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Health care signup misses target demographic: uninsured

Tuesday, Jan. 28, 2014, 9:48 a.m.

Most Americans who enrolled in health plans under the Affordable Care Act previously were insured, calling into question whether President Obama's signature health overhaul law is working as intended, experts say.

A goal of the 2010 law, implemented fully on Jan. 1, was to cut the number of uninsured. But data from two national polls suggest that during the first three months of health plan enrollment, people without coverage stayed away.

The Obama administration has said 2.2 million people selected plans on state and federal online marketplaces between Oct. 1 and Jan. 1. Officials have not said how many of those people were uninsured.

Few enrollees were uninsured, according to a McKinsey & Co. survey released on Monday.

The management consulting firm surveyed more than 4,500 Americans eligible to shop on the marketplaces in October, November and December and found that 1,250 people, or 28 percent, enrolled in plans — 90 percent of whom previously were insured.

McKinsey found that many people who didn't select plans were uninsured and were still considering buying.

“This suggests a higher percent of prospective market growth from those previously uninsured” by the end of the enrollment period on March 31, the firm said.

HealthMarkets Inc., a Texas-based insurance agency operating in all states, signed 7,500 people for plans. Nearly two-thirds of them had prior coverage, said Michael Stahl, senior vice president of marketing.

Stahl expected more uninsured people to enroll as the deadline approaches.

“The uninsured may be waiting,” he said. “We think the mix probably will change.”

Officials with the Department of Health and Human Services declined to be interviewed.

The early trend is “very troubling” for the Obama administration, said Robert Laszewski, president of Health Policy and Strategy Associates, an Alexandria, Va., health industry consulting company.

“The whole point of the Affordable Care Act was to cover the people who are uninsured,” he said.

In Western Pennsylvania, health insurer Highmark Inc. said 43 percent of its 37,100 Obamacare enrollees through Jan. 13 are previous customers. But the company has no way of knowing how many of the other members had been uninsured or migrated from a different insurer, spokeswoman Kristen Ash said.

Highmark had no expectations for enrolling uninsured people, Ash said: “It was hard to have any expectations going into a new way of selling insurance.”

But the company is pleased with the results, especially considering early technical problems with that delayed enrollments, she said.

People in Pennsylvania and 35 other states can shop for policies on the federal website. The remaining states set up their own websites.

The Congressional Budget Office estimates 47 million Americans lack health coverage and that the law could reduce that number to about 30 million over 10 years. The Obama administration wants to sign up 7 million by the end of March.

In addition to making private health insurance available to people not covered through an employer, Obamacare is designed to lower the number of uninsured Americans by expanding Medicaid, the government insurance program for poor Americans.

Though the Obama administration has claimed 3.9 million Americans were eligible for Medicaid in October and November, that total includes an unknown number of renewals.

Only 26 states agreed to expand Medicaid. Pennsylvania Gov. Tom Corbett, who opposes the law, proposed an alternative: using additional federal Medicaid dollars to buy private insurance for poor people. Health and Human Services is considering his proposal.

Alex Nixon is a Trib Total Media staff writer. He can be reached at 412-320-7928 or

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