Is Connecticut’s Obamacare insurance age mix a problem?

Twenty-one percent of the customers buying private coverage through Connecticut’s health insurance exchange are in the coveted 18-to-34 age brackets, and one member of the exchange’s board worries that it’s not higher.

“Is there something that we can do other than sit here and kind of feel badly about the [age] mix?” Paul Philpott, a member of the exchange’s board of directors, asked during a meeting Thursday.

Of those buying insurance through Access Health CT, the state’s exchange, 59 percent are 45 and older, including 36 percent who are 55 and older. As of Wednesday, 43,840 people had signed up for private insurance through Access Health.

The mix of ages among exchange customers is important because insurers rely on younger, healthy people to balance out the cost of covering older, sicker members. And too many older, sicker members could lead to higher prices in the future to keep the insurance pools solvent, the thinking goes.

But others caution against too much focus on the age mix, at least for now. The federal government has in place three temporary programs designed to insulate insurers that sell plans to individuals through the exchanges from significant losses through 2016.

The share of exchange insurance customers who are young adults matches that age group’s representation in the Connecticut population. Twenty-one percent of state residents are ages 18 to 34, according to Census figures. And 21 percent of those buying insurance through the exchange are in that age bracket.

But among the uninsured — the population Access Health is trying to reach — young adults are disproportionately represented. While those ages 18 to 34 make up 21 percent of the state population and exchange insurance customers, they represent 36 percent of the state’s uninsured.

By comparison, people aged 55 to 64 make up 12.5 percent of the state’s population and 7.7 percent of the uninsured. But they represent 35 percent of the exchange’s private insurance customers.

Exchange CEO Kevin Counihan has called the focus on age balance a “red herring” because of those risk-reducing programs. And he said he’s not concerned about Connecticut’s enrollees so far.

“I actually feel good about the mix,” he said in response to Philpott’s comments.

Still, Counihan noted that exchange officials are working to reach young people through marketing efforts, and said many younger customers tend to buy coverage closer to the last minute. Connecticut residents have until March 31 to sign up for private insurance through Access Health.

But Philpott noted that the programs intended to limit carriers’ losses are temporary, and don’t change the underlying age balance.


Dr. Robert Scalettar, another board member, said there’s other information needed before drawing conclusions about how viable the insurance pools will be. For one thing, without seeing members’ medical claims, there’s no way to yet know how healthy the people who signed up are. Perhaps there are some 60-year-old gym rats and sick young people, he said.

Implicit in the conversation about ages, he noted, is the question of how viable the exchange insurance pools are, and whether insurers will seek to increase premiums in the coming years to account for a membership that racks up high medical bills.

And that, he said, will depend largely on what the insurance companies assumed about the age mix and health status when they proposed their rates for this year.

Representatives for the other two companies selling individual insurance through the exchange, Anthem Blue Cross and Blue Shield and ConnectiCare Benefits, did not provide information on their assumptions about the age mix and health status of exchange customers who setting rates.

A representative for HealthyCT, a new insurer that has 3 percent of the exchange’s customers, said the company’s enrollment numbers aren’t high enough to have a strong sense of what the membership pool means.

Data Editor Alvin Chang contributed to this story.

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