Express Scripts: New ACA exchange enrollees healthier & use fewer prescriptions than 2014 enrollees
New ObamaCare enrollees are healthier and spent less on drugs than enrollees last year, according to a new analysis.
The report from Express Scripts, the country’s largest pharmacy benefits manager, is a positive sign for the law, given the need to maintain a mix of healthy and sick enrollees to keep costs down.
Still, ObamaCare exchange enrollees tended to be sicker than those in other health plans. Costs were 16 percent higher per member per month compared to non-ObamaCare plans, the report finds, largely due to higher spending on costly drugs for complex conditions.
The encouraging sign for the law is that the number of new enrollees who used at least one prescription medication declined 18 percent in the first quarter of 2015. Costs were 36 percent lower per member per month compared to the first quarter of 2014.
It's important to note the distinction here: What the report is saying is that the 4 million new enrollees who enrolled in 2015 are racking up fewer expenses this year than the original 7 million or so who were enrolled in 2014 (6.3 million of whom stuck around for the 2nd year).
However, overall expenses for all ACA exchange enrollees are running 16% higher than off-exchange enrollees (which isn't particularly surprising since many of the enrollees--especially last year--were those with pre-existing conditions).
As Bruce Japsen notes over at Forbes, another bit of good news is that contraceptive use is up...which means a) fewer unwanted pregnancies and...
Meanwhile, usage of prescriptions like birth control pills increased, another sign younger people are signing up for subsidized coverage under the health law, the reports authors say. Use of oral contraceptives jumped 29 percent in the first quarter of this year compared to the year ago quarter for newly enrolled in public exchange plans.
“This could mean that you are starting to see those who are healthier on average coming into public exchanges and buying insurance,” Julie Huppert, vice president of healthcare reform at Express Scripts said in an interview.
How this news will jibe with yesterday's CMS report on two of the "Three R's" when it comes to setting 2016 rates, however, I have no idea.