Insurers say the early buyers of health coverage on the nation's troubled new websites are older than expected so far, raising early concerns about the economics of the insurance marketplaces.
If the trend continues, an older, more expensive set of customers could drive up prices for everyone, the insurers say, by forcing them to spread their costs around. "We need a broad range of people to make this work, and we're not seeing that right now," said Heather Thiltgen of Medical Mutual of Ohio, the state's largest insurer by individual customers. "We're seeing the population skewing older."
The early numbers, described to The Wall Street Journal by insurance executives, agents, state officials and actuaries, are still small—partly a consequence of the continuing technical problems plaguing the federally run exchanges, experts say. HealthCare.gov, the federally run marketplace serving 36 states, is suffering serious technical problems that have prevented many people from signing up.
But the numbers demonstrate a real-world fallout from the digital snafus: Less-healthy customers are more likely to persevere through technical obstacles to gain coverage, insurers say. Younger, healthier customers who feel less need for insurance—but whose widespread participation is important to the financial success of the system—could be quicker to give up.
The average enrollee age at Priority Health, a Michigan insurer, has ticked up to age 51 for newcomers, from about 41 years old for plans offered for the current year, said Joan Budden, chief marketing officer. Arise Health Plan, Wisconsin's largest nonprofit insurer, said more than half its 150 signees are over 50, a higher proportion than expected, while declining to be specific on its target age.
Industry experts cautioned that, a month into the health law's enrollment period, it is too soon to say what insurers' final pool of members will look like. Medical Mutual, for instance, has seen health-law enrollments so far in the "low triple digits," and Priority Health has seen fewer than 100. Both are selling on the federal exchange.
A White House official said the Obama administration expects most young, healthy enrollees to wait until the last minute to sign up, citing research showing that pattern when Massachusetts embarked on a similar health overhaul in 2007. People have until Dec. 15 to enroll in coverage starting Jan. 1, with open enrollment for coverage during the year lasting through next March.
In states that are running their own marketplaces and have seen smoother rollouts, officials are now also reporting a similar phenomenon, suggesting the economics of the law play a role, too. In Connecticut and Kentucky, which have enrolled more than 4,000 people each in private health plans so far, the largest segments of enrollees in new commercial health-law plans are over age 55, much older than industry actuaries say they had anticipated. Each state ultimately expects to register several hundred thousand people in their exchanges.
Age expectations for enrollees vary by market, but one adviser and several insurers said an average age of around 40 would be a typical target.
The more difficult it is for a person to sign up, "the more danger there is of having a bad risk pool," said Jim Whisler, an actuary for Deloitte Consulting LLP, which advises health plans participating in the marketplaces. "Indications to date are that that is playing out," he said.
The law bars insurers from charging sicker customers higher rates, and limits the amount they can charge older people compared with younger ones. It offers new subsidies to help cover premiums available to many lower-income applicants. Insurers are relying on a steady stream of younger, healthier enrollees to offset medical bills of older, sicker customers.
"The more sick people who do enroll, the more exposed [insurers] become," said Jim O'Connor, an actuary for Milliman Inc., a consulting firm.
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