Analyzing Colorado's Insurance Marketplace Enrollment

Connect for Health Colorado, Colorado’s health insurance marketplace, has released information about the first Coloradans who have signed up for coverage.

The new data offer, for the first time, a glimpse into the characteristics of these Colorado insurance marketplace pioneers. It gives us an early sense of how well the Affordable Care Act (ACA) is performing in our state.

For example, of the 9,980 or so people who have enrolled in private insurance through November 30, about 17 percent are between the ages of 18 and 34, even though this age group makes up about 24 percent of Colorado’s population. They also have the state’s highest uninsured rates – upwards of one in four – according to the 2013 Colorado Health Access Survey.

This is the age group – often labeled the “young invincibles”- that is so crucial to the success of the insurance marketplaces. They tend to be healthier, and will help the health insurance risk pool to balance the costs of older, and likely sicker, enrollees. While the health reform law requires most people to buy insurance or pay a penalty, it’s possible many will choose the penalty.

On the other end of the age spectrum, Coloradans between the ages of 55 and 65 appear to be disproportionately enrolling in marketplace insurance. They make up about 14 of the state’s population, according to estimates from the State Demography Office, but comprise 43 percent of these early enrollees.

How does this compare to other states? It’s a bit hard to tell because many states with their own marketplaces roll Medicaid enrollments into their enrollment figures. A few states offer a clue, however.

California has seen a similar disproportionate enrollment of the older age cohort, with people between 55 and 64 making up 34 percent of private insurance enrollments even though they account for 11 percent of California’s population. Younger Californians between 18 and 34, on the other hand, comprise about 23 percent of enrollments and 21 percent of the population. Maryland offers a different picture, where 27 percent of enrollees are young invincibles and 22 percent of enrollees are between 55 and 64. No word yet on the age distribution of enrollees on the federally-run exchange.   

The Connect for Health Colorado report suggests a slight uptick in use of the marketplace. The numbers reveal:

  • 74,270 total enrollments, with 87 percent in Colorado’s Medicaid program and 13 percent – the 9,980 Coloradans – in the private health insurance.
  • A 66 percent increase in private insurance enrollment from the 6,001 reported November 16.
  • An 8 percent increase in website traffic, up from an average of 3,303 visitors per day in October to 3,553 per day in November.
  • A 10 percent decrease in the number of website accounts created per day, from 1,185 to 1,069.
  • A 75 percent increase in the average number of enrollments per day in private insurance compared to earlier in the month, according to Colorado Health Institute’s calculations.  The average enrollments per day increased from 162 in the first half of November to 284 per day in the latter half of November.

The enrollment figures are below the marketplace’s worst-case projection of 11,108 enrollments originally anticipated by mid-November. No further information is available on enrollees’ income levels, eligibility for subsidies or other demographic characteristics such as race and ethnicity.

These new figures clearly signal that enrollment of young adults will continue to be a focus. It makes sense that those who likely need coverage the most will be the first to sign up. It may also follow that young adults may wait until the last minute to enroll. The Colorado Health Institute will continue to monitor these enrollment metrics as they become available.

Jeff Bontrager is the director of research on coverage and access at CHI.