Handling the Math

People have a hard time with math. Even people who write about it.

Take a recent article in Slate called “Obamacare and the ‘Young Invincibles,’” that purports to evaluate the recent enrollment figure under the Affordable Care Act. This article is not written by an Obamacare basher, and yet the author’s failure to do the math possibly paints a more negative picture than warranted.

It all has to do with the health insurance enrollments of young people in the age 18-34 bracket.

Enrollment of young people is important because young people tend to avoid buying health insurance, but they are needed in the risk pool to balance off people of my age. The ideal risk pool has full representation from all ages.

The article says that 40 percent of the uninsured in this country were in this age bracket. Final enrollment figures say that 28 percent of those who enrolled were in this age bracket, far short of the 40 percent.

Is 28 percent good enough?

The article says that there is no benchmark because underwriting information is unavailable from the insurance companies. But it does compare the figure to the initial enrollment figure when the similar Massachusetts program was first launched. The figure for that age group in Massachusetts was 28.3 percent. The Massachusetts program went on to be a success.

Is the national figure of 28 percent comparable to the Massachusetts 28.3?

The article correctly states that it depends on how the enrollments break down by state. Some states encouraged enrollment, some states discouraged it. Some states made Medicaid available, some did not.

Another factor to be considered is the fact that, under Obamacare, young adults up to age 26 may now be included in their parents’ employer-provided health insurance. The article doesn’t account for these young adults. They would not have enrolled through the health exchanges and would, therefore, not be part of the 28 percent. The question is: were they or were they not counted as part of the 40 percent who were uninsured.

Unless we know about these young adults, how can we even come up with a figure? We can’t. The figure could be 28 percent or it could be more. Health exchanges were not the only avenue for young adult enrollment. You have to account for them all.

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