Mil­lions of Amer­i­cans are will­ing to buy health insur­ance — but only if it is avail­able at steep dis­counts.  Read more at The Hilll.

The Oba­ma Admin­is­tra­tion this after­noon announced that more than 4.2 mil­lion peo­ple had select­ed plans sold through health insur­ance exchanges.  The fig­ure includes data on exchange enroll­ment from Octo­ber 1 of last year through March 1.

I’ve post­ed a com­pre­hen­sive analy­sis of exchange and Med­ic­aid enroll­ment through Feb­ru­ary 1.  Here are some updates on major trends, as of today’s announcement:

• Month­ly enroll­ment fell for the sec­ond straight month.  HHS today announced that 942,800 select­ed plans dur­ing the month of Feb­ru­ary, down from 1.15 mil­lion in Jan­u­ary and 1.79 mil­lion in
  Decem­ber.  HHS expects enroll­ment to accel­er­ate again this month, giv­en the March 31 end of open sea­son, but enroll­ment so far this year has lagged Decem­ber 2013 levels.
• The age dis­tri­b­u­tion of those who select­ed a plan did not improve in Feb­ru­ary.  Peo­ple aged 18–34 con­tin­ue to com­prise just 25 per­cent of enrollees, while those 45 and old­er com­prise 53 per­cent.  This makes it like­ly that even a surge of young, healthy enrollees in March will not cre­ate a favor­able risk pool for insur­ers sell­ing through the exchanges.
• Most peo­ple who com­plet­ed the enroll­ment process and were deter­mined eli­gi­ble to select a plan chose not to.  Of 8.75 mil­lion eli­gi­ble to enroll, just over 4.2 mil­lion select­ed a plan.  That rate is some­what improved over the fig­ures report­ed last month.
• 83 per­cent of peo­ple who have select­ed a plan are receiv­ing sub­si­dized cov­er­age.  Of the 5.25 mil­lion peo­ple who com­plet­ed the appli­ca­tion process and were deter­mined qual­i­fied for sub­si­dies, 3.47 mil­lion select­ed a plan, a take­up rate of 66 percent.
• Peo­ple who don’t qual­i­fy for sub­si­dies con­tin­ued to shun enroll­ment. Of 3.5 mil­lion peo­ple who were eli­gi­ble to enroll in plans but who did not qual­i­fy for sub­si­dies, only 690,000 select­ed a plan, a take­up rate of just under 20 per­cent.  Even with rel­a­tive­ly low pre­mi­ums, few peo­ple appear will­ing to pay full price for exchange-based coverage.
• The new data do not esti­mate how many of the 4.2 mil­lion who have so far select­ed a plan have paid their first mon­th’s pre­mi­um. Those that have not done so remain uninsured.
• Nor does the gov­ern­ment know how many who select­ed a plan pre­vi­ous­ly lacked cov­er­age.  A McK­in­sey sur­vey recent­ly found that only 27 per­cent of enrollees were pre­vi­ous­ly unin­sured and, of those, just 53 per­cent had paid their first pre­mi­um.  Apply­ing those pro­por­tions to the 4.2 mil­lion fig­ure sug­gests that around 600,000 peo­ple are new­ly insured in plans sold through exchanges.  That fig­ure, of course, is not pre­cise and rep­re­sents an esti­mate based on sur­vey data.