The participation of young, healthy individuals in the health insurance marketplace is important to its long-term success. But the latest numbers from Texas may not be enough to keep the Obamacare exchanges afloat.
The percentage of so-called "young invincibles" in Texas without health insurance has dropped by a third since the implementation of the Patient Protection and Affordable Care Act.
The percentage of Texas young adults (18 – 34) without health insurance dropped from 33% to 21% between September 2013 and March 2016, according to a report issued by Rice University's Baker Institute for Public Policy and the Episcopal Health Foundation.
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The young adult population now has a lower uninsured rate than that of the 36 – 49 age group.
But it still may not be enough.
Recent decisions by many health insurance companies participating in the Obamacare exchanges to drop out after this year have been blamed on the fact that such healthy individuals have largely stayed away from participation in the insurance pools. This drive up rates as sicker and less healthy patients obtain insurance in greater numbers than healthy people.
"The ability of many young invincibles to remain on their parents' plans likely explains a substantial part of the drop in the uninsured," said Vivian Ho, a professor of economics at Rice and professor of medicine at Baylor College of Medicine, in a press release.
Indeed, participation of young invincibles in the ACA health insurance marketplace is important to its long-term success, the report contends.
Researchers said the lack of sufficient numbers of young invincibles and other healthier adults enrolled in ACA marketplace plans is a factor in anticipated increases in 2017 premiums and the withdrawal of large insurance carriers from some state health insurance marketplaces.
"The composition of risk pools, including a mix of healthier and less healthy participants, is vital for the long-term sustainability of the ACA health insurance marketplace," Ho said.
A Call for Outreach
Elena Marks, EHF's president and CEO and a nonresident health policy fellow at the Baker Institute, said outreach and enrollment organizations should develop new approaches to reach young adults in Texas, especially those who paid the escalating tax penalty fee for being uninsured.
"Another promising strategy is to encourage enrollment groups to assist young adults who are aging out of Medicaid and CHIP (Children's Health Insurance Program) and help transition them to ACA marketplace insurance plans or other coverage," Marks said.
"Youth-friendly e-outreach during the upcoming open enrollment period may also be effective."
Philip Betbeze is the senior leadership editor at HealthLeaders.