The news that roughly 7,040,000 Americans signed up for health insurance under the Affordable Care Act was met with celebration from the White House and lingering questions from those in the insurance industry.
With deadlines looming for 2015 health insurance rates, carriers are expressing concern over the marginal knowledge they have on who applied for the new health plans—age and health status, for example, are largely unknown. And without that information, it is difficult for carriers to accurately contain risk with next year’s premiums.
While most of that information is still difficult to decipher, clues as to who signed up by March 31 are beginning to emerge.
An analysis released this week by pharmacy benefit manager Express Scripts indicates that new enrollees are by and large sicker than average. Based on claims data from the first two months of the year, Americans insured through Obamacare plans buy far more expensive specialty drugs like those used to treat HIV/AIDS and hepatitis C.
“Our early analysis reveals that, in January and February, use of specialty medications was greater among exchange enrollees vs. patients enrolled in a commercial health plan,” Express Scripts said in its report. “Approximately 1.1% of total prescriptions in exchange plans were for specialty medications, compared to 0.75%in commercial health plans, a 47% difference.”
The analysis also found that paid medication prescriptions were 35% higher in exchanges than in commercial plans, anti-seizure scripts were 27% higher and antidepressant scripts were 14% higher.
Express Scripts did warn that it is too early to draw any lasting conclusions from the data, however—particularly given that the numbers do not reflect the late surge of applicants who enrolled in a plan in late March and even early April.
“This is a snapshot of the population early on,” Julie Huppert, Vice President of Health Care Reform with Express Scripts said. “The hope is the young and healthy come into the system in the later weeks of the enrollment period.”
Insurance industry consultant Robert Lazsewksi added that it will be a while before carriers know what they’re dealing with in terms of Obamacare demographics.
“We all expected that the people who signed up by January and February would be a lot sicker than anyone else,” Lazsewski told MedCity News. “It will be a year before we know what we’ve got.”
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