Enrollments Exceed Obama's Target for Health Care Act

WASHINGTON - President Obama announced Thursday that eight million people have signed up for health insurance under the Affordable Care Act, including what the White House said were a sufficient number of young, healthy adults, a critical milestone that might counter election-year attacks by Republicans on the law's success and viability.

The total number of enrollees exceeds by a million the target set by the administration for people to buy insurance through government-run health care exchanges. In particular, the number of young people signing up appears to have surged during the final weeks of enrollment.

'This thing is working,' Mr. Obama told reporters in the White House briefing room, in what amounted to a second victory lap after he announced two weeks ago that 7.1 million people had signed up for insurance during an initial enrollment period. 'The Affordable Care Act is covering more people at less cost than most people would have predicted a few months ago.'

Still, critics of the law cautioned that promising top-line numbers were not by themselves proof of success.

Although more young people signed up for health insurance, for example, the number remained below the level that some analysts believe is optimal for keeping premiums low in the insurance marketplaces. The administration said Thursday that 28 percent of those who bought policies were between the ages of 18 and 34, but some analysts said the optimum level would be 40 percent.

'In an ideal world, you'd want to get as close to that as possible,' said Larry Levitt, a senior vice president at the Kaiser Family Foundation. 'But what is important is what the insurance companies expected, and this is what they expected.'

The administration did not release two other crucial statistics that would help determine the success of the law: the number of people among the eight million who bought insurance for the first time and the number who paid their initial premiums.

The number of those who were previously uninsured is important, since many people could simply have been moved from plans that were canceled by the law. Administration officials have promised to release that information when they have it, but they have said it is not data that is collected by the government.

Administration officials have said previously that they could not tell how many people have paid premiums because those payments are between individuals and their insurance companies. In February, however, industry experts and insurance companies said that one in five people who signed up failed to pay their premiums on time and therefore did not receive coverage when it began in January.

Mr. Obama nonetheless seized on the numbers to make his case that the law is a success and to challenge his opponents to drop their opposition to it. 'I find it strange that the Republican position on this law is still stuck,' the president said. 'They still can't bring themselves to admit that the Affordable Care Act is working.'

Mr. Obama's remarks came a week after he announced the resignation of Kathleen Sebelius, his health and human services secretary, at an orchestrated White House event that sought to put a positive light on a tenure marred by the disastrous rollout of the HealthCare.gov website that Ms. Sebelius oversaw last year. On Thursday, Mr. Obama focused his remarks on the future.

'We've got a sizable part of the U.S. population, for the first time, that are in a position to enjoy the financial security of health insurance,' the president said.

Mr. Obama spoke after meeting with state insurance commissioners at the White House, where he shared some of the new enrollment numbers and demographic data.

In the early months of signups, the number of young people between the ages of 18 and 34 - who tend to be healthier - hovered around 25 percent. But as White House officials predicted, many young people appear to have waited until close to the March 31 deadline to enroll, increasing their participation. The administration had offered a grace period until Tuesday to accommodate people who had begun, but not completed, the signup process by a deadline of March 31.

Health experts have long warned that the state-by-state, competitive insurance marketplaces set up by the law could be severely undermined if the pool of customers who signed up were mostly sick or elderly. In such a case, premiums could spike, and insurance companies might choose to abandon the federal marketplaces entirely.

The overall percentage of young people enrolled is not a guarantee that all of the insurance marketplaces across the country will work perfectly. Individual insurance companies will make decisions about what their premiums are based on the makeup of their own client list.

But the higher proportion of young enrollees is a rebuke to the critics of the Affordable Care Act, who had predicted that it would fail to attract younger, healthier customers to buy insurance.

In the months ahead, insurance companies will assess the age and health of their customers as a way of determining their premiums for next year. Mr. Obama said he expected premiums would probably increase, as they have annually for many years.

But White House officials insisted that the overall cost of health care is rising more slowly than previous estimates by the Congressional Budget Office. And they said that the higher proportion of young people who have enrolled is likely to keep many premiums lower than they would otherwise have been.

'Health care spending has risen more slowly than at any time in the last 40 years,' Mr. Obama said.

In recent weeks, as the enrollment numbers improved from the difficult start last fall, Mr. Obama and his aides have become more aggressive in their efforts to promote moments in the law's success.

By having Mr. Obama be the first person in the administration to announce the latest enrollment numbers - in previous months, that task often went to Ms. Sebelius - administration officials signaled their willingness to more directly engage Republican critics on a by-the-numbers assessment of the law.

In addition to the enrollment figures, officials on Thursday cited other statistics that they said proved the law was working. They said 129 million Americans with pre-existing health conditions, including 17 million children, were no longer in danger of losing health coverage or having premiums rise drastically.

They also said that 105 million people did not have to worry about reaching a lifetime cap on insurance benefits, something that was made illegal under the health law. And they said that eight million older Americans have saved $10 billion because of lower prescription drug costs under the law.

Republicans dismissed the president's announcements, saying they were a misleading attempt to make the health law look rosier than it is. Brendan Buck, a spokesman for House Speaker John A. Boehner, said the White House was continuing to 'obscure the full impact of Obamacare.'

Correction: April 17, 2014