By Mary Orndorff Troyan, Gannett Washington Bureau
WASHINGTON - More than 24,000 people in South Carolina have chosen a private health insurance plan through the HealthCare.gov marketplace, according to data released Monday.
The new numbers from the Obama administration reflect a spike in enrollment since the end of November.
In the first two months of enrollment in October and November, 2,761 people in South Carolina found private coverage through HealthCare.gov, the federal government's online health insurance marketplace created under the Affordable Care Act.
In December, the number of people who selected coverage on the marketplace jumped to 24,116. That includes people who have not yet started paying for the coverage.
"We feel like today's numbers do a good job of beginning to make sure that more and more people can access the promise at the heart of the Affordable Care Act, which is obviously not just access, but also affordable access," said Denis McDonough, White House chief of staff.
The nearly 800 percent enrollment increase in South Carolina exceeds the national trend, where the number of people choosing a private health plan through a state marketplace or HealthCare.gov increased 500 percent in the last month.
"We always felt that the need and peoples' desire to enroll was out there," said Sue Berkowitz, director of the South Carolina Appleseed Justice Center.
She said South Carolina residents who were uninsured or under-insured, or were paying too much for too little coverage, are signing up for new plans.
"For the most part, these are people who have been needing health insurance and had no way to access it before," she said.
Nationally, 2.1 million people have selected private coverage through the marketplaces, up from 364,682 at the end of November. HHS officials did not have exact figures on how many of those people have started paying their premiums yet, or how many are buying health insurance for the first time.
Open enrollment continues through the end of March. The 2010 Affordable Care Act requires almost everyone to carry health insurance, and the online marketplaces were created as places for people to shop for coverage who don't already get it from an employer or a government program like Medicare or Medicaid.
The government attributed the enrollment spike to improvements in the troubled HealthCare.gov web site and intensive public outreach and education about how the marketplaces work.
The number of completed insurance applications in South Carolina covers 86,371 people, most of whom were divided into two groups based on income.
The first group of 74,162 was found to be eligible for private health care coverage. The second group of 10,793 lower-income children and adults were enrolled in Medicaid or public children's health insurance. The income status of the remaining 1,416 has yet to be determined.
For the first time, federal officials provided more details about the ages, gender and family income of people shopping and buying coverage on the marketplaces.
In South Carolina, 57 percent of the 24,116 people who have picked plans are women, and more than a third are between 55 and 64.
Silver-level plans were the most popular. Those plans are more expensive and offer better benefits than bronze-level plans, but they are cheaper than gold- or platinum-level plans. In South Carolina, 64 percent bought a silver plan, 19 percent bought a gold plan and 17 percent bought a bronze plan.
Federal health officials are closely watching the age of enrollees. Like any health insurance system, the pool of insured must mix young and old and health and unhealthy in order to be solvent. Nationally, one-third of people who have selected marketplace plans are between 55 and 64, and about one-quarter are between 18 and 34 years old.
"The demographics that we are reporting today are similar to our expectations and similar to the state of Massachusetts," said Nancy Delew, acting deputy assistant secretary for planning and evaluation at HHS. "The younger tended to sign up later."
Massachusetts' health insurance system was a model for the Affordable Care Act.
Republican opponents of the law seized on the low enrollment numbers by younger Americans.
"There's no way to spin it: youth enrollment has been a bust so far," said Brendan Buck, a spokesman for House Speaker John Boehner of Ohio. "When they see that Obamacare offers high costs for limited access to doctors - if the enrollment goes through at all - it's no surprise that young people aren't rushing to sign up."
The percentage of South Carolina enrollees eligible for federal tax breaks to help reduce monthly premiums is similar to the national data. Of the 24,116 in South Carolina who are in the process of paying for their private coverage, 81 percent qualified for the tax credits. Nationally, the figure was 79 percent.
The amount of the tax credits are based on income and family size. Generally, a family of four earning $23,550-$94,200 will qualify for a credit that is applied to the monthly premium.
South Carolina is among states that refused to expand the number of people eligible for Medicaid under the Affordable Care Act, but HealthCare.gov appears to be helping the state find and enroll people who qualify for the joint federal-state insurance program. In December alone, the marketplace routed 6,694 South Carolina children and adults into Medicaid.