Gallup survey finding that only 12% of those with exchange coverage rated themselves in “excellent” health, compared with 21% buying new coverage this year outside the exchanges and 21% for the U.S. adult population. The Kaiser study did not break out results by age, but the Gallup survey found that only 24% of exchange purchasers were ages 18 to 29, whereas 37% of people in that age bracket purchased coverage this year outside an exchange.

The exchanges appear to attract a different clientele than non-exchange plans, but it’s not yet clear whether that is a first-year anomaly or a larger pattern. Provisions in the law that require insurers to treat their exchange and non-exchange plans as a single risk pool may mitigate disparities between the two markets. But if the insurance exchanges become the virtually exclusive province of the old, sick and those who qualify for subsidies, it is likely to have ramifications throughout the insurance industry and on Obamacare as a whole.

This post was originally published at the Wall Street Journal Think Tank blog.