The ACA needs healthy people in the exchange not just young people
A good point that's often overlooked in all this Obamacare discussion is this from Igor Volksy in his discussion of the President's announcement:
Responding to criticism that the proposal could keep younger and healthier applicants in their current plans and out of the exchanges — thus increasing premiums in the law’s marketplaces — the officials argued that individuals have traditionally remained in the individuals market for only a short period of time and claimed that it contains older individuals.
A senior administration official pointed to data showing that 40 percent of beneficiaries in the individual market are between the ages of 45 and 64 and that just a quarter or less are under the age of 26. The administration also plans to re-evaluate the effectiveness of the law’s “risk adjustment” tools, which are designed to spread risk among health care insurers and stabilize the health care market in the first two years of reform.
But health policy experts argue that churn in the individual market will dissipate with the implementation of the individual mandate and claim that an older demographic does not necessarily translate into sicker applicants. “It again depends on the health status not as much on age, if older and sicker go to the exchanges and older and healthier stay outside,” premiums in the exchanges will eventually increase, Park said.
That's right. It's not just about getting younger people into the exchanges. It's about getting healthy people into the exchanges. There are a lot of us healthy older people in the individual market who are paying way too much for lousy plans and we are very likely to want to get a better deal if we can. (And, by the way, we are paying a lot more for those plans than the youngsters in the first place so the "extra money" we bring into the system due to our advanced age may be just as important to the success of the exchanges as the younger people.)
Young people think they're immortal. I certainly did. So, they are probably the last people who will be dragged kicking and screaming to buy health insurance if they don't already have it. Healthy older people, on the other hand, know that something could go wrong at any time and we are not going to go without insurance unless it's absolutely impossible for us to get it. We aren't sick and we don't "overuse" the system. We just need the peace of mind that it will be there if we need it. We will figure out those exchanges and we will find a better deal.
If it were up to me I'd buy into Medicare right now. But Joe Lieberman was mad at the hippies so that didn't happen. Therefore, I'll do the best I can, which at this point is going on the exchange and signing up for a more comprehensive plan that I have right now for the same money I've been paying. I'm one of the luckier ones. Some of my friends are going to be paying more. But in the end it's people like us, older healthy people, who will join up right after the unfortunate sick people who've been denied insurance up until now. And that will go a long way toward stabilizing the exchanges and getting this off the ground, regardless of when the youngsters who think they are going to live forever can be coerced into jumping into the pool.