By PHIL CAUTHON
KHI News Service

WASHINGTON — Enrollment in health insurance via the Obamacare marketplace surged in December, with 1.8 million people nationwide selecting a plan last month versus just 400,000 in October and November combined.

In Kansas, according to federal officials:

• 14,242 people had selected a marketplace plan;
• 5,508 were steered to Medicaid by the marketplace;
• 27,763 have completed applications, that possibly would cover 45,228 lives; and
• 18,896 were determined to be eligible for financial aid.

The figures are part of new enrollment data released today by the U.S. Department of Health and Human Services.

Administration officials touted the numbers as proof of strong interest in the benefits of the health reform law.

“We’re pleased to see such a strong response and heavy demand for the health insurance marketplace,” said HHS Secretary Kathleen Sebelius in a teleconference with news reporters. “The numbers show that there is a very strong national demand for affordable health care made possible by the Affordable Care Act.”

Of the 2.2 million people who have so far selected a private insurance plan via HealthCare.gov:

• 55 percent are ages 45 to 64
• 30 percent are ages 26 to 44
• 54 percent are female
• 79 percent will receive tax subsidies
• 60 percent selected a Silver plan
• 20 percent selected a Bronze plan
• 13 percent selected a Gold plan
• 7 percent selected a Platinum plan
• 1 percent selected catastrophic coverage

Michael Hash, Director of the Office of Health Reform, said enrollment so far mirrored the expectation that older people would enroll first, while younger people would wait until the deadline. Open enrollment for 2014 ends March 31.

“The trends so far, as we’ve released in this report, are suggestive of an appropriate mix in the marketplace. But we’re only halfway through the open enrollment period and we expect an increase in the proportion of young adults,” Hash said.

Sheldon Weisgrau — director of the Health Reform Resource Project, a foundation-funded initiative to educate Kansas consumers and businesses about the health reform law — said it would be difficult to draw many conclusions from the data released today.

“The key to appropriate risk balance in insurance pools is really healthy versus unhealthy. Because we no longer ask about health status on insurance applications, we usually use age as a proxy for health status. That’s appropriate for the most part, but is not the whole story. For example, an insurer would probably prefer a healthy, older enrollee to a sick, younger enrollee. But we don’t have these details,” Weisgrau said.

“That said, the percentage of younger enrollees is lower than ideal given their representation in the population,” he said, citing a recent study by the Kaiser Family Foundation that estimated that people ages 18 to 34 make up about 40 percent of the eligible population.

“So, the hope would be that they make up about 40 percent of enrollees,” Weisgrau said. So far, 24 percent of those who have selected plans are ages 18 to 34.

“But it’s much too early to draw conclusions. It was entirely predictable that the first people to sign up would be those most desperate for insurance coverage — people with pre-existing conditions who were previously denied coverage, people with very high premiums because of poor health status, etc.,” he said.

Weisgrau said he expected enrollment figures would spike in March as the enrollment deadline approaches.

Projections are that less than one-third of the uninsured population in Kansas would buy coverage via the insurance marketplace, Weisgrau said.

“So, assuming 360,000 uninsured in Kansas, at most 120,000 would be expected to purchase in the marketplace; 45,228 lives is about 38 percent of that number…that’s not bad,” he said.

Among the main things that stood out in the report to officials at the Kansas Insurance Department was the relatively high percentage of Kansans who selected Gold plans: 25 percent versus the national average of 13 percent.

“That is interesting because it may show some recognition on the part of some of our consumers that they are willing to pay a bit more in their monthly premiums in exchange for a bit more control over their out of pocket costs throughout the plan year,” said Linda Sheppard, Director of Health Care Policy and Analysis at the insurance department.