Glass Half Full: Using Data to Make a Point

March 10, 2014

From the desk of

SHADAC Director Lynn Blewett

Glass Half Full: Using Data to Make a Point

Data can be presented in a lot of different ways to make a point. Here I present enrollment in private health insurance plans through the ACA's Health Insurance Marketplace using data to support different points of view.

There has been a lot of talk about the risk profile of the Health Insurance Marketplaces, with concern that mostly older and sicker individuals are signing up for coverage.

Let’s look at some February 2014 enrollment data from the Assistant Secretary for Planning and Evaluation (ASPE) and see what the numbers have to say.

Figure 1 provides data on enrollment by age to show that over half (57%) of adult enrollment in the Health Insurance Marketplaces is between the ages of 45 and 64—an age group in which people do tend to have more health care needs and are likely to use more services. Too many older, sicker adults signing up will tend to increase the overall risk profile of the exchange, increasing health insurance premiums. The point here is pretty clear: We need more young adults to sign up for insurance coverage through the Health Insurance Marketplaces.

Note that Figure 1 provides information on adults only, starting with adults age 18. In Figure 2, we include the children of the adults who signed up for coverage and change the age categories in a different by not unreasonable way. It now looks like the distribution of enrollment in the Health Insurance Marketplaces is pretty evenly spread between those with the potentially highest need for services (age 45-64) and those with the lowest need (age 0-34), with both age groups at the low and high ends making up about one-third of total enrollment. The point here is also pretty clear: High-need enrollees are largely balanced out by their low-needs children. We need young adults to sign up for coverage, but we also need to target outreach and enrollment strategies to families with children--preferably younger children.

Two different points of view. Same data source, selectively displayed. Lots of different ways to look at the data.

Of course, we do need more young adults to sign up for coverage—no question—but we also need families with young children.

Figure 3 offers the full distribution of age categories included the February 2014 ASPE report.

How would you combine and display the data?

SHADAC archives ASPE Marketplace Enrollment Reports and State-Based Marketplace Enrollment Reports regularly at http://www.shadac.org/publications/insurance-market-enrollment-reports.

In the Glass Half Full blog series, SHADAC Director Lynn Blewett highlights some of the bright spots in the implementation of the Health Insurance Exchanges by the states and the federal government.