By Elise Viebeck - 03/31/14 08:37 PM EDT
An apparent surge of visitors on Monday rushed to register before the 11:59 p.m. insurance enrollment deadline for President Obama’s healthcare law.
By 2 p.m., the site had received some 1.6 million visits, a higher volume of traffic than ever before, according to the administration.
Visitors were unable to access HealthCare.gov immediately on Monday morning because of what the administration said Tuesday was extended maintenance issues. The site, which was supposed to open at 5 a.m. eventually opened after 8 a.m.
The site was also unable to begin new applications for a period of time during the middle of the day as the website dealt with huge traffic. Applicants queued for several hours as the website coped with a peak of 125,000 concurrent visitors.
“We’re going to have a very strong number when this period ends,” Carney said Monday.
The administration had not announced a final sign-up count as of Tuesday morning.
The big remaining mystery is the makeup of these enrollees.
State by state, the age and health status of those who have enrolled in insurance plans through ObamaCare will determine the stability of the marketplaces and how much premium prices will rise next year. It will also determine how much money insurers receive from one another to balance the risk.
Federal health officials last month reported that 1 in 4 sign-ups were young people, fewer than needed, which raised concerns about an imbalance.
Analysts tied to the insurance industry, however, said the average enrollment age has fallen steadily since then.
“The mix has continued to improve, even in the last couple of weeks,” said Dan Mendelson, CEO of Avalere Health, a consulting firm that counts insurers among its clients.
“The younger people are signing up now, and [insurers] see that mix improving, in some cases substantially.”
Several insurance company executives echoed those comments.
“We’re seeing our average age come down every week, so it’s clear that younger people are starting to come into the pool,” Wayne DeVeydt, WellPoint’s chief financial officer, told The Wall Street Journal. “What isn’t clear yet, though, is, did it come down enough.”
The administration has been selective in releasing data on the healthcare law, often putting numbers out that bolster its position in a midterm election year that has been dominated by ObamaCare.
Reporters have pressed consistently for official figures on how many people have paid their first premium, the real threshold for gaining coverage.
The administration denies it has this data, though Health and Human Services Secretary Kathleen Sebelius quoted industry estimates on Monday that 80 percent to 90 percent of enrollees have sent in their first check.
“What we know from insurance companies ... for their initial customers, it’s somewhere between 80, 85, some say as high as 90 percent, have paid so far,” Sebelius said on KWTV-TV, an Oklahoma station.
Since November, the administration has released enrollment reports with age data in the middle of every month, reflecting the previous month’s gains. An HHS spokeswoman said the final numbers will come out in mid-April, on that timetable.
But it’s possible that officials will announce select figures before that, as they did when reporting that enrollments exceeded 6 million last week.
“They’ll do it as it suits them politically,” Mendelson said. “They’re in a toxic political environment and they don’t want to load the other guy’s gun” with bad numbers.
In the meantime, insurers on the exchanges are closely watching the age mix of their enrollees.
While not a perfect match, the age breakdown is the best way to guess which policyholders are healthy and how much they’re likely to bill in medical claims, the foundation of insurers’ business model.
The mix will affect whether plans stay in the marketplaces and how much they raise premiums next year. It all depends on each plan’s assumptions about enrollment when they set 2014 premium levels last year.
For example, if one company sees a higher proportion of sicker enrollees than it expected or concludes it set premiums too low to cover costs, it will raise prices more for 2015.
Even the administration’s final report will not be the last word on the matter. Experts expect wide variation in how states and plans fare, with some thriving and others struggling with their mix of policyholders.
Though 40 percent of potential customers on the exchanges consists of people aged 18 to 34, most insurers don’t need to achieve that proportion of younger people because of how they set their premium prices.
“What really matters for next year is the demographic composition of actual enrollment in total in each state compared to what insurers as a whole projected,” experts with the Kaiser Family Foundation said in a December analysis.
Still, the administration has a lot at stake in the overall age distribution of enrollees.
It repeatedly has sought to woo younger people, who strongly supported President Obama’s election, to the exchanges.
These recruitment efforts have widened over the last month to include a television ad featuring Miami Heat star LeBron James, targeted interviews in publications like Cosmopolitan magazine, and an appearance by Obama on the online comedy show, “Between Two Ferns.” Supporters of the administration are upbeat about these efforts, arguing they are reaping dividends as younger people begin to show interest in healthcare coverage.
But Republicans continued to strongly criticize the law on Monday, arguing that policyholders are still seeing higher premiums as a result.
“House Republicans will continue to work to repeal this law and protect families and small businesses from its harmful consequences,” Speaker John Boehner (R-Ohio) said Monday in a statement.
“We will also continue our work to replace this fundamentally-flawed law with patient-centered solutions focused on lowering health care costs and protecting jobs.”
This story was updated at 9:45 a.m. on Tuesday.,