Blue Cross: Older, sicker sought coverage under health law
Posted May 8, 2014
Chapel Hill, N.C. — The people who signed up for health coverage with Blue Cross Blue Shield of North Carolina through the Affordable Care Act's online marketplace are older and sicker than expected, which could mean higher premiums in the future, the insurer said Thursday.
Blue Cross was one of only two companies to offer plans in North Carolina through the online marketplace, and as of May 1, 232,000 people were on Blue Cross marketplace plans. Seventy percent of them didn't have coverage through Blue Cross previously, the company said.
Initial Blue Cross projections called for 50 percent of the marketplace customers to be 34 years old or younger, but after the enrollment period ended on March 31, the company found that only 32 percent of the people who signed up under the federal health care law fit that profile. Forty percent are ages 35 to 54, and 29 percent are 55 or older.
Younger customers are usually coveted by insurers because they are healthier and can balance out the spending of older customers who consume more medical services. But Blue Cross said even the younger customers who signed up for coverage through the online marketplace are sicker than one would expect.
Thirteen percent of enrollees ages 18 to 34 reported experiencing chronic pain as part of a Blue Cross self-assessment, compared with 8 percent for the age group as a whole. Seven percent have diabetes, compared with 4 percent of the group as a whole, and 24 percent said they have depression, compared with 14 percent for the group as a whole.
"The frequency and types of care ACA customers receive and the conditions for which they are being treated are key factors that will determine future premiums," Blue Cross said in a statement.
Other issues that could affect premiums in 2015 and beyond include changes in the Affordable Care Act, such as allowing people to remain on policies that don't meet the minimum coverage standards under the law, and how many people use their insurance to obtain needed medical services and then drop coverage before paying many premiums, the company said.