Health Status of Exchange Enrollees

There has been widespread speculation that the individuals who are likely to enroll in health insurance exchanges in 2014 under the Affordable Care Act are a sicker group who will instigate a "rate shock" on those currently enrolled in nongroup coverage.

However, many insurers are finding that expanding the pool to a larger population is an opportunity to offer competitively priced coverage to attract lower-cost enrollees. This report. as part of the Urban Institute's Quick Strike series, examines the differences between the enrollees in health insurance exchanges and those covered by employers.

Key Findings

  • Those expected to enroll through health insurance exchanges will be similar in health—if not healthier in some aspects – than those who currently get health insurance through an employer.

  • Among the categories that the nongroup enrollees are expected to excel: lesser reported chronic conditions, including obesity.

  • Any rate shock that does occur should prove to be a relatively short-lived, transitional phenomenon

  • Premiums will still vary due to differences in administrative costs, benefits provided and cost-sharing required.