Lizzie Bunnen鈥檚 medical insurance ran out this fall. She had every intention of buying new, subsidized coverage under the health law in October.
Ashante Thurston, John Riascos and Julieth Riascos speak with Mario Ricart an insurance agent with Sunshine Life and Health Advisors about purchasing insurance under the health law at a kiosk setup at the Mall of Americas on December 11 in Miami. (Photo by Joe Raedle/Getty Images)
鈥淭hen obviously I heard all the coverage about how terrible the website was,鈥 said Bunnen, 26, a George Washington University grad student who lives in Virginia. 鈥淎nd I said, OK I鈥檒l wait. And I kept waiting. And November came around and the website was still terrible. And I was going to do it over Thanksgiving.鈥
But she didn鈥檛.
The success of the Affordable Care Act鈥檚 online marketplaces may depend on people like Lizzie Bunnen.
If healthy adults her age don鈥檛 sign up, the risk is that predominantly older and sicker members will drive up costs and threaten the portals鈥 future. With the Dec. 23 deadline approaching for January coverage, and at the end of March for all 2014 enrollment, the clock is ticking on what many believe is one of the health law鈥檚 biggest challenges.
As a result, ACA backers have stepped up efforts to persuade Bunnen and others aged 18 to their mid-30s to give Obamacare a second chance on newly improved websites such as healthcare.gov.
鈥淩emind your friends and your peers 鈥 imagine what happens if you get sick, what happens with the massive bills鈥 if there鈥檚 no health insurance, President聽 of young people at the White House this month.
The president called on radio hosts and bartenders to publicize Obamacare. First Lady Michelle Obama聽 to talk to loved ones 鈥渁bout what health care reform can mean to them鈥 over the holidays.
Young Invincibles, a healthcare consumer group, would like young adults to聽 for a holiday gift.
The Colorado Consumer Health Initiative聽 pregnancy, bike crashes, ski injuries and handstands on beer kegs as reasons for young adults to buy coverage.
Health law supporters also lined up Adam Levine 鈥 Maroon 5 frontman and People magazine鈥檚 Sexiest Man Alive 鈥 to urge young folks to get insured.
Still, a聽 by Harvard University鈥檚 Institute of Politics suggested the recruitment challenge is substantial. More than half of the uninsured young adults who responded disapproved of the Affordable Care Act.
Only 20 percent said they would 鈥渄efinitely鈥 or 鈥減robably鈥 sign up.
鈥淚 personally haven鈥檛 been on Covered California,鈥 that state鈥檚 website for enrolling in the new coverage, said Jasun Boles, 32, a California construction worker. 鈥淎s I鈥檓 listening to the news they鈥檙e saying, whoa, the online thing isn鈥檛 working. If you enter your personal information, it might be stolen. I鈥檓 thinking I鈥檓 just going to wait.鈥
Few numbers have been published on enrollees鈥 ages so far. California聽 of those who signed up through early December are between the ages of 18 and 34 while Kentucky reports that about 20 percent of those buying plans through late November are in the same category.
鈥淚t鈥檚 still a little bit too early to tell鈥 how the balance will turn out, said Peter Cunningham, a senior fellow at the nonprofit Center for Studying Health System Change. 鈥淭he California experience is probably better than what a lot of people expected and maybe as good as we can expect鈥 in the first year.
If total signups meet expectations across the country, the White House figures聽 will be in that category. But the Department of Health and Human Services hasn鈥檛 published age breakdowns for enrollees in healthcare.gov, the troubled online marketplace it is running for 36 states.
Even though older subscribers in premiums and the health law contains 鈥渞einsurance鈥 and other safety valves for plans that lose money in the early years, some believe disproportionate enrollment of older and sicker people could drive up premiums and threaten the policies鈥 long-term stability.
While December enrollment will probably rise with a better functioning site, 鈥渁t this juncture it seems unlikely that the administration will meet its goals for young adult enrollment,鈥 said Conor Ryan, a health data analyst with the American Action Forum, a right-leaning think tank.
New York singer and actress Gabrielle Sterbenz waited until finishing a tour of Britain and Ireland in October to enroll recently on New York鈥檚 insurance portal to replace what she called 鈥渕inimal鈥 coverage now.
After subsidies she鈥檚 paying $60 a month for a medium-level silver plan, she said.
鈥淭he New York site is great,鈥 said Sterbenz, 36. 鈥淚鈥檓 getting full coverage. I found a plan that my voice doctor is on and my regular primary care [doctor] and my ob-gyn 鈥 and I鈥檓 paying less,鈥 thanks to the health law鈥檚 tax credits. 鈥淚 know actors and musicians who have been looking forward to Obamacare kicking in.鈥
New York鈥檚 online exchange has been praised along with California鈥檚 and Kentucky鈥檚 as working relatively well. As the federal portal and other troubled sites such as Maryland鈥檚 improve, the portion of younger, healthier applicants should grow, suggests Timothy Jost, a law professor and health policy specialist at Washington and Lee University.
鈥淚t seems to me that a person who really needs health insurance will spend a day trying to enroll,鈥 Web problems or not, Jost said. 鈥淎 healthy person will probably wait until he or she can enroll in 20 minutes.鈥
Travis Hoium, 31, a contract writer for The Motley Fool financial site was able to sign up on MNsure, . 鈥淭he signup was pretty painless,鈥 he said. 鈥淚 wouldn鈥檛 say that it was anything harder than signing up for anything similar online.鈥
Ineligible for subsidies, he enrolled in a high-benefit gold plan for $165 a month, he said.
Even perfect software was unlikely to persuade Kerry Haack, 31, a homemaker in Lewisville, Idaho, to enroll in a plan created by the health law.
鈥淭he government鈥檚 role is not to tell people that they need to buy health insurance,鈥 she said. 鈥淚t鈥檚 a wrongheaded law, and I鈥檓 opposed to [Idaho] implementing it.鈥
While she lacks coverage now, her recently graduated husband expects to take a job offering a family health plan next year, which she鈥檒l sign up for, she said.
Nor will California鈥檚 Jasun Boles probably sign up this month, he said.
Even if he gets hurt and racks up a $20,000 emergency room bill, he figures that鈥檚 affordable next to the $70,000 he already owes in student debt.
He realizes under the health law he鈥檒l pay a penalty if he lacks coverage. (Next year it鈥檚 $95 or 1 percent of income.) But, he said, 鈥渋t鈥檚 cheaper for me to pay that once rather than pay the full price of health care for the first year.鈥
Having missed her Thanksgiving-break chance to sign up, Lizzie Bunnen was going to get it done in early December. Then finals got in the way. Then travel.
She finally enrolled in a gold plan on healthcare.gov without 鈥渢oo much difficulty,鈥 she said. But she didn鈥檛 immediately get a confirming email from either the portal or the insurer.
鈥淪o I鈥檓 concerned that my application never actually made it鈥 to the insurance company, she said.