In order for the Affordable Healthcare Plan to "work," millions of healthy young people need to enroll in the exchanges in order to defray the cost of older less healthy people. If younger Americans do not become paying contributors into the health exchanges, we will enter what many call "the death spiral" with skyrocketing premiums. As the health insurance companies are not able to defray the higher costs of caring for the old onto the "young invincibles," history will be left with another failed attempt at socialized medicine.
Are young people going to sign up and pay double the current rates to become paying contributors into this system? Most critics point out that young people are not likely to sign up because of increased costs. What is the incentive to pay into a system that would accept them if they have an accident or get sick since there are no longer pre-existing condition roadblocks? One ironic and unintended consequence now coming to light is many young people are discovering that they don't have to pay into the system at all but can get free or heavily subsidized insurance via Medicaid.
For example, a friend of mine in Colorado, a 27-year-old healthy young married man, was forced onto the exchanges when the Obamacare portal opened. He began shopping for plans and was stunned to see the minimum plan premiums have tripled from the previous plan he was on. Earning about $21,000 a year, he is not able to afford even the most basic plan. As he scrolled down to the bottom of the screen and entered his income, he was shocked to discover that he was now eligible for Medicaid. That's right, a strong healthy 27 year old male is now eligible under the new law for government subsidized health insurance. He could not resist a free offer for health care and is now enrolled in Medicaid. He was previously a content customer paying for a private health care plan but now has been "forced" into a free plan which raises the question where is the money coming from to subsidize his "free" plan? Furthermore, will he find a primary care doctor who is able to see him on short notice?