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Exchanges drew sicker consumers

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Uninsured consumers who were sicker and older than average led the rush to “get covered” this year — and many got covered through plans purchased outside the new public exchange system.

Analysts at Gallup are reporting that finding in a summary of results from a telephone survey of 31,000 U.S. adults conducted from April 15 through June 17.

See also: Uninsured rate remains at record low.

About 5 percent of the participants said they lacked health coverage last year and have coverage this year.

About 2.8 percent of all participants — and 56 percent of the newly insured participants — said they got covered through the new Patient Protection and Affordable Care Act (PPACA) public health insurance exchange system.

The other 2.2 percent — or 44 percent of the newly insured people — said they got covered by buying off-exchange plans.

See also: Kaiser: Off-exchange individual health sales were strong.

PPACA created the exchange system to help people shop for coverage on an apples-to-apples basis and use a new tax credit premium subsidy system. But PPACA also requires insurers selling individual major medical coverage outside the exchange system to sell the coverage without taking personal health status into account. The only personal health information insurers can use when pricing individual coverage is age and tobacco use.

Another PPACA provision is supposed to impose penalties on many individuals who fail to own a minimum level of health coverage.

One open question is how old and sick the people who gained coverage because of PPACA are when compared with the demographic assumptions insurers used to develop 2014 individual medical rates.

Exchange program marketers were trying to hold claims costs down by encouraging young, healthy consumers to get covered.

Gallup analysts say the newly insured public exchange users they surveyed seem to be less healthy than members of the general population.

“Thirty-eight percent of those using an exchange for their new policies reported being in very good or excellent health, compared with 50 percent of the general population,” the analysts say.

But 29 percent of the newly insured exchange users said they were ages 18 to 29. Only 21 of all U.S. adults are in that age group.

Gallup analysts say the new survey results are compatible with earlier survey results suggesting that the percentage of U.S. adults who are uninsured dropped to 13 percent this spring, from 18 percent last fall.