Nolan Morice has been struggling this winter to hit the reset button on health insurance through MNsure.

So, the healthy 29-year-old from Minneapolis was happy last week to get help during an enrollment event in the unlikely setting of a bowling alley.

Health exchange officials hope Morice is a trendsetter, because sign-ups among younger adults in private plans through MNsure have been lagging.

“I definitively think people should have health insurance,” Morice said, with the crash of bowling pins in the background and a hoppy beer in hand. The MNsure website has been “better,” he said, but the system is “still not adequate.”

Whereas 18 to 34 year olds accounted for 24.3 percent of MNsure enrollees last year, they accounted by late January for only 21.3 percent of the private insurance total during the current open enrollment period.

MNsure officials say they aren’t worried. Younger adults were late to buying coverage last year, too, so the exchange expects a last-minute surge as the Feb. 15 deadline for people to enroll in private plans through MNsure draws near.

Pitching health insurance in a bowling alley is just one example, they say, of how MNsure and community groups are experimenting with innovative marketing strategies.

Insurers are watching the numbers closely, wondering if younger adults will conclude that gutter balls from MNsure’s rocky rollout last year are a thing of the past.

“The consumer experience with MNsure certainly is vastly improved from what it was in 2014,” said Dannette Coleman, a senior vice president with Minnetonka-based Medica. “But is it good enough for younger folks who are tech-savvy and have very high expectations?”

Finding uninsured people in Minnesota has become more challenging, because the share of those without coverage already has fallen to just 5 percent — one of the lowest rates in the nation.

Whatever the age of applicants, MNsure has a target of enrolling 67,000 people in private coverage by the Feb. 15 deadline. The tally Thursday stood at 45,973.

“We should be watching the rise in total enrollment, and the age distribution,” said Roger Feldman, a health insurance expert at the University of Minnesota.

Passage of the federal health law prompted speculation about whether enough young and healthy adults would buy coverage. The group is sometimes dubbed the “young invincibles,” since some stress their current health as a reason to forgo the expense of insurance.

If younger adults don’t buy, the fear is there won’t be enough healthy people to offset the cost of those with medical problems. Premiums, in turn, could spike in a process that experts describe as a “death spiral.”

Premiums are higher this year on MNsure than they were last year, but Jennifer Tolbert of the Kaiser Family Foundation said she didn’t see warning sings of a death spiral. Rates in Minnesota remain among the lowest in the nation, Tolbert pointed out.

During the current open enrollment period, about 26 percent of those signing up for commercial coverage through exchanges across the country are younger adults, Tolbert said. Minnesota’s 21 percent share is one of the lower scores across the country, she said, but that doesn’t necessarily point to a problem, either.

Many younger adults who’d buy through exchanges in other states wind up with richer benefits in the state’s MinnesotaCare program. No state has yet hit the 38 percent younger-adult share that the federal government initially set as a target.

There is no magic number that specifies exactly what share of those signing up need to be 18 to 34, said Feldman of the U. The general idea is “the more the better,” he said.

So, insurers pay close attention to the data point. Looking at this year’s numbers, insurers in Minnesota are cautious about drawing conclusions.

“My concern would be that this is indicative — potentially — of the fact that younger people, who purchased those very low premiums in 2014, are declining to purchase at all in 2015,” said Scott Keefer, vice president of public affairs and communications at Eagan-based Blue Cross and Blue Shield of Minnesota.

Another confounding factor is that the risk profile for those who buy on MNsure is blended with the much larger group of people who purchase individual health insurance policies outside the exchange. At this point, it’s not clear how many young people are buying directly from insurers.

While insurers look for clues about the riskiness of the risk pool, MNsure is focused on making the pool bigger by enticing last-minute enrollees.

TV ads directed at younger adults are a bigger part of MNsure’s marketing campaign this year. The exchange is doing more with social media and digital outreach efforts, as well.

Last week, MNsure focused on sign-up events for patrons and workers at bars and restaurants. Connecting with younger adults was part of the plan, said Scott Leitz, the MNsure chief executive.

“I am simply anticipating that we are going to see a phenomenon this year like we did last year, where the demographic that comes in right at the tail end is going to skew a little bit younger,” Leitz said.

More recruiting efforts this year are being directed by community groups, MNsure says, and some of those organizations are targeting younger adults as well. Outreach workers from Centro Tyrone Guzman in Minneapolis, for example, are using iPads from MNsure as they educate younger Latinos about health insurance options.

“If you approach them with your iPad, they look at you differently than if you approach them with a flier,” said Roxana Linares, the group’s executive director.

Hundreds of enrollment events are scheduled in locations across the state for the days leading up to Feb. 15. The outreach event Tuesday in Minneapolis at Bryant Lake Bowl wasn’t directed at younger adults specifically, but instead had a focus on connecting with people who are gay, lesbian, bisexual or transgender and lack coverage.

The theme wasn’t the draw for Morice, the 29-year-old from Minneapolis, but rather the event’s proximity to his workplace. He learned through social media that health insurance navigators would be available, and decided to seek help with a MNsure application he filed in mid-December.

Following frustration with the MNsure website in late 2013, Morice purchased a private insurance policy from an insurance company. If he can’t get coverage sorted out through MNsure by Feb. 15, he’ll go back to the off-exchange market — and not join other young invincibles.

“I’ve known other people my age that were totally healthy, and then had really bad diseases and incurred massive bills,” said Morice, who says he supports single-payer health care. “It can happen to me.”

 

Twitter: @chrissnowbeck