In the Carolinas, the new health insurance exchanges that are part of the Affordable Care Act didn't sign up nearly as many young people as the White House had targeted. The U.S. Department of Health and Human Services on Thursday released the final enrollment data for this year.
From the online exchanges' opening day in October through their close of business this year, about 360,000 North Carolinians signed up for health insurance. In South Carolina, about 120,000 signed up.
UNC public health professor Mark Holmes says the most important thing is how those enrollments break down by age.
"One of the key drivers of a good health insurance pool is to have a good mix of what we call risk – having young, healthy, as well as older people," he said.
The idea is for young people to balance out the costs for older folks who tend to spend more on health care. If that doesn't happen, insurance companies will raise their premiums.
The White House's target was for young people to account for about 40 percent of total signups. But in the Carolinas and nationally, young people only accounted for 28 percent of signups.
On a conference call with reporters, Mike Hash with the U.S. Department of Health and Human Services said that percentage is good enough.
"We believe premiums will be stable and the risk pool is sufficiently large and varied to support that kind of pricing," he said.
But it's the insurance companies that call the shots. Here's UNC professor Holmes again:
"I think the more important question is how does it compare to what the insurers had projected," Holmes said. "If an insurer had projected 30 percent and they're at 30 percent, then the insurer is in sort of a stable spot, and they can make that work."
But the insurance companies aren't sharing those projections, at least not yet. Blue Cross Blue Shield and Coventry Health Care are the only companies that were part of the exchange in North Carolina. Both companies say they're not ready to discuss the final numbers and if premiums will rise.